Effect of lifestyle interventions on cardiovascular risk factors among adults without impaired glucose tolerance or diabetes: A systematic review and meta-analysis.
Structured lifestyle interventions can reduce diabetes incidence and cardiovascular disease (CVD) risk among persons with impaired glucose tolerance (IGT), but it is unclear whether they should be implemented among persons without IGT. We conducted a systematic review and meta-analyses to assess the...
Saved in:
| Main Authors: | , , , , , , , , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Public Library of Science (PLoS)
2017-01-01
|
| Series: | PLoS ONE |
| Online Access: | https://doi.org/10.1371/journal.pone.0176436 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1839655711208898560 |
|---|---|
| author | Xuanping Zhang Heather M Devlin Bryce Smith Giuseppina Imperatore William Thomas Felipe Lobelo Mohammed K Ali Keri Norris Stephanie Gruss Barbara Bardenheier Pyone Cho Isabel Garcia de Quevedo Uma Mudaliar Christopher D Jones Jeffrey M Durthaler Jinan Saaddine Linda S Geiss Edward W Gregg |
| author_facet | Xuanping Zhang Heather M Devlin Bryce Smith Giuseppina Imperatore William Thomas Felipe Lobelo Mohammed K Ali Keri Norris Stephanie Gruss Barbara Bardenheier Pyone Cho Isabel Garcia de Quevedo Uma Mudaliar Christopher D Jones Jeffrey M Durthaler Jinan Saaddine Linda S Geiss Edward W Gregg |
| author_sort | Xuanping Zhang |
| collection | DOAJ |
| description | Structured lifestyle interventions can reduce diabetes incidence and cardiovascular disease (CVD) risk among persons with impaired glucose tolerance (IGT), but it is unclear whether they should be implemented among persons without IGT. We conducted a systematic review and meta-analyses to assess the effectiveness of lifestyle interventions on CVD risk among adults without IGT or diabetes. We systematically searched MEDLINE, EMBASE, CINAHL, Web of Science, the Cochrane Library, and PsychInfo databases, from inception to May 4, 2016. We selected randomized controlled trials of lifestyle interventions, involving physical activity (PA), dietary (D), or combined strategies (PA+D) with follow-up duration ≥12 months. We excluded all studies that included individuals with IGT, confirmed by 2-hours oral glucose tolerance test (75g), but included all other studies recruiting populations with different glycemic levels. We stratified studies by baseline glycemic levels: (1) low-range group with mean fasting plasma glucose (FPG) <5.5mmol/L or glycated hemoglobin (A1C) <5.5%, and (2) high-range group with FPG ≥5.5mmol/L or A1C ≥5.5%, and synthesized data using random-effects models. Primary outcomes in this review included systolic blood pressure (SBP), diastolic blood pressure (DBP), total cholesterol (TC), low density lipoprotein cholesterol (LDL-C), high density lipoprotein cholesterol (HDL-C), and triglycerides (TG). Totally 79 studies met inclusion criteria. Compared to usual care (UC), lifestyle interventions achieved significant improvements in SBP (-2.16mmHg[95%CI, -2.93, -1.39]), DBP (-1.83mmHg[-2.34, -1.31]), TC (-0.10mmol/L[-0.15, -0.05]), LDL-C (-0.09mmol/L[-0.13, -0.04]), HDL-C (0.03mmol/L[0.01, 0.04]), and TG (-0.08mmol/L[-0.14, -0.03]). Similar effects were observed among both low-and high-range study groups except for TC and TG. Similar effects also appeared in SBP and DBP categories regardless of follow-up duration. PA+D interventions had larger improvement effects on CVD risk factors than PA alone interventions. In adults without IGT or diabetes, lifestyle interventions resulted in significant improvements in SBP, DBP, TC, LDL-C, HDL-C, and TG, and might further reduce CVD risk. |
| format | Article |
| id | doaj-art-3f9dd9ae529949e4bd9eb8da95e75a00 |
| institution | Matheson Library |
