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Jeanpierre Despres - One of the best experts on this subject based on the ideXlab platform.
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benefits of 1 year Lifestyle Modification program on exercise capacity and diastolic function among coronary artery disease men with and without type 2 diabetes
Metabolic Syndrome and Related Disorders, 2019Co-Authors: Marieeve Piche, Paul Poirier, Andre Marette, Patrick Mathieu, Valerie Levesque, Karine Bibeau, Eric Larose, Jeanpierre DespresAbstract:Abstract Background: To assess the benefits of a 1-year Lifestyle Modification program on exercise capacity and diastolic function in men with left ventricular (LV) diastolic dysfunction (LVDD) and...
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changes in igfbp 2 levels following a one year Lifestyle Modification program are independently related to improvements in plasma apo b and ldl apo b levels
Atherosclerosis, 2019Co-Authors: Sophie Carter, Isabelle Lemieux, N Almeras, Jeanpierre Despres, Zhuo Li, Angelo Tremblay, Jean Bergeron, Paul Poirier, Frederic PicardAbstract:Abstract Background and aims Recent transversal studies have associated insulin-like growth factor binding protein (IGFBP)-2 levels with glucose tolerance and parameters of the lipoprotein-lipid profile. Here, we aimed at determining the longitudinal effects of a one-year Lifestyle Modification program on IGFBP-2 levels and to identify specific metabolic improvements impacted by the changes in IGFBP-2. Methods 99 middle-aged Caucasian men were involved in a Lifestyle Modification program consisting in personalized healthy eating and physical activity counseling, combined to elicit a daily 500 kcal deficit. Anthropometric and metabolic parameters as well as circulating IGFBP-2 levels were measured before and after one year of the Lifestyle Modification program. Results The intervention triggered positive changes in many metabolic parameters and a 43% (p Conclusions The 1-year Lifestyle Modification program was associated with increased IGFBP-2 concentrations. Increases in IGFBP-2 levels were closely associated with reduced LDL apo B concentrations and independently of the Modifications in fat mass and insulin sensitivity. Further mechanistic studies are required to assess the effects of IGFBP-2 levels on LDL metabolism.
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impact of a 1 year Lifestyle Modification program on plasma lipoprotein and pcsk9 concentrations in patients with coronary artery disease
Journal of Clinical Lipidology, 2016Co-Authors: Marjorie Boyer, Jeanpierre Despres, Paul Poirier, Andre Marette, Patrick Mathieu, Valerie Levesque, Eric Larose, Benoit J ArsenaultAbstract:Background Patients with coronary artery disease (CAD) are characterized by an impaired cardiometabolic risk profile including high levels of atherogenic apolipoprotein (apo) B-containing lipoprotein levels. Genetic studies have highlighted a critical role for proprotein convertase subtilisin/kexin type 9 (PCSK9) in lipoprotein metabolism and CAD risk. Objective To determine whether improving dietary quality and increasing physical activity levels improve parameters of the cardiometabolic risk profile such as plasma apoB and PCSK9 levels in patients with CAD. Methods We recruited 86 men aged between 39 and 80 years (82 of them on statins) undergoing coronary artery bypass graft (CABG) surgery. These patients participated in a 1-year Lifestyle Modification program aiming at achieving a minimum of 150 minutes/week of physical activity and improving diet quality by following dietary guidelines. We used magnetic resonance imaging to measure visceral adipose tissue and a modified Bruce protocol to measure fitness levels before and after the intervention. Results Plasma apoB and low-density lipoprotein cholesterol levels were not modified by the intervention (−3.0%, P = .08 and 1.3%, P = .56, respectively), whereas non-HDL cholesterol decreased by 4.5% ( P = .04) and triglycerides by 13% ( P = .002). In contrast, PCSK9 levels increased by 5.2% after the intervention ( P = .05). HDL cholesterol and apolipoprotein A-I levels also increased (+12%, P P r = 0.23, P = .04) and visceral fat mobilization ( r = −0.23, P = .04). Conclusion In post-CABG patients, a Lifestyle Modification program lead to significant improvements in some parameters of the lipoprotein profile but unexpectedly increased plasma PCSK9 levels.
