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.

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 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.