| issn | 1932-6203 |
| language | English |
| publishDate | 2017-01-01 |
| publisher | Public Library of Science (PLoS) |
| record_format | Article |
| series | PLoS ONE |
| spelling | doaj-art-3f9dd9ae529949e4bd9eb8da95e75a002025-06-25T05:31:51ZengPublic Library of Science (PLoS)PLoS ONE1932-62032017-01-01125e017643610.1371/journal.pone.0176436Effect of lifestyle interventions on cardiovascular risk factors among adults without impaired glucose tolerance or diabetes: A systematic review and meta-analysis.Xuanping ZhangHeather M DevlinBryce SmithGiuseppina ImperatoreWilliam ThomasFelipe LobeloMohammed K AliKeri NorrisStephanie GrussBarbara BardenheierPyone ChoIsabel Garcia de QuevedoUma MudaliarChristopher D JonesJeffrey M DurthalerJinan SaaddineLinda S GeissEdward W GreggStructured lifestyle interventions can reduce diabetes incidence and cardiovascular disease (CVD) risk among persons with impaired glucose tolerance (IGT), but it is unclear whether they should be implemented among persons without IGT. We conducted a systematic review and meta-analyses to assess the effectiveness of lifestyle interventions on CVD risk among adults without IGT or diabetes. We systematically searched MEDLINE, EMBASE, CINAHL, Web of Science, the Cochrane Library, and PsychInfo databases, from inception to May 4, 2016. We selected randomized controlled trials of lifestyle interventions, involving physical activity (PA), dietary (D), or combined strategies (PA+D) with follow-up duration ≥12 months. We excluded all studies that included individuals with IGT, confirmed by 2-hours oral glucose tolerance test (75g), but included all other studies recruiting populations with different glycemic levels. We stratified studies by baseline glycemic levels: (1) low-range group with mean fasting plasma glucose (FPG) <5.5mmol/L or glycated hemoglobin (A1C) <5.5%, and (2) high-range group with FPG ≥5.5mmol/L or A1C ≥5.5%, and synthesized data using random-effects models. Primary outcomes in this review included systolic blood pressure (SBP), diastolic blood pressure (DBP), total cholesterol (TC), low density lipoprotein cholesterol (LDL-C), high density lipoprotein cholesterol (HDL-C), and triglycerides (TG). Totally 79 studies met inclusion criteria. Compared to usual care (UC), lifestyle interventions achieved significant improvements in SBP (-2.16mmHg[95%CI, -2.93, -1.39]), DBP (-1.83mmHg[-2.34, -1.31]), TC (-0.10mmol/L[-0.15, -0.05]), LDL-C (-0.09mmol/L[-0.13, -0.04]), HDL-C (0.03mmol/L[0.01, 0.04]), and TG (-0.08mmol/L[-0.14, -0.03]). Similar effects were observed among both low-and high-range study groups except for TC and TG. Similar effects also appeared in SBP and DBP categories regardless of follow-up duration. PA+D interventions had larger improvement effects on CVD risk factors than PA alone interventions. In adults without IGT or diabetes, lifestyle interventions resulted in significant improvements in SBP, DBP, TC, LDL-C, HDL-C, and TG, and might further reduce CVD risk.https://doi.org/10.1371/journal.pone.0176436 |
| spellingShingle | Xuanping Zhang Heather M Devlin Bryce Smith Giuseppina Imperatore William Thomas Felipe Lobelo Mohammed K Ali Keri Norris Stephanie Gruss Barbara Bardenheier Pyone Cho Isabel Garcia de Quevedo Uma Mudaliar Christopher D Jones Jeffrey M Durthaler Jinan Saaddine Linda S Geiss Edward W Gregg Effect of lifestyle interventions on cardiovascular risk factors among adults without impaired glucose tolerance or diabetes: A systematic review and meta-analysis. PLoS ONE |
| title | Effect of lifestyle interventions on cardiovascular risk factors among adults without impaired glucose tolerance or diabetes: A systematic review and meta-analysis. |