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pcsk9 levels in abdominally obese men association with cardiometabolic risk profile and effects of a one year Lifestyle Modification program
Atherosclerosis, 2014Co-Authors: Benoit J Arsenault, N Almeras, Angelo Tremblay, Jean Bergeron, Paul Poirier, Emilie Pelletierbeaumont, Jeanpierre DespresAbstract:Abstract Objectives Studies performed in rodents have suggested a role for proprotein convertase subtilisin/kexin type 9 (PCSK9) in insulin resistance and impaired body fat distribution. Our objective was to examine the relationships between markers of adiposity and insulin resistance and plasma PCSK9 levels in humans. In addition, we explored the effect of a one-year Lifestyle Modification program on plasma PCSK9 levels in abdominally obese, dyslipidemic men. Methods Plasma PCSK9 levels were measured by ELISA in 175 abdominally obese, dyslipidemic sedentary men. Of these abdominally obese men, 117 non-diabetic individuals completed a one-year Lifestyle Modification program aiming at increasing cardiorespiratory fitness levels and improving nutritional quality. Results We found no association between plasma PCSK9 levels and body mass index, waist circumference, fat and fat-free mass, or visceral and subcutaneous adipose tissue measured by computed tomography. Compared to men with the lowest PCSK9 levels (bottom tertile), those with the highest PCSK9 levels (top tertile) had the most detrimental lipoprotein-lipid profile including lower LDL particle size (253.6 ± 4.0 vs. 251.6 ± 4.0 Å, p p p p p = 0.07). Conclusions Plasma PCSK9 levels are not associated with body fat distribution indices, modestly associated with markers of insulin resistance and LDL particle size and are slightly affected by a Lifestyle Modification program in abdominally obese men.
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normalization of visceral adiposity is required to normalize plasma apolipoprotein b levels in response to a healthy eating physical activity Lifestyle Modification program in viscerally obese men
Atherosclerosis, 2012Co-Authors: Emilie Pelletierbeaumont, Benoit J Arsenault, N Almeras, Angelo Tremblay, Jean Bergeron, Paul Poirier, Jeanpierre DespresAbstract:Abstract Objective Little is known about how visceral adipose tissue (VAT) influences circulating apolipoprotein B (apoB) levels, which reflect atherogenic risk. We have examined the effects of a 1-year Lifestyle Modification program on plasma apoB levels in viscerally obese men and compared post-intervention levels to those of a reference group of lean healthy men. Methods Fasting plasma apoB levels were measured in 107 non-diabetic, viscerally obese men, before and after a 1-year Lifestyle intervention program aiming at improving nutritional and physical activity/exercise habits. Results After the intervention, subjects significantly decreased their volume of VAT ( Δ =−26±18%, p Δ =−3±14%, p =0.04). When compared to the reference group, men in the intervention group still had higher apoB levels suggesting that they did not "normalize" their apoB concentrations to the level of the healthy non-obese reference men. To further explore the relationship between VAT and apoB, men in the intervention group were stratified according to quartiles of VAT achieved after the intervention. Only men of the lowest quartile of VAT (corresponding to 844±42cm 3 , similar to the value of the reference group; 809±52cm 3 of VAT) showed plasma apoB levels which were similar to those of the reference group (0.98±0.21 vs. 0.99±0.24g/L, NS, for lowest VAT quartile and reference group, respectively). Conclusion These results suggest that, in order to "normalize" apoB levels in response to a Lifestyle Modification program, viscerally obese dyslipidemic men need to achieve levels of VAT similar to healthy non-obese men.
Ruth Chan - One of the best experts on this subject based on the ideXlab platform.
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psychological factors of long term dietary and physical activity adherence among chinese adults with overweight and obesity in a community based Lifestyle Modification program a mixed method study
Nutrients, 2020Co-Authors: Alice W Y Leung, Ruth ChanAbstract:: There is a paucity of research on factors influencing long-term adherence to Lifestyle Modification. We conducted a mixed-method study to explore the psychological factors of dietary and physical activity (PA) adherence among Chinese adults with overweight and obesity at 10 months after enrollment of a community-based Lifestyle Modification program in Hong Kong. We recruited Chinese adults newly enrolled in a culturally adapted Lifestyle Modification program and followed them for 10 months. For the quantitative study, primary outcomes were dietary and PA adherence scores while secondary outcomes included knowledge, self-efficacy, motivation and stage of change. For the qualitative study, data were collected using semi-structured interviews and observation. A total of 140 participants completed the 10-month follow-up. They reported moderate level of dietary adherence but low level of PA adherence at 10 months. Multivariable regression analyses revealed that greater improvement in nutrition knowledge and diet stage of change predicted higher dietary adherence while greater improvement in PA self-efficacy and PA stage of change predicted higher PA adherence. Qualitative data on 26 participants suggest that participants' knowledge and self-efficacy but not motivation were enhanced during the program. The findings of this study enhanced our understanding on factors influencing long-term adherence to Lifestyle changes.
