Effect of an Intensive Exercise Intervention Strategy on Modifiable Cardiovascular Risk Factors in Subjects With Type 2 Diabetes Mellitus A Randomized Controlled Trial: The Italian Diabetes and Exercise Study (IDES)

被引：250

作者：

Balducci, Stefano ^{[1
,3
,4
,27
]}

Zanuso, Silvano ^{[5
]}

Nicolucci, Antonio ^{[6
]}

De Feo, Pierpaolo ^{[7
]}

Cavallo, Stefano ^{[2
,3
]}

Cardelli, Patrizia ^{[2
,3
]}

Fallucca, Sara ^{[2
,3
]}

Alessi, Elena ^{[1
,3
,8
]}

Fallucca, Francesco ^{[1
,3
,4
]}

Pugliese, Giuseppe ^{[1
,3
,8
]}

Falluca, Francesco ^{[8
]}

Pugliese, Giuseppe ^{[1
,3
,8
]}

Missori, Serena ^{[8
]}

Ribaudo, Maria Cristina ^{[8
]}

Alessi, Elena ^{[1
,3
,8
]}

Strollo, Felice ^{[9
]}

More, Massimo ^{[9
]}

Alimonti, Pietro ^{[10
]}

Di Biase, Nicolina ^{[10
]}

Lasaracina, Filomena ^{[10
]}

Santantonio, Graziano ^{[11
]}

Cruciani, Laura ^{[12
]}

Manunta, Mario ^{[13
]}

Di Mauro, Maurizio ^{[14
]}

Sesti, Giorgio ^{[15
]}

Irace, Concetta ^{[15
]}

Puccio, Luigi ^{[16
]}

Cignarelli, Mauro ^{[17
]}

Nicastro, Vincenzo ^{[17
]}

Piemontese, Sabrina ^{[17
]}

Corigliano, Gerardo ^{[18
]}

Rossi, Ernesto ^{[18
]}

Corigliano, Marco ^{[18
]}

Fatone, Cri ^{[19
]}

Baggiore, Cristiana ^{[20
]}

Russo, Roberto ^{[20
]}

Boemi, Massimo ^{[21
]}

Lanari, Luigi ^{[21
]}

Valentini, Umberto ^{[22
]}

Girelli, Angela ^{[22
]}

Di Bartolo, Paolo ^{[23
]}

Pellicano, Francesca ^{[23
]}

Mazzuca, Paolo ^{[23
]}

Manicardi, Enrica ^{[24
]}

Bruno, Alberto ^{[25
]}

Sambataro, Maria ^{[26
]}

Pontiroli, Antonio ^{[28
]}

Laneri, Marco ^{[28
]}

Boggio, Anna ^{[28
]}

Zagari, Nunzio ^{[29
]}

机构：

[1] St Andrea Hosp, Diabet Div, Rome, Italy

[2] St Andrea Hosp, Clin Chem Lab, Rome, Italy

[3] Univ Roma La Sapienza, Dept Clin & Mol Med, Sch Med 2, I-00161 Rome, Italy

[4] Metab Fitness Assoc, Rome, Italy

[5] Univ Padua, Dept Sport Sci, Padua, Italy

[6] Ist Ric Farmacol Mario Negri, Consorzio Mario Negri Sud, Dept Clin Pharmacol & Epidemiol, I-66030 Santa Maria Imbaro, Italy

