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Improved fibrinolysis by intense lifestyle intervention. A randomized trial in subjects with impaired glucose tolerance
Author(s) -
Lindahl B.,
Nilsson T. K.,
Jansson J.H.,
Asplund K.,
Hallmans G.
Publication year - 1999
Publication title -
journal of internal medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.625
H-Index - 160
eISSN - 1365-2796
pISSN - 0954-6820
DOI - 10.1046/j.1365-2796.1999.00537.x
Subject(s) - medicine , randomized controlled trial , fibrinolysis , impaired glucose tolerance , physical therapy , plasminogen activator , fibrinogen , vo2 max , obesity , tissue plasminogen activator , psychological intervention , insulin resistance , blood pressure , nursing , heart rate
Objective. To assess the effects of lifestyle intervention on cardiovascular risk factors in general and especially on fibrinolysis. Design. Randomized clinical study. Subjects. A total of 186 subjects with impaired glucose tolerance and obesity. Interventions. The intervention programme included a low‐fat, high‐fibre diet and regular physical exercise. Half of the participants ( n = 93) took part in a one‐month learning and training session using different behavioural modification techniques and conducted in a full‐board wellness centre (intense intervention group). The other half ( n = 93) was randomized a one‐hour counselling session with a specially trained nurse (usual care group). Follow‐up was carried out after 12 months. Main outcome measures. Body weight, oxygen consumption, plasminogen activator inhibitor type 1 (PAI‐1) activity, tissue plasminogen activator (tPA) antigen, fibrinogen and fasting plasma insulin measured at the start of the programme and at follow‐up after 1 year. Results. The intense intervention group had a mean weight decline by 1 year of 5.4 kg compared to 0.5 kg in the usual care group. Oxygen consumption in the intense group increased 10% vs. a 1% decline in the usual care group. In the intense group, PAI‐1 activity decreased 31% (– 10.1 U mL –1 ), which was significantly more than in the usual care group (12%; – 3.0 U mL –1 ). The corresponding reductions in tPA antigen were 14% (– 1.65 μg L –1 ) and 6% (– 0.69 μg L –1 ). Conclusions. The present randomized study shows that an intense lifestyle programme has sustained beneficial effects on fibrinolysis.