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identifying psychological predictors of adherence to a community based Lifestyle Modification program for weight loss among chinese overweight and obese adults
Nutrition Research and Practice, 2019Co-Authors: Alice W Y Leung, Ruth ChanAbstract:BACKGROUND/OBJECTIVES: Existing evidence on Lifestyle Modification programs for weight loss is limited by the high attrition rate of such programs. Identifying predictors of adherence to a Lifestyle Modification program could result in program improvement. However, little is known about behavior-specific adherence and its psychological predictors. This study aimed to examine the psychological predictors of adherence after one-month participation in a community-based Lifestyle Modification program among Chinese overweight and obese adults in Hong Kong. SUBJECTS/METHODS: A total of 205 Chinese overweight and obese adults aged 38.9 ± 10.5 years completed the study. Data were collected at baseline and after one month using self-reported questionnaires, which assessed knowledge (self-developed scale), motivation (Treatment Self-Regulation Questionnaire), stage of change (Stage of Exercise Scale) and self-efficacy (Self-Rated Abilities for Health Practices Scale). At one month, a 4-day dietary recall and the International Physical Activity Questionnaire-Short Form were used to assess dietary and physical activity (PA) adherence. Food and PA diaries were examined to indicate self-monitoring. Program attendance was tracked between baseline and one-month follow-up. RESULTS: After one month, participants reported high dietary adherence, attendance, and adherence to self-monitoring but low PA adherence. Multiple regression analyses suggested that diet self-efficacy (baseline) and nutrition knowledge (one-month change) were independent predictors of dietary adherence score at one month, whereas autonomous PA motivation (baseline) and PA self-efficacy (both baseline and one-month change) were independent predictors of PA adherence score at one month. No significant psychological predictor was identified for attendance or self-monitoring. CONCLUSIONS: The results suggest that the effect of psychological factors on adherence differs between diet and PA adherence outcomes. To promote adherence, practitioners should assess self-efficacy, knowledge, and motivation at the beginning of a weight-loss program and explore behavior-specific strategies to improve knowledge and self-efficacy. The results of this study have direct implications for program improvements.
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dietitian led Lifestyle Modification programme for obese chinese adolescents with non alcoholic fatty liver disease a randomized controlled study
International Journal of Obesity, 2018Co-Authors: D F Y Chan, Ruth Chan, H K So, Albert M Li, Michael H M Chan, E A S NelsonAbstract:The prevalence of non-alcoholic fatty liver disease (NAFLD) in children is increasing. This study evaluated the efficacy of a dietitian-led Lifestyle Modification programme (D-LMP) to reduce NAFLD in obese adolescents. Subjects with intra-hepatic triglyceride content (IHTC) equal to or greater than 5% diagnosed by proton-magnetic resonance spectroscopy (1H-MRS) were enroled and randomly assigned to either the D-LMP intervention or conventional paediatrician-led consultation (P-CON) group. Subjects in the P-CON group received usual care consisting of a consultation by a paediatrician with the child and parents every 16 weeks. Intention-to-treat analysis was used for data analysis. Fifty-two subjects were recruited, with 26 in each group. After the initiation phase (at week-16), there was a greater difference in the change in the IHTC and BMI z-score in the D-LMP group (P = 0.029 and <0.001, respectively) and there was a decrease in dietary intake of fat content (P = 0.019). After 52 weeks of the maintenance phase, both groups had reductions of IHTC to 2–3% and there was no intergroup difference in the rate of reduction. During the maintenance phase, parents’ involvement was minimal in the D-LMP group, with only three parents accompanying their children to attend the dietitian sessions. In contrast, over 90% of the parents in the P-CON group regularly accompanied their children to attend the consultations suggesting the possibility that regular parental and paediatrician involvement may contribute to increasing awareness on fatty liver complications. Multivariate analysis showed that only reduction in body fat remained as an independent factor associated with remission of NAFLD at the end of both study phases. A dietitian-led Lifestyle Modification intervention reduced IHTC, BMI z-score and body fat in obese Chinese adolescents with NAFLD. To sustain the effect of this intervention, regular parental and paediatrician involvement may be important.