| title_full | Effect of lifestyle interventions on cardiovascular risk factors among adults without impaired glucose tolerance or diabetes: A systematic review and meta-analysis. |
| title_fullStr | Effect of lifestyle interventions on cardiovascular risk factors among adults without impaired glucose tolerance or diabetes: A systematic review and meta-analysis. |
| title_full_unstemmed | Effect of lifestyle interventions on cardiovascular risk factors among adults without impaired glucose tolerance or diabetes: A systematic review and meta-analysis. |
| title_short | Effect of lifestyle interventions on cardiovascular risk factors among adults without impaired glucose tolerance or diabetes: A systematic review and meta-analysis. |
| title_sort | effect of lifestyle interventions on cardiovascular risk factors among adults without impaired glucose tolerance or diabetes a systematic review and meta analysis |
| url | https://doi.org/10.1371/journal.pone.0176436 |
| work_keys_str_mv | AT xuanpingzhang effectoflifestyleinterventionsoncardiovascularriskfactorsamongadultswithoutimpairedglucosetoleranceordiabetesasystematicreviewandmetaanalysis AT heathermdevlin effectoflifestyleinterventionsoncardiovascularriskfactorsamongadultswithoutimpairedglucosetoleranceordiabetesasystematicreviewandmetaanalysis AT brycesmith effectoflifestyleinterventionsoncardiovascularriskfactorsamongadultswithoutimpairedglucosetoleranceordiabetesasystematicreviewandmetaanalysis AT giuseppinaimperatore effectoflifestyleinterventionsoncardiovascularriskfactorsamongadultswithoutimpairedglucosetoleranceordiabetesasystematicreviewandmetaanalysis AT williamthomas effectoflifestyleinterventionsoncardiovascularriskfactorsamongadultswithoutimpairedglucosetoleranceordiabetesasystematicreviewandmetaanalysis AT felipelobelo effectoflifestyleinterventionsoncardiovascularriskfactorsamongadultswithoutimpairedglucosetoleranceordiabetesasystematicreviewandmetaanalysis AT mohammedkali effectoflifestyleinterventionsoncardiovascularriskfactorsamongadultswithoutimpairedglucosetoleranceordiabetesasystematicreviewandmetaanalysis AT kerinorris effectoflifestyleinterventionsoncardiovascularriskfactorsamongadultswithoutimpairedglucosetoleranceordiabetesasystematicreviewandmetaanalysis AT stephaniegruss effectoflifestyleinterventionsoncardiovascularriskfactorsamongadultswithoutimpairedglucosetoleranceordiabetesasystematicreviewandmetaanalysis AT barbarabardenheier effectoflifestyleinterventionsoncardiovascularriskfactorsamongadultswithoutimpairedglucosetoleranceordiabetesasystematicreviewandmetaanalysis AT pyonecho effectoflifestyleinterventionsoncardiovascularriskfactorsamongadultswithoutimpairedglucosetoleranceordiabetesasystematicreviewandmetaanalysis AT isabelgarciadequevedo effectoflifestyleinterventionsoncardiovascularriskfactorsamongadultswithoutimpairedglucosetoleranceordiabetesasystematicreviewandmetaanalysis AT umamudaliar effectoflifestyleinterventionsoncardiovascularriskfactorsamongadultswithoutimpairedglucosetoleranceordiabetesasystematicreviewandmetaanalysis AT christopherdjones effectoflifestyleinterventionsoncardiovascularriskfactorsamongadultswithoutimpairedglucosetoleranceordiabetesasystematicreviewandmetaanalysis AT jeffreymdurthaler effectoflifestyleinterventionsoncardiovascularriskfactorsamongadultswithoutimpairedglucosetoleranceordiabetesasystematicreviewandmetaanalysis AT jinansaaddine effectoflifestyleinterventionsoncardiovascularriskfactorsamongadultswithoutimpairedglucosetoleranceordiabetesasystematicreviewandmetaanalysis AT lindasgeiss effectoflifestyleinterventionsoncardiovascularriskfactorsamongadultswithoutimpairedglucosetoleranceordiabetesasystematicreviewandmetaanalysis AT edwardwgregg effectoflifestyleinterventionsoncardiovascularriskfactorsamongadultswithoutimpairedglucosetoleranceordiabetesasystematicreviewandmetaanalysis |