Torjesen P A, Birkeland K I, Anderssen S A, Hjermann I, Holme I, Urdal P
Hormone Laboratory, Aker University Hospital, Oslo, Norway.
Diabetes Care. 1997 Jan;20(1):26-31. doi: 10.2337/diacare.20.1.26.
To compare and assess the single and joint effect of diet and exercise intervention for 1 year on insulin resistance and the development leading toward the insulin resistance syndrome.
An unmasked, randomized 2 x 2 factorial intervention trial was applied with a duration of 1 year for each participant. The trial comprised 219 men and women with diastolic blood pressure of 86-99 mmHg, HDL cholesterol < 1.20 mmol/l, triglycerides > 1.4 mmol/l, total cholesterol of 5.20-7.74 mmol/l, and BMI > 24 kg/m2. Participants were randomly allocated to diet group (n = 35), diet and exercise group (n = 67), exercise group (n = 54), and control group (n = 43). The diet included increased intake of fish and reduced total fat intake. The exercise program entailed supervised endurance exercise three times a week. Baseline cross-sectional changes and 1-year changes in insulin resistance, fasting serum levels of insulin, C-peptide, proinsulin, glucose, and lipids as well as weight, mean blood pressure, and plasminogen activator inhibitor 1 (PAI-1) values were recorded.
The cross-sectional results at baseline showed significant correlations between the calculated insulin resistance and BMI (r = 0.54) and correlations between the mean blood pressure (mBP) (r = 0.26) and PAI-1 (r = 0.40). The 1-year diet intervention gave a significant decrease in the calculated insulin resistance from 4.6 to 4.2 and a positive correlation between the changes in insulin resistance and changes in BMI (r = 0.40). The diet and exercise intervention also led to significantly decreased insulin resistance (from 5.0 to 4.0). The exercise intervention did not significantly change insulin resistance.
The cross-sectional and 1-year intervention results supported each other and underscored the important connection between increased BMI and the development leading toward the insulin resistance syndrome.
比较并评估饮食和运动干预1年对胰岛素抵抗以及向胰岛素抵抗综合征发展的单一和联合作用。
对每位参与者进行为期1年的开放、随机2×2析因干预试验。该试验纳入了219名男女，其舒张压为86 - 99 mmHg，高密度脂蛋白胆固醇<1.20 mmol/L，甘油三酯>1.4 mmol/L，总胆固醇为5.20 - 7.74 mmol/L，体重指数>24 kg/m²。参与者被随机分配至饮食组（n = 35）、饮食和运动组（n = 67）、运动组（n = 54）和对照组（n = 43）。饮食包括增加鱼类摄入量并减少总脂肪摄入量。运动计划为每周三次有监督的耐力运动。记录基线横断面变化以及1年时胰岛素抵抗、空腹血清胰岛素、C肽、胰岛素原、葡萄糖和脂质水平以及体重、平均血压和纤溶酶原激活物抑制剂1（PAI - 1）值的变化。
基线时的横断面结果显示，计算得出的胰岛素抵抗与体重指数之间存在显著相关性（r = 0.54），平均血压（mBP）（r = 0.26）与PAI - 1（r = 0.40）之间也存在相关性。1年的饮食干预使计算得出的胰岛素抵抗显著降低，从4.6降至4.2，且胰岛素抵抗变化与体重指数变化之间呈正相关（r = 0.40）。饮食和运动干预也导致胰岛素抵抗显著降低（从5.0降至4.0）。运动干预未显著改变胰岛素抵抗。
横断面和1年干预结果相互印证，强调了体重指数增加与向胰岛素抵抗综合征发展之间的重要联系。
