title: Successful diet and exercise therapy as evaluated on self-assessment score significantly improves endothelial function in metabolic syndrome patients.
abstract: BACKGROUND
  Simple office-based counseling for diet and exercise does not appear to positively affect success rates in metabolic syndrome (MetS) patients. The utility of the lifestyle modification self-assessment score (Self-AS) in the improvement of endothelial function by office-based counseling for patients with MetS was investigated.
  
  
  RESULTS
  Patients with MetS (n=207) and age- and sex-matched individuals without MetS (n=124) were enrolled in this cross-sectional study. Endothelial function was assessed using reactive hyperemia-peripheral arterial tonometry index (RHI). Patients with MetS had significant endothelial dysfunction compared with those without MetS (RHI, 0.502±0.178 vs. 0.614±0.229; P<0.001). Seventy MetS patients participating in the prospective interventional study received simple office-based lifestyle modification counseling that was accompanied by Self-AS questionnaire after 10 months. RHI was significantly improved following lifestyle modifications (from 0.452±0.136 to 0.547±0.202, P<0.001). Reductions in waist circumference (R(2)=0.094, P=0.01) and increased high-density lipoprotein cholesterol (R(2)=0.227, P<0.001) independently correlated with improved RHI. Self-AS significantly correlated with changes in waist circumference (r=-0.57, P<0.001) and RHI (r=0.30, P=0.02). Patients with a good achievement of lifestyle modifications (higher Self-AS) had significant improvement in endothelial function compared with those with lower scores (% change in RHI, +48.7±61.6 vs. +7.8±35.1, P=0.001).
  
  
  CONCLUSIONS
  Good achievement of lifestyle modifications as evaluated on Self-AS significantly improved endothelial function with concomitant reductions in waist circumferences in MetS patients.
authors.affiliation: Department of Cardiovascular Medicine, Faculty of Life Sciences, Kumamoto University.
authors.forename: Yasushi
authors.initials: Y
authors.lastname: Matsuzawa
authors.forename: Seigo
authors.initials: S
authors.lastname: Sugiyama
authors.forename: Koichi
authors.initials: K
authors.lastname: Sugamura
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Sumida
authors.forename: Hirofumi
authors.initials: H
authors.lastname: Kurokawa
authors.forename: Koichiro
authors.initials: K
authors.lastname: Fujisue
authors.forename: Masaaki
authors.initials: M
authors.lastname: Konishi
authors.forename: Eiichi
authors.initials: E
authors.lastname: Akiyama
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Suzuki
authors.forename: Naoki
authors.initials: N
authors.lastname: Nakayama
authors.forename: Megumi
authors.initials: M
authors.lastname: Yamamuro
authors.forename: Satomi
authors.initials: S
authors.lastname: Iwashita
authors.forename: Hideaki
authors.initials: H
authors.lastname: Jinnouchi
authors.forename: Kazuo
authors.initials: K
authors.lastname: Kimura
authors.forename: Satoshi
authors.initials: S
authors.lastname: Umemura
authors.forename: Hisao
authors.initials: H
authors.lastname: Ogawa
mesh_terms: D000368:Aged; D004035:Diet Therapy; D004730:Endothelium, Vascular / Q000378:metabolism / Q000473:pathology / Q000503:physiopathology; D005081:Exercise Therapy; D005260:Female; D006801:Humans; D008297:Male; D024821:Metabolic Syndrome / Q000473:pathology / Q000503:physiopathology / Q000628:therapy; D008875:Middle Aged; D012720:Severity of Illness Index