[7] Univ Perugia, Dept Internal Med, I-06100 Perugia, Italy

[8] Sant Andrea Hosp, Diabet Div, Rome, Italy

[9] INRCA, Natl Geriatr Inst, Div Endocrinol & Metab, Rome, Italy

[10] Villa San Pietro Hosp, Diabet Unit, Rome, Italy

[11] City Hosp Civitavecchia, Diabet Unit, Civitavecchia, Italy

[12] ACISMOM, Diabet Prevent Ctr, Latina, Italy

[13] Triolo Zancia Clin, Diabet Unit, Palermo, Italy

[14] Univ Catania, Res Ctr Phys Activ Diabet, Catania, Italy

[15] Univ Catanzaro, Dept Expt & Clin Med, Catanzaro, Italy

[16] City Hosp Catanzaro, Diabet Unit, Catanzaro, Italy

[17] Univ Foggia, Div Endocrinol & Metab, Foggia, Italy

[18] Prov Hlth Author, AID, Diabet Unit, Naples, Italy

[19] Univ Perugia, Dept Internal Med, Perugia, Italy

[20] New Hosp San Giovanni di Dio, Diabet Unit, Florence, Italy

[21] INRCA Ancona, Natl Geritr Inst, Div Diabet & Metab, Ancona, Italy

[22] City Hosp Brescia, Diabet Unit, Brescia, Italy

[23] City Hosp Rimini, Diabet Unit, Rimini, Italy

[24] City Hosp Reggio Emilia, Diabet Unit, Reggio Emilia, Italy

[25] San G Battista Hosp, Diabet Unit, Turin, Italy

[26] Ca Foncello, Diabet Unit, Treviso, Italy

[27] Monterotondo, Diabet Clin, Rome, Italy

[28] Univ Milan, Sao Paolo Hosp, Dept Internal Med, Milan, Italy

[29] Belcolle Hosp, Diabet Unit, Viterbo, Italy

[30] Sant Andrea Hosp, Ctr Funct Assessment Sport, Rome, Italy

[31] Hlth Care Team, Monterotondo, Italy

[32] Athlos Club, Civitavecchia, Italy

[33] Metab Fitness, Latina, Italy

[34] Wellness Ctr, Naples, Italy

[35] Elisir Club, Perugia, Italy

[36] Fisioclub, Ancona, Italy

[37] Lifeplanet, Ravenna, Italy

[38] Steven Sporting Club, Rimini, Italy

[39] VITALIA, Ctr Physiatr & Sports Med, Turin, Italy

[40] Winners Club, Reggio Emilia, Italy

[41] Millennium, Brescia, Italy

[42] GCube Fitness & Wellness, Viterbo, Italy

[43] Zenith Ctr Med, Foggia, Italy

[44] SS Free Studios UISP, Catanzaro, Italy

[45] Ctr Phys Activ Diabet, Catania, Italy

[46] Ctr La Fonte del Benessere, Milan, Italy

[47] DO IN, Palermo, Italy

[48] Pianeta Sport, Treviso, Italy

来源：

ARCHIVES OF INTERNAL MEDICINE | 2010年 / 170卷 / 20期

关键词：

TIME PHYSICAL-ACTIVITY; LIFE-STYLE INTERVENTION; CORONARY-HEART-DISEASE; CARDIORESPIRATORY FITNESS; GLYCEMIC CONTROL; MORTALITY; GLUCOSE; ADULTS; MEN; METAANALYSIS;

D O I：

10.1001/archinternmed.2010.380

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Background: This study aimed to assess the efficacy of an intensive exercise intervention strategy in promoting physical activity (PA) and improving hemoglobin A(1c) (HbA(1c)) level and other modifiable cardiovascular risk factors in patients with type 2 diabetes mellitus (T2DM). Methods: Of 691 eligible sedentary patients with T2DM and the metabolic syndrome, 606 were enrolled in 22 outpatient diabetes clinics across Italy and randomized by center, age, and diabetes treatment to twice-a-week supervised aerobic and resistance training plus structured exercise counseling (exercise group) vs counseling alone (control group) for 12 months. End points included HbA(1c) level (primary) and other cardiovascular risk factors and coronary heart disease risk scores (secondary). Results: The mean (SD) volume of PA (metabolic equivalent hours per week) was significantly higher (P<.001) in the exercise (total PA [nonsupervised conditioning PA + supervised PA], 20.0 [0.9], and nonsupervised, 12.4 [7.4]) vs control (10.0 [8.7]) group. Compared with the control group, supervised exercise produced significant improvements (mean difference [95% confidence interval]) in physical fitness; HbA(1c) level (-0.30% [-0.49% to -0.10%]; P<.001); systolic (-4.2 mm Hg [-6.9 to -1.6 mmHg]; P=.002) and diastolic (-1.7mm Hg [-3.3 to -1.1 mm Hg]; P=.03) blood pressure; high-density lipoprotein (3.7 mg/dL [2.2 to 5.3 mg/dL]; P<.001) and low-density lipoprotein (-9.6 mg/dL [-15.9 to -3.3 mg/dL]; P=.003) cholesterol level; waist circumference (-3.6 cm [-4.4 to -2.9 cm]; P<.001); body mass index; insulin resistance; inflammation; and risk scores. These parameters improved only marginally in controls. Conclusions: This exercise intervention strategy was effective in promoting PA and improving HbA(1c) and cardiovascular risk profile. Conversely, counseling alone, though successful in achieving the currently recommended amount of activity, was of limited efficacy on cardiovascular risk factors, suggesting the need for a larger volume of PA in these high-risk subjects.

引用

页码：1794 / 1803

页数：10

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