带有体育锻炼的戒烟项目能改善久坐女性的心血管疾病生物标志物
2011/08/10
摘要
背景：目前，已经找到了一些对烟草暴露敏感的心血管疾病（CVD）生物标志物，但戒烟对这些生物标志物的影响尚不清楚。本试验旨在研究带有体育锻炼的戒烟项目对久坐女性CVD生物标志物的影响。
方法：本试验为队列研究，为2×2因素设计的随机对照试验（RCT）（锻炼环境：家庭或机构；锻炼咨询水平：仅基于运动处方或运动处方和主动咨询），研究时间从2004年1月至2007年12月。本试验于2010年10月进行分析。在大波士顿地区，130名久坐女性吸烟者完成为期15周的项目，年龄为19～55岁。所有参与者接受为期12周的尼古丁替代治疗（经皮贴剂）和短期咨询。同时，参与者接受中等强度的运动锻炼。所有运动干预持续15周（戒烟前3周至戒烟后12周）。主要检测结果有与戒烟或运动相关的CVD生物标志物，在基线状态和戒烟后12周检测。
结果：炎症（血白细胞）、血栓因子（红细胞）和心血管健康水平[最大氧耗（VO2max）]得到了改善，但与戒烟无关。这表明，即使未获得完全戒烟，烟草暴露下降和运动增加能改善心血管危险。仅在戒断者中观察到总胆固醇与高密度脂蛋白胆固醇(HDL-C)比例显著下降。所有参与者均出现心率下降，但戒断者下降更为显著。戒断者和复吸者中还观察到明显的体重增加和体重指数增加。此外，虽然糖化血红蛋白(HbA1c)增加，但仅在各组联合时才有显著性。
结论：带有体育锻炼的戒烟干预能选择性降低3个月内与烟草有关的心血管损伤。
（刘国梁 审校）
J Womens Health (Larchmt). 2011 Jun 15. [Epub ahead of print]
Smoking Cessation Program with Exercise Improves Cardiovascular Disease Biomarkers in Sedentary Women.
Korhonen T, Goodwin A, Miesmaa P, Dupuis EA, Kinnunen T.
Source
1 University of Helsinki , Department of Public Health, Helsinki, Finland .
Abstract
BACKGROUND: Several cardiovascular disease (CVD) biomarkers sensitive to tobacco exposure have been identified, but how tobacco use cessation impacts them is less clear. We sought to investigate the effects of a smoking cessation program with an exercise intervention on CVD biomarkers in sedentary women.
METHODS: This is a cohort study on a subsample of a 2×2 factorial randomized controlled trial (RCT) (exercise setting: home vs. facility; level of exercise counseling: prescription only vs. prescription and adherence counseling) conducted January 2004 through December 2007. The analyses were completed in October 2010. In the greater Boston area, 130 sedentary female smokers aged 19-55 completed a 15-week program. All participants received nicotine replacement therapy (transdermal patch) and brief behavioral counseling for 12 weeks. They all received an exercise prescription on a moderate intensity level. All exercise interventions lasted for 15 weeks, from 3 weeks precessation until 12 weeks postcessation. Main outcome measures were selected CVD biomarkers hypothesized to be affected by smoking cessation or exercise measured at baseline and 12 weeks postcessation.
RESULTS: Independent of tobacco abstinence, improvement was seen in inflammation (white blood cells [WBC]), prothrombotic factor (red blood cells [RBC]), and cardiovascular fitness level (maximum oxygen consumption [Vo(2)max]). This suggests that even if complete abstinence is not achieved, reduction in tobacco exposure and increase in exercise can improve the cardiovascular risk profile. A significant decrease was seen for total cholesterol and the total cholesterol high-density lipoprotein cholesterol (HDL-C): ratio only among the abstainers. The heart rate was reduced among all participants, but this decrease was more profound among abstainers. A significant weight gain and body mass index (BMI) increase were observed among abstainers and those who relapsed. We also found an increase in hemoglobin A1c (Hb A1c), although significant only when the groups were combined.
CONCLUSIONS:A smoking cessation intervention including exercise reduced tobacco-induced cardiovascular damage selectively within 3 months.
J Womens Health (Larchmt). 2011 Jun 15. [Epub ahead of print]
