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

Objective. To assess the effects of lifestyle intervention on cardiovascula r risk factors in general and especially on fibrinolysis. Design. Randomized clinical study, Subjects, A total of 186 subjects with impaired glucose tolerance and obesi ty. Interventions. The intervention programme included a low-fat, high-fibre di et and regular physical exercise. Half of the participants (n = 93) took pa rt in a one-month learning and training session using different behavioural modification techniques and conducted in a full-board wellness centre (int ense intervention group). The other half (n = 93) was randomized a one-hour counselling session with a specially trained nurse (usual care group). Fol low-up was carried out after 12 months. Main outcome measures. Body weight, oxygen consumption, plasminogen activat or inhibitor type 1 (PAI-1) activity, tissue plasminogen activator (tPA) an tigen, fibrinogen and fasting plasma insulin measured at the start of the p rogramme 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 i n the intense group increased 10% vs. a 1% decline in the usual care group. In the intense group, PAI-I activity decreased 31% (- 10.1 U mL(-1)), whic h 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 mu g L-1) an d 6% (- 0.69 mu g L-1). Conclusions. The present randomized study shows that an intense lifestyle p rogramme has sustained beneficial effects on fibrinolysis.