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a randomized controlled study to examine the effect of a Lifestyle Modification program in osa
Chest, 2015Co-Authors: Susanna S S Ng, Ruth Chan, Taton Chan, Bernice H K Cheung, Kinwang To, Ken K P Chan, Jenny Ngai, Fanny W S KoAbstract:Background Obesity is an important risk factor for OSA. This study aimed to assess the effect of weight reduction through a Lifestyle Modification program (LMP) on patients with moderate to severe OSA. Methods This was a parallel group, randomized controlled trial. Altogether, 104 patients with moderate to severe OSA diagnosed on portable home sleep monitoring were randomized to receive a dietician-led LMP or usual care for 12 months. The primary outcome was reduction of apnea-hypopnea index (AHI) at 12 months as assessed by portable home sleep monitoring. Results In the intention-to-treat analysis (ITT), LMP (n = 61) was more effective in reducing AHI from baseline (16.9% fewer events in the LMP group vs 0.6% more events in the control group, P = .011). LMP was more effective in reducing BMI (–1.8 kg/m2, 6.0% of the initial BMI; –0.6 kg/m2, 2.0% of the initial BMI in control group; P Conclusions LMP was effective in reducing the severity of OSA and daytime sleepiness. The beneficial effect was sustained in 12 months. Trial Registry ClinicalTrials.gov; No.: NCT01384760; URL: www.clinicaltrials.gov
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pnpla3 gene polymorphism and response to Lifestyle Modification in patients with nonalcoholic fatty liver disease
Journal of Gastroenterology and Hepatology, 2015Co-Authors: Jiayun Shen, Grace Laihung Wong, Henry Likyuen Chan, Bernice Hoki Cheung, Liz Sin Li, Ruth Chan, David K.w. Yeung, Vincent Waisun WongAbstract:BACKGROUND AND AIM: Lifestyle Modification is the cornerstone for the management of nonalcoholic fatty liver disease (NAFLD), and patatin-like phospholipase 3 (PNPLA3) is one of the most important genetic determinants of NAFLD. We aimed to investigate the effect of PNPLA3 gene polymorphism on the response to Lifestyle Modification in NAFLD patients. METHODS: This was a post-hoc analysis of a randomized controlled trial on a Lifestyle Modification program in community NAFLD patients. The PNPLA3 rs738409 gene polymorphism was correlated with changes in metabolic profile and intrahepatic triglyceride content (IHTG) as measured by proton magnetic resonance spectroscopy. RESULTS: One hundred and fifty-four patients were equally randomized into the intervention and control groups. The presence of G allele was associated with greater reduction in IHTG (CC: 3.7 ± 5.2%, CG: 6.5 ± 3.6%), and GG: 11.3 ± 8.8% (Spearman's correlation, 0.34; P = 0.002), body weight (P = 0.030), waist-to-hip ratio (P = 0.024), total cholesterol (P = 0.031), and low-density lipoprotein cholesterol (P = 0.009) in the intervention group. In contrast, PNPLA3 polymorphism had no impact on IHTG changes in the control group. By multivariable analysis, PNPLA3 genotype and body mass index (BMI) change were independently associated with IHTG reduction in the intervention group. Only BMI change was associated with IHTG reduction in the control group. CONCLUSION: Although the PNPLA3 rs738409 GG genotype confers a higher risk of NAFLD, these patients are more sensitive to the beneficial effects of Lifestyle Modification and should be encouraged to do so.
Paul Poirier - One of the best experts on this subject based on the ideXlab platform.
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benefits of 1 year Lifestyle Modification program on exercise capacity and diastolic function among coronary artery disease men with and without type 2 diabetes
Metabolic Syndrome and Related Disorders, 2019Co-Authors: Marieeve Piche, Paul Poirier, Andre Marette, Patrick Mathieu, Valerie Levesque, Karine Bibeau, Eric Larose, Jeanpierre DespresAbstract:Abstract Background: To assess the benefits of a 1-year Lifestyle Modification program on exercise capacity and diastolic function in men with left ventricular (LV) diastolic dysfunction (LVDD) and...
