Vanninen E, Laitinen J, Uusitupa M
Department of Clinical Physiology, Kuopio University Hospital, Finland.
Diabetes Care. 1994 Sep;17(9):1031-8. doi: 10.2337/diacare.17.9.1031.
To evaluate whether plasma fibrinogen concentration is correlated with the level of physical activity and aerobic power in patients with newly diagnosed non-insulin-dependent diabetes mellitus (NIDDM).
We studied 78 middle-aged (54 +/- 6 years, mean +/- SD), obese (body mass index [BMI] 32+/- 5 kg/m2) patients (45 men and 33 women) before and after a 12-month treatment period consisting of either conventional treatment given by community health centers or intensified dietary and exercise education given by a university outpatient clinic. Plasma fibrinogen concentration was measured by using a coagulometer. Physical activity was assessed by a questionnaire, and the patients were classified into a sedentary group or moderately or intensively exercising groups. Aerobic power (maximum oxygen uptake [VO2max], anaerobic threshold [VO2at]) was measured by direct breath-by-breath technique.
At baseline, the sedentary patients had higher fibrinogen concentration than those with moderate or high physical activities (3.8 +/- 0.8 vs. 3.3 +/- 0.7 g/l, P < 0.01). Both VO2max and VO2at (ml.min-1.kg-1) showed an inverse linear correlation with fibrinogen (r = -0.38, P < or = 0.001, and r = -0.29, P < 0.01, respectively). In the stepwise multiple regression analysis, BMI, VO2 (ml/min), and smoking were the only significant independent factors explaining 23% of the variance in fibrinogen concentration. In sedentary patients, poor glycemic control was related with high fibrinogen concentration. During the follow-up period, patients maintained, on the average, good to moderate glycemic control. The originally sedentary group showed a decrease in fibrinogen concentration (to 3.3 +/- 0.7 g/l, P < or = 0.001) that reached the same level that the physically more active groups had at baseline. This change was associated with improved glycemic control, but not with any of the other assessed factors, including fatty acid composition of serum lipids reflecting dietary intake of fats.
In addition to BMI and smoking, low reported physical activity and low aerobic power are independently associated with high plasma fibrinogen concentration in newly diagnosed NIDDM.
评估新诊断的非胰岛素依赖型糖尿病（NIDDM）患者血浆纤维蛋白原浓度是否与体力活动水平及有氧能力相关。
我们对78名中年（54±6岁，均值±标准差）、肥胖（体重指数[BMI] 32±5 kg/m²）患者（45名男性和33名女性）进行了为期12个月治疗期前后的研究，治疗期包括社区卫生中心给予的常规治疗或大学门诊诊所给予的强化饮食及运动教育。采用凝血仪测量血浆纤维蛋白原浓度。通过问卷调查评估体力活动情况，并将患者分为久坐组或适度或高强度运动组。采用逐次呼吸直接测量技术测量有氧能力（最大摄氧量[VO₂max]、无氧阈值[VO₂at]）。
在基线时，久坐患者的纤维蛋白原浓度高于适度或高强度体力活动患者（3.8±0.8 vs. 3.3±0.7 g/l，P<0.01）。VO₂max和VO₂at（ml·min⁻¹·kg⁻¹）均与纤维蛋白原呈负线性相关（分别为r=-0.38，P≤0.001；r=-0.29，P<0.01）。在逐步多元回归分析中，BMI、VO₂（ml/min）和吸烟是仅有的显著独立因素，可解释纤维蛋白原浓度变异的23%。在久坐患者中，血糖控制不佳与高纤维蛋白原浓度相关。在随访期间，患者平均维持了良好至中等的血糖控制。最初的久坐组纤维蛋白原浓度降低（至3.3±0.7 g/l，P≤0.001），达到了体力活动较多组在基线时的水平。这种变化与血糖控制改善相关，但与其他任何评估因素无关，包括反映脂肪饮食摄入量的血清脂质脂肪酸组成。
除BMI和吸烟外，低体力活动报告和低有氧能力在新诊断的NIDDM中与高血浆纤维蛋白原浓度独立相关。
