生活方式干预对糖耐量异常者动脉内膜厚度及弹性的影响

Effects of Lifestyle Intervention on Arterial Stiffness in Patients with Impaired Glucose Tolerance

目的探讨饮食、运动等生活方式干预对糖耐量异常者颈动脉内膜中膜厚度与臂踝脉搏波传导速度的影响。方法收集糖耐量异常者162例,随机分为78例对照组,84例干预组;对照组给予每3个月1次的糖尿病健康知识宣教(电话),干预组在此基础上进行为期24个月的生活方式干预,并每月随访1次。每例均采用超声及全自动动脉硬化仪测定颈动脉内膜中膜厚度与臂踝脉搏波传导速度。各组均进行前后自身对照和组间对照,并评价干预效果。结果经过24个月生活方式干预,干预组糖尿病累计发病率较对照组显著下降;干预组较干预前甘油三酯、口服糖耐量试验2 h血糖显著降低(P<0.05),其余指标经对比后差异无统计学意义;干预组与对照组比较,两组颈动脉内膜中膜厚度有显著性差异(P<0.05),除臂踝脉搏波传导速度、体质指数、高密度脂蛋白外,其余各项指标均有显著改善(P<0.05或P<0.01)。结论生活方式干预能有效改善糖耐量异常患者的代谢状态,降低糖尿病发病率,并能延缓其血管病变的发展;强化生活方式干预应在糖耐量异常人群中大力推行。

Aim The present study investigated the effect of lifestyle modification on arterial stiffness in patients with impaired glucose tolerance（IGT）. Methods There were 162 subjects with IGT were randomized to either a usual care control group（n=78） or an intensive lifestyle intervention group（n=84）.Both two groups,their height,weight,body mass index and blood pressure were measured.The carotid intima-media thickness（IMT） was measured by ultrasonography,the brachial-ankle pulse wave velocity（baPWV） was measured by automatic atherosclerosis assay instrument at the baseline and after intervention. Results The intervention group showed a significant difference in triglycerides,oral glucose tolerance test 2-hour plasma glucose（OGTT2hPG） following the 24 months of intervention compared with baseline（P〈0.01）,without differences in changes of the values of carotid IMT and baPWV.At 24 months,significant improvements were noted in most anthropometric values in the intervention group than the control group（P〈0.05 or P〈0.01）,and the values of carotid IMT were significantly lower than the control group（P〈0.05）,without significant differences in baPWV between the two groups. Conclusion The finding suggests the active intervention may have beneficial effects on arterial stiffness for the patients at-risk for diabetes through improving anthropometric and certain metabolic outcomes.