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changes in igfbp 2 levels following a one year Lifestyle Modification program are independently related to improvements in plasma apo b and ldl apo b levels
Atherosclerosis, 2019Co-Authors: Sophie Carter, Isabelle Lemieux, N Almeras, Jeanpierre Despres, Zhuo Li, Angelo Tremblay, Jean Bergeron, Paul Poirier, Frederic PicardAbstract:Abstract Background and aims Recent transversal studies have associated insulin-like growth factor binding protein (IGFBP)-2 levels with glucose tolerance and parameters of the lipoprotein-lipid profile. Here, we aimed at determining the longitudinal effects of a one-year Lifestyle Modification program on IGFBP-2 levels and to identify specific metabolic improvements impacted by the changes in IGFBP-2. Methods 99 middle-aged Caucasian men were involved in a Lifestyle Modification program consisting in personalized healthy eating and physical activity counseling, combined to elicit a daily 500 kcal deficit. Anthropometric and metabolic parameters as well as circulating IGFBP-2 levels were measured before and after one year of the Lifestyle Modification program. Results The intervention triggered positive changes in many metabolic parameters and a 43% (p Conclusions The 1-year Lifestyle Modification program was associated with increased IGFBP-2 concentrations. Increases in IGFBP-2 levels were closely associated with reduced LDL apo B concentrations and independently of the Modifications in fat mass and insulin sensitivity. Further mechanistic studies are required to assess the effects of IGFBP-2 levels on LDL metabolism.
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impact of a 1 year Lifestyle Modification program on plasma lipoprotein and pcsk9 concentrations in patients with coronary artery disease
Journal of Clinical Lipidology, 2016Co-Authors: Marjorie Boyer, Jeanpierre Despres, Paul Poirier, Andre Marette, Patrick Mathieu, Valerie Levesque, Eric Larose, Benoit J ArsenaultAbstract:Background Patients with coronary artery disease (CAD) are characterized by an impaired cardiometabolic risk profile including high levels of atherogenic apolipoprotein (apo) B-containing lipoprotein levels. Genetic studies have highlighted a critical role for proprotein convertase subtilisin/kexin type 9 (PCSK9) in lipoprotein metabolism and CAD risk. Objective To determine whether improving dietary quality and increasing physical activity levels improve parameters of the cardiometabolic risk profile such as plasma apoB and PCSK9 levels in patients with CAD. Methods We recruited 86 men aged between 39 and 80 years (82 of them on statins) undergoing coronary artery bypass graft (CABG) surgery. These patients participated in a 1-year Lifestyle Modification program aiming at achieving a minimum of 150 minutes/week of physical activity and improving diet quality by following dietary guidelines. We used magnetic resonance imaging to measure visceral adipose tissue and a modified Bruce protocol to measure fitness levels before and after the intervention. Results Plasma apoB and low-density lipoprotein cholesterol levels were not modified by the intervention (−3.0%, P = .08 and 1.3%, P = .56, respectively), whereas non-HDL cholesterol decreased by 4.5% ( P = .04) and triglycerides by 13% ( P = .002). In contrast, PCSK9 levels increased by 5.2% after the intervention ( P = .05). HDL cholesterol and apolipoprotein A-I levels also increased (+12%, P P r = 0.23, P = .04) and visceral fat mobilization ( r = −0.23, P = .04). Conclusion In post-CABG patients, a Lifestyle Modification program lead to significant improvements in some parameters of the lipoprotein profile but unexpectedly increased plasma PCSK9 levels.
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pcsk9 levels in abdominally obese men association with cardiometabolic risk profile and effects of a one year Lifestyle Modification program
Atherosclerosis, 2014Co-Authors: Benoit J Arsenault, N Almeras, Angelo Tremblay, Jean Bergeron, Paul Poirier, Emilie Pelletierbeaumont, Jeanpierre DespresAbstract:Abstract Objectives Studies performed in rodents have suggested a role for proprotein convertase subtilisin/kexin type 9 (PCSK9) in insulin resistance and impaired body fat distribution. Our objective was to examine the relationships between markers of adiposity and insulin resistance and plasma PCSK9 levels in humans. In addition, we explored the effect of a one-year Lifestyle Modification program on plasma PCSK9 levels in abdominally obese, dyslipidemic men. Methods Plasma PCSK9 levels were measured by ELISA in 175 abdominally obese, dyslipidemic sedentary men. Of these abdominally obese men, 117 non-diabetic individuals completed a one-year Lifestyle Modification program aiming at increasing cardiorespiratory fitness levels and improving nutritional quality. Results We found no association between plasma PCSK9 levels and body mass index, waist circumference, fat and fat-free mass, or visceral and subcutaneous adipose tissue measured by computed tomography. Compared to men with the lowest PCSK9 levels (bottom tertile), those with the highest PCSK9 levels (top tertile) had the most detrimental lipoprotein-lipid profile including lower LDL particle size (253.6 ± 4.0 vs. 251.6 ± 4.0 Å, p p p p p = 0.07). Conclusions Plasma PCSK9 levels are not associated with body fat distribution indices, modestly associated with markers of insulin resistance and LDL particle size and are slightly affected by a Lifestyle Modification program in abdominally obese men.
