title: Improved fibrinolysis by intense lifestyle intervention. A randomized trial in subjects with impaired glucose tolerance.
abstract: 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.
authors.affiliation: Department of Nutritional Research, Umeå University, Sweden. bernt.lindahl@medicin.umu.se
authors.forename: B
authors.initials: B
authors.lastname: Lindahl
authors.forename: T K
authors.initials: TK
authors.lastname: Nilsson
authors.forename: J H
authors.initials: JH
authors.lastname: Jansson
authors.forename: K
authors.initials: K
authors.lastname: Asplund
authors.forename: G
authors.initials: G
authors.lastname: Hallmans
mesh_terms: 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
chemical_list: D000941:Antigens; D001786:Blood Glucose; D004041:Dietary Fats; D004043:Dietary Fiber; D007328:Insulin; D017395:Plasminogen Activator Inhibitor 1; D005340:Fibrinogen; D010959:Tissue Plasminogen Activator