Improved fibrinolysis by intense lifestyle intervention. A randomized trial in subjects with impaired glucose tolerance

• Published in: Journal of internal medicine 1999-07, Vol.246 (1), p.105-112
• Main Authors: Lindahl, B., Nilsson, T. K., Jansson, J.‐H., Asplund, K., Hallmans, G.
• Format: Article
• Language: English
• Subjects: Adult; Antigens - blood; Atherosclerosis (general aspects, experimental research); Behavior Therapy; Biological and medical sciences; Blood and lymphatic vessels; Blood Glucose - metabolism; Body Weight; Cardiology. Vascular system; Dietary Fats - administration & dosage; Dietary Fiber - administration & dosage; Exercise; Female; Fibrinogen - metabolism; Fibrinolysis; Glucose Tolerance Test; Humans; Insulin - blood; insulin resistance; intervention; Life Style; Male; Medical sciences; Middle Aged; nonpharmacologic; Oxygen Consumption; Patient Education as Topic; plasminogen activator inhibitor; Plasminogen Activator Inhibitor 1 - metabolism; Tissue Plasminogen Activator - immunology
• ISSN: 0954-6820; 1365-2796
• DOI: 10.1046/j.1365-2796.1999.00537.x

Objective. To assess the effects of lifestyle intervention on cardiovascular risk factors in general and especially on fibrinolysis. Design. Randomized clinical study. Subjects. A total of 186 subjects with impaired glucose tolerance and obesity. Interventions. 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. Main outcome measures. 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 μg L–1) and 6% (– 0.69 μg L–1). Conclusions. The present randomized study shows that an intense lifestyle programme has sustained beneficial effects on fibrinolysis.