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normalization of visceral adiposity is required to normalize plasma apolipoprotein b levels in response to a healthy eating physical activity Lifestyle Modification program in viscerally obese men
Atherosclerosis, 2012Co-Authors: Emilie Pelletierbeaumont, Benoit J Arsenault, N Almeras, Angelo Tremblay, Jean Bergeron, Paul Poirier, Jeanpierre DespresAbstract:Abstract Objective Little is known about how visceral adipose tissue (VAT) influences circulating apolipoprotein B (apoB) levels, which reflect atherogenic risk. We have examined the effects of a 1-year Lifestyle Modification program on plasma apoB levels in viscerally obese men and compared post-intervention levels to those of a reference group of lean healthy men. Methods Fasting plasma apoB levels were measured in 107 non-diabetic, viscerally obese men, before and after a 1-year Lifestyle intervention program aiming at improving nutritional and physical activity/exercise habits. Results After the intervention, subjects significantly decreased their volume of VAT ( Δ =−26±18%, p Δ =−3±14%, p =0.04). When compared to the reference group, men in the intervention group still had higher apoB levels suggesting that they did not "normalize" their apoB concentrations to the level of the healthy non-obese reference men. To further explore the relationship between VAT and apoB, men in the intervention group were stratified according to quartiles of VAT achieved after the intervention. Only men of the lowest quartile of VAT (corresponding to 844±42cm 3 , similar to the value of the reference group; 809±52cm 3 of VAT) showed plasma apoB levels which were similar to those of the reference group (0.98±0.21 vs. 0.99±0.24g/L, NS, for lowest VAT quartile and reference group, respectively). Conclusion These results suggest that, in order to "normalize" apoB levels in response to a Lifestyle Modification program, viscerally obese dyslipidemic men need to achieve levels of VAT similar to healthy non-obese men.
Robert J Norman - One of the best experts on this subject based on the ideXlab platform.
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restoration of reproductive potential by Lifestyle Modification in obese polycystic ovary syndrome role of insulin sensitivity and luteinizing hormone
The Journal of Clinical Endocrinology and Metabolism, 1999Co-Authors: M M Huberbuchholz, D G P Carey, Robert J NormanAbstract:Weight reduction and exercise have been shown to help with menstrual disturbance and infertility in obese women with polycystic ovary syndrome. We studied the relationship between insulin sensitivity and ovulation patterns in 18 infertile anovulatory obese polycystic ovary syndrome (PCOS) women (NO) with normal glucose tolerance, aged between 22-39 yr with a body mass index of 27-45 kg/m2, before and after a 6-month diet and exercise program. This program promotes healthy Lifestyle factors, but does not lead to rapid weight loss. The anthropometric, metabolic, and endocrine factors of these subjects were compared to those of 10 age- and weight-matched PCOS women with regular monthly ovulation (RO). Before Lifestyle Modification, the anovulatory subjects had greater central obesity than regular ovulators, as assessed by percent central fat (NO, 45.7 +/- 0.8%; RO, 42.2 +/- 1.6%; P < 0.05), higher glucose increment after glucose challenge (NO, 10.1 +/- 1.0 mmol/L; RO, 6.4 +/- 1.1 mmol/L; P < 0.02), lower insulin sensitivity index (NO, 1.2 +/- 0.2; RO, 2.8 +/- 0.6 micromol/kg x min/pmol/L; P < 0.005), higher plasma LH (NO, 8.9 +/- 0.9; RO, 4.6 +/- 0.9 IU/L; P < 0.005), and lower plasma sex hormone-binding globulin (NO, 18.0 +/- 2.5; RO, 27.8 +/- 5.7 nmol/L; P < 0.05]. Anovulatory subjects were classified as responders (R) to the intervention if they regained ovulation during the study. As a result of intervention, R showed an 11% reduction in central fat, a 71% improvement in insulin sensitivity index, a 33% fall in fasting insulin levels, and a 39% reduction in LH levels. None of these parameters changed significantly in nonresponders (NR). At the end of the study, R had lower fasting insulin (R, 13.6 +/- 1.7; NR, 23.0 +/- 3.5 mU/L) and LH levels (R, 5.0 +/- 1.7; NR, 7.4 +/- 1.4 IU/L), but similar androgen levels compared to NR. We conclude that Lifestyle Modification without rapid weight loss leads to a reduction of central fat and improved insulin sensitivity, which restores ovulation in overweight infertile women with PCOS. Lifestyle Modification is the best initial management for obese women seeking to improve their reproductive function.
