title: Prevention of the metabolic syndrome in IGT subjects in a lifestyle intervention: results from the SLIM study.
abstract: OBJECTIVE
  The Study on Lifestyle intervention and Impaired glucose tolerance Maastricht (SLIM), a randomized controlled trial, directed at diet and physical activity in impaired glucose tolerant subjects was effective to improve glucose tolerance and prevent type 2 diabetes. The aim of this study was to determine the effects of the SLIM lifestyle intervention on the incidence and prevalence of the metabolic syndrome (MetS) during the active intervention and four years thereafter.
  
  
  RESULTS
  MetS was diagnosed according to the NCEP ATP III criteria. At baseline, 66.4% of all participants (n = 146, age 57 ± 7 years, BMI 29.7 ± 3.6, 51.3% female) fulfilled the criteria for MetS. No significant difference in MetS prevalence was observed between the intervention (63.9%) and control group (68.9%). At the end of active intervention (average duration 4.2 ± 2.0 years), prevalence of MetS was significantly lower in the intervention group (52.6%, n = 57) compared to the control group (74.6%, n = 59) (p = 0.014). Furthermore, in participants without MetS at baseline, cumulative incidence of MetS was 18.2% in the intervention group at the end of active intervention, compared to 73.7% in the control group (Log-rank test, p = 0.011). Four years after stopping active intervention, the reduced incidence of MetS was maintained (Log-rank test, p = 0.002).
  
  
  CONCLUSIONS
  In conclusion, a combined diet-and-exercise intervention to improve glucose tolerance, not only prevented type 2 diabetes, but also reduced the prevalence of MetS and prevented MetS development, showing the long-term impact of lifestyle intervention on cardiovascular risk reduction.
authors: Department of Human Biology, NUTRIM School for Nutrition, Toxicology and Metabolism, Maastricht University Medical Centre +, Maastricht, The Netherlands. Electronic address: A.denBoer@maastrichtuniversity.nl.
authors: A Th
authors: AT
authors: den Boer
authors: I J T
authors: IJ
authors: Herraets
authors: J
authors: J
authors: Stegen
authors: C
authors: C
authors: Roumen
authors: E
authors: E
authors: Corpeleijn
authors: N C
authors: NC
authors: Schaper
authors: E
authors: E
authors: Feskens
authors: E E
authors: EE
authors: Blaak
mesh_terms: D003131:Combined Modality Therapy; D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control; D015444:Exercise; D005260:Female; D005500:Follow-Up Studies; D018149:Glucose Intolerance / Q000178:diet therapy / Q000503:physiopathology / Q000628:therapy*; D006293:Health Promotion; D006801:Humans; D015994:Incidence; D008019:Life Style; D008297:Male; D024821:Metabolic Syndrome / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control*; D008875:Middle Aged; D009043:Motor Activity; D009426:Netherlands / Q000453:epidemiology; D018673:Nutrition Policy; D010353:Patient Education as Topic; D057285:Precision Medicine; D015995:Prevalence; D055070:Resistance Training; D012307:Risk Factors; D016019:Survival Analysis
keywords: Lifestyle intervention; Metabolic syndrome; Prevention; Risk factors; Type 2 diabetes