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Previous issue date: 2015-03-31 / Purpose: The aim was to verify the effects of different interventions for lifestyle
modifications on the number of diagnosis criteria and clinical aspects involved in
Metabolic Syndrome (MS).
Methods: A randomized controlled clinical trial including 125 individuals from 30 to 59
years old with MS was conducted in the Rehabilitation Center of PUCRS. Individuals
were randomized into three intervention groups: Standard Intervention (SI) ? nonpharmalogical
intervention recommended by the guidelines for clinical management of
MS, considered the control group in this trial; Group Intervention (GI) ? group lifestyle
change implemented weekly by a multidisciplinary team; Individual Intervention (II) ?
outpatient care through weekly individual consultations performed by a multidisciplinary
team. The outcomes studied include the modification of the number of diagnosis criteria
for MS and other clinical parameters such as cardiovascular risk score, Castelli Index
(CI) and insulin resistance index HOMA-IR. Each group was assessed at the beginning
and at the end of the interventions (three months).
Results: Seventy-two individuals concluded the intervention, among them: SI: 19, GI:
25, and II: 28. Groups GI and II presented significant decrease of body mass index, waist
circumference, and systolic arterial pressure after three months. The number of
diagnosis criteria for MS decreased significantly ? 40% of the individuals did not meet the
criteria for the clinical condition studied at the end of the intervention. The largest
reduction occurred within group II, where 52% of the individuals presented less than
three criteria. Regarding CI and HOMA-IR, both variables were significantly reduced (p <
0.05) in groups GI and II.
Conclusion: The interventions proposed by this study reinforce that nonpharmacological
strategies for changing lifestyle impact the reduction of cardiovascular
risk factors involved in MS. They are also able to remove the population from this clinical
condition by decreasing diagnosis criteria. / Objetivos: O objetivo do estudo foi verificar o efeito de diferentes interven??es para
modifica??o do estilo de vida sobre o n?mero de crit?rios de diagn?stico e aspectos
cl?nicos envolvidos na S?ndrome Metab?lica (SM).
M?todos: Foi realizado um ensaio cl?nico randomizado controlado, o qual incluiu 125
indiv?duos de 30-59 anos com SM, conduzido no Centro de Reabilita??o da PUCRS. Os
indiv?duos foram randomizados em tr?s grupos de interven??o: Interven??o Padr?o (IP)
- interven??o n?o medicamentosa recomendada nas diretrizes para o manejo cl?nico
da SM, considerada nesse estudo grupo controle; Interven??o em Grupo (IG) - a
mudan?a do estilo de vida foi trabalhada semanalmente em grupo com equipe
multidisciplinar; Interven??o Individual (II) - atendimento ambulatorial com consultas
semanais individualizadas realizadas por equipe multidisciplinar. Os desfechos
estudados compreendem a modifica??o no n?mero de crit?rios para o diagn?stico da
SM e outros par?metros cl?nicos, como o escore de risco cardiovascular ?ndice de
Castelli (IC), e ?ndice de resist?ncia ? insulina HOMA-IR. Todos os grupos foram
avaliados no in?cio, ao final das interven??es (tr?s meses).
Resultados: Conclu?ram a interven??o 72 indiv?duos, sendo: IP: 19, IG: 25 e II: 28. O
grupo IG e II promoveram significativa redu??o do ?ndice de massa corporal,
circunfer?ncia abdominal, e press?o arterial sist?lica aos tr?s meses. O n?mero de
crit?rios para o diagn?stico da SM reduziu de forma significativa, 40% dos indiv?duos
n?o preenchiam mais o crit?rio para a condi??o cl?nica estudada ao final da interven??o.
A maior redu??o ocorreu no grupo II no qual 52% dos indiv?duos tinham menos de tr?s
crit?rios. Em rela??o ao IC e ao HOMA-IR ambas vari?veis reduziram de forma
significativa (p<0.05) nos grupos IG e II.
Conclus?o: As interven??es propostas neste estudo refor?am que estrat?gias n?o
farmacol?gicas de modifica??o do estilo de vida tem impacto na redu??o dos fatores de
risco cardiovasculares envolvidos na SM. Tais interven??es demonstraram ser capazes
de retirar a popula??o desta condi??o cl?nica por redu??o nos crit?rios de diagn?stico.
| Identifer | oai:union.ndltd.org:IBICT/oai:tede2.pucrs.br:tede/7402 |
| Date | 31 March 2015 |
| Creators | Piovesan, Carla Haas |
| Contributors | Bodanese, Luiz Carlos, Feoli, Ana Maria Pandolfo |
| Publisher | Pontif?cia Universidade Cat?lica do Rio Grande do Sul, Programa de P?s-Gradua??o em Medicina e Ci?ncias da Sa?de, PUCRS, Brasil, Escola de Medicina |
| Source Sets | IBICT Brazilian ETDs |
| Language | Portuguese |
| Detected Language | English |
| Type | info:eu-repo/semantics/publishedVersion, info:eu-repo/semantics/doctoralThesis |
| Format | application/pdf |
| Source | reponame:Biblioteca Digital de Teses e Dissertações da PUC_RS, instname:Pontifícia Universidade Católica do Rio Grande do Sul, instacron:PUC_RS |
| Rights | info:eu-repo/semantics/openAccess |
| Relation | 7620745074616285884, 600, 600, 600, -224747486637135387, -969369452308786627 |
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