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restoration of reproductive potential by Lifestyle Modification in obese polycystic ovary syndrome role of insulin sensitivity and luteinizing hormone
The Journal of Clinical Endocrinology and Metabolism, 1999Co-Authors: M M Huberbuchholz, D G P Carey, Robert J NormanAbstract:Weight reduction and exercise have been shown to help with menstrual disturbance and infertility in obese women with polycystic ovary syndrome. We studied the relationship between insulin sensitivity and ovulation patterns in 18 infertile anovulatory obese polycystic ovary syndrome (PCOS) women (NO) with normal glucose tolerance, aged between 22–39 yr with a body mass index of 27–45 kg/m2, before and after a 6-month diet and exercise program. This program promotes healthy Lifestyle factors, but does not lead to rapid weight loss. The anthropometric, metabolic, and endocrine factors of these subjects were compared to those of 10 age- and weight-matched PCOS women with regular monthly ovulation (RO). Before Lifestyle Modification, the anovulatory subjects had greater central obesity than regular ovulators, as assessed by percent central fat (NO, 45.7 ± 0.8%; RO, 42.2 ± 1.6%; P < 0.05), higher glucose increment after glucose challenge (NO, 10.1 ± 1.0 mmol/L; RO, 6.4 ± 1.1 mmol/L; P < 0.02), lower insulin sen...
C Snehalatha - One of the best experts on this subject based on the ideXlab platform.
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effectiveness of mobile phone messaging in prevention of type 2 diabetes by Lifestyle Modification in men in india a prospective parallel group randomised controlled trial
The Lancet Diabetes & Endocrinology, 2013Co-Authors: Ambady Ramachandran, C Snehalatha, Sundaram Selvam, Jagannathan Ram, Mary Simon, Arun Nanditha, Ananth Samith Shetty, Ian F Godsland, Nish Chaturvedi, Azeem MajeedAbstract:Summary Background Type 2 diabetes can often be prevented by Lifestyle Modification; however, successful Lifestyle intervention programmes are labour intensive. Mobile phone messaging is an inexpensive alternative way to deliver educational and motivational advice about Lifestyle Modification. We aimed to assess whether mobile phone messaging that encouraged Lifestyle change could reduce incident type 2 diabetes in Indian Asian men with impaired glucose tolerance. Methods We did a prospective, parallel-group, randomised controlled trial between Aug 10, 2009, and Nov 30, 2012, at ten sites in southeast India. Working Indian men (aged 35–55 years) with impaired glucose tolerance were randomly assigned (1:1) with a computer-generated randomisation sequence to a mobile phone messaging intervention or standard care (control group). Participants in the intervention group received frequent mobile phone messages compared with controls who received standard Lifestyle Modification advice at baseline only. Field staff and participants were, by necessity, not masked to study group assignment, but allocation was concealed from laboratory personnel as well as principal and co-investigators. The primary outcome was incidence of type 2 diabetes, analysed by intention to treat. This trial is registered with ClinicalTrials.gov, number NCT00819455. Results We assessed 8741 participants for eligibility. 537 patients were randomly assigned to either the mobile phone messaging intervention (n=271) or standard care (n=266). The cumulative incidence of type 2 diabetes was lower in those who received mobile phone messages than in controls: 50 (18%) participants in the intervention group developed type 2 diabetes compared with 73 (27%) in the control group (hazard ratio 0·64, 95% CI 0·45–0·92; p=0·015). The number needed to treat to prevent one case of type 2 diabetes was 11 (95% CI 6–55). One patient in the control group died suddenly at the end of the first year. We recorded no other serious adverse events. Interpretation Mobile phone messaging is an effective and acceptable method to deliver advice and support towards Lifestyle Modification to prevent type 2 diabetes in men at high risk. Funding The UK India Education and Research Initiative, the World Diabetes Foundation.
