Improved fibrinolysis by intense lifestyle intervention. A randomized trial in subjects with impaired glucose tolerance.
OBJECTIVE
To assess the effects of lifestyle intervention on cardiovascular risk factors in general and especially on fibrinolysis.


METHODS
Randomized clinical study.


METHODS
A total of 186 subjects with impaired glucose tolerance and obesity.


METHODS
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.


METHODS
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 microg L(-1)) and 6% (-0.69 microg L(-1)).


CONCLUSIONS
The present randomized study shows that an intense lifestyle programme has sustained beneficial effects on fibrinolysis.
Lindahl
B
B
Department of Nutritional Research, Umeå University, Sweden. bernt.lindahl@medicin.umu.se
Nilsson
T K
TK
Jansson
J H
JH
Asplund
K
K
Hallmans
G
G
D000328:Adult; D000941:Antigens / Q000097:blood; D001521:Behavior Therapy; D001786:Blood Glucose / Q000378:metabolism*; D001835:Body Weight; D004041:Dietary Fats / Q000008:administration & dosage*; D004043:Dietary Fiber / Q000008:administration & dosage*; D015444:Exercise; D005260:Female; D005340:Fibrinogen / Q000378:metabolism; D005342:Fibrinolysis; D005951:Glucose Tolerance Test; D006801:Humans; D007328:Insulin / Q000097:blood; D008019:Life Style; D008297:Male; D008875:Middle Aged; D010101:Oxygen Consumption; D010353:Patient Education as Topic; D017395:Plasminogen Activator Inhibitor 1 / Q000378:metabolism; D010959:Tissue Plasminogen Activator / Q000276:immunology
D000941:Antigens; D001786:Blood Glucose; D004041:Dietary Fats; D004043:Dietary Fiber; D007328:Insulin; D017395:Plasminogen Activator Inhibitor 1; D005340:Fibrinogen; D010959:Tissue Plasminogen Activator