农村代谢综合征患者强化生活方式干预效果评价

Effectiveness evaluation of intensive lifestyle intervention on rural residents with metabolic syndrome

目的评价强化生活方式对农村代谢综合征(MS)患者的干预效果。方法从MS横断面调查研究中纳入253例MS患者,不完全随机分成干预组(182例)和常规管理组(71例)。干预组采用合理膳食、规律运动及健康教育为重点的强化生活方式进行干预;常规管理组按慢性病管理工作规范和程序进行管理。干预6个月后比较干预前后MS患者体格指标及代谢相关生化指标差异。结果两组MS患者体格指标和代谢相关生化指标基线水平差异均无统计学意义(P>0.05)。干预6个月后,干预组和常规管理组MS患病率分别为67.14%和60.95%,差异无统计学意义(P>0.05)。干预组体重、BMI、腰围分别下降3.11 kg、1.50 kg/m^2、4.29 cm,常规管理组分别下降1.23 kg、0.47 kg/m^2、1.22 cm,差异均有统计学意义(P<0.01)。干预组尿酸(UA)、三酰甘油(TG)分别减少14.30μmol/L、0.01 mmol/L,常规管理组分别增加18.17μmol/L、0.41 mmol/L,差异均有统计学意义(P<0.05)。干预组高密度脂蛋白胆固醇(HDL-C)增加0.02 mmol/L,常规管理组减少0.10 mmol/L,差异有统计学意义(P<0.01)。干预组中高依从性组体重、BMI分别减少3.93 kg、1.40 kg/m^2,低依从性组分别减少2.80 kg、1.00 kg/m^2;高依从性组体脂率(BF%)减少2.27%,低依从性组增加1.01%,差异均有统计学意义(P<0.05)。结论强化生活方式干预可有效改善农村居民MS代谢组分异常状况。

Objective To evaluate the effectiveness of intensive lifestyle intervention on rural residents with metabolicsyndrome （MS） . Methods A total of 253 patients with MS selected from cross-sectional survey were divided intointensive lifestyle intervention and conventional management group incomplete randomly. Aimed to control weight,patientsin the intervention group were treated with dietary control and exercise guidance. Besides,their compliances were assessed.In conventional management group, patients were disposed according to chronic disease management specification.Anthropometric measurements and biochemical markers detection were carried out in both groups at baseline and at the endof 6 months. Results These main anthropometric measurements and biochemical markers have no significant differencebetween the intervention group and conventional management group at the baseline （P〉0.05 ） . After 6 months intensivelifestyle modification,the prevalence of MS did not significantly differ between the two groups：it was 67.14% in theintervention group and 60.95% in the conventional management group （P〉0.05） .In the intervention group,the bodyweight,BMI and the waist circumference were decreased by 3.11 kg,1.50 kg/m2,4.29 cm,respectively,and 1.23 kg,0.47 kg/m2,1.22 cm in the conventional management group. The changes were significantly larger in the intervention groupthan in the conventional management group （P〈0.01） .Uric acid,triglyceride were decreased by 14.30 滋mol/L,0.01 mmol/L,respectively,in the intervention group and in the conventional management group they were increased by18.17 滋mol/L and 0.41 mmol/L conversely. While the high density lipoprotein cholesterol was increased by 0.02 mmol/L,it was decreased by 0.10 mmol/L in the conventional management group （P〈0.01） . Body weight and BMI decreased by3.93kg and 1.40 kg/m2in the high compliance group,compared to low compliance group,there was statistically differencewith regard to this change between the two groups （P〈0.05 ） . While the body fat% was decreased by 2.27%,and it wasincreased by 1.01% in the conventional management group （P〈0.05 ） . Conclusion For rural residents,the beneficialeffects of intensive lifestyle intervention are improving metabolic risk factors. The compliance is the main factor of the effectsof intervention.