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pioglitazone does not enhance the effectiveness of Lifestyle Modification in preventing conversion of impaired glucose tolerance to diabetes in asian indians results of the indian diabetes prevention programme 2 idpp 2
Diabetologia, 2009Co-Authors: Anup Ramachandran, C Snehalatha, Simon Mary, Sundaram Selvam, C K S Kumar, A C Seeli, A S ShettyAbstract:The objective of this prevention programme was to study whether combining pioglitazone with Lifestyle Modification would enhance the efficacy of Lifestyle Modification in preventing type 2 diabetes in Asian Indians with impaired glucose tolerance. In a community-based, placebo-controlled 3 year prospective study, 407 participants with impaired glucose tolerance (mean age 45.3 ± 6.2 years, mean BMI 25.9 ± 3.3 kg/m2) were sequentially grouped to receive either: Lifestyle Modification plus pioglitazone, 30 mg (n = 204) or Lifestyle Modification plus placebo (n = 203). The participants and investigators were blinded to the assignment. The primary outcome was development of diabetes. At baseline, both groups had similar demographic, anthropometric and biochemical characteristics. At year 3, the response rate was 90.2%. The cumulative incidence of diabetes was 29.8% with pioglitazone and 31.6% with placebo (unadjusted HR 1.084 [95% CI 0.753–1.560], p = 0.665). Normoglycaemia was achieved in 40.9% and 32.3% of participants receiving pioglitazone and placebo, respectively (p = 0.109). In pioglitazone group, two deaths and two non-fatal hospitalisations occurred due to cardiac problems; in the placebo group there were two occurrences of cardiac disease. Despite good adherence to Lifestyle Modification and drug therapy, no additional effect of pioglitazone was seen above that achieved with placebo. The effectiveness of the intervention in both groups was comparable with that of Lifestyle Modification alone, as reported from the Indian Diabetes Prevention Programme-1. The results are at variance with studies that showed significant relative risk reduction in conversion to diabetes with pioglitazone in Americans with IGT. An ethnicity-related difference in the action of pioglitazone in non-diabetic participants may be one explanation. Trial registration: ClinicalTrials.gov NCT00276497 Funding: This study was funded by the India Diabetes Research Foundation
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the indian diabetes prevention programme shows that Lifestyle Modification and metformin prevent type 2 diabetes in asian indian subjects with impaired glucose tolerance idpp 1
Diabetologia, 2006Co-Authors: Anup Ramachandran, C Snehalatha, Simon Mary, B Mukesh, A D Bhaskar, V VijayAbstract:Lifestyle Modification helps in the primary prevention of diabetes in multiethnic American, Finnish and Chinese populations. In a prospective community-based study, we tested whether the progression to diabetes could be influenced by interventions in native Asian Indians with IGT who were younger, leaner and more insulin resistant than the above populations. We randomised 531 (421 men 110 women) subjects with IGT (mean age 45.9±5.7 years, BMI 25.8±3.5 kg/m2) into four groups. Group 1 was the control, Group 2 was given advice on Lifestyle Modification (LSM), Group 3 was treated with metformin (MET) and Group 4 was given LSM plus MET. The primary outcome measure was type 2 diabetes as diagnosed using World Health Organization criteria. The median follow-up period was 30 months, and the 3-year cumulative incidences of diabetes were 55.0%, 39.3%, 40.5% and 39.5% in Groups 1–4, respectively. The relative risk reduction was 28.5% with LSM (95% CI 20.5–37.3, p=0.018), 26.4% with MET (95% CI 19.1–35.1, p=0.029) and 28.2% with LSM + MET (95% CI 20.3–37.0, p=0.022), as compared with the control group. The number needed to treat to prevent one incident case of diabetes was 6.4 for LSM, 6.9 for MET and 6.5 for LSM + MET. Progression of IGT to diabetes is high in native Asian Indians. Both LSM and MET significantly reduced the incidence of diabetes in Asian Indians with IGT; there was no added benefit from combining them.
