Zhao Guixiang, Ford Earl S, Li Chaoyang, Mokdad Ali H
Division of Adult and Community Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
Cardiovasc Diabetol. 2009 Mar 6;8:13. doi: 10.1186/1475-2840-8-13.
Obesity is a major risk factor for development and progression of hypertension and diabetes, which often coexist in obese patients. Losing weight by means of energy restriction and physical activity has been effective in preventing and managing these diseases. However, weight control behaviors among overweight/obese adults with these conditions are poorly understood.
Using self-reported data from 143,386 overweight/obese participants (aged >or= 18 years) in the 2003 Behavioral Risk Factor Surveillance System, we examined the proportion of overweight/obese adults who tried to lose weight and their weight control strategies by hypertension and/or diabetes status.
Among all participants, 58% of those with hypertension, 60% of those with diabetes, and 72% of those with both diseases tried to lose weight, significantly higher than the 50% of those with neither condition (Bonferroni corrected P < 0.017 for all comparisons). The multivariate-adjusted odds ratio (AOR) for trying to lose weight was 1.11 (95% confidence interval [CI]: 1.05-1.17) in participants with hypertension, 1.02 (95% CI: 0.90-1.15) in participants with diabetes, and 1.18 (95% CI: 1.07-1.29) in participants with both diseases (participants with neither condition as the referent). Among 78,446 participants who tried to lose weight, 23% of those with hypertension only and 28% of those with both hypertension and diabetes reported adopting a low fat/low calorie (LF/LC) diet in controlling their weight, significantly higher than 19% of those with neither disease (Bonferroni corrected P < 0.017 for all comparisons). Participants with both diseases had a significantly lower percentage of adopting physical activity in controlling their weight than those with neither condition (6% versus 12%, P < 0.01). After multivariate adjustment, the AOR for adopting a LF/LC diet plus physical activity to lose weight was 1.46 (95% CI: 1.15-1.84) in participants with both diseases. The AOR for adopting a LF/LC diet only to lose weight was 1.72 (95% CI: 1.35-2.20) in participants with both diseases and was 1.21 (95% CI: 1.03-1.40) in participants with hypertension only.
The proportion of overweight/obese patients with diagnosed hypertension and/or diabetes who attempted to lose weight remains suboptimal and the weight control strategies varied significantly among these patients.
肥胖是高血压和糖尿病发生及进展的主要危险因素，这两种疾病在肥胖患者中常常并存。通过能量限制和体育活动来减轻体重，已被证明在预防和管理这些疾病方面有效。然而，对于患有这些疾病的超重/肥胖成年人的体重控制行为，我们了解甚少。
利用2003年行为危险因素监测系统中143386名超重/肥胖参与者（年龄≥18岁）的自我报告数据，我们根据高血压和/或糖尿病状况，研究了试图减肥的超重/肥胖成年人的比例及其体重控制策略。
在所有参与者中，患有高血压的参与者中有58%、患有糖尿病的参与者中有60%以及同时患有这两种疾病的参与者中有72%试图减肥，这一比例显著高于两种疾病都没有的参与者中的50%（所有比较经邦费罗尼校正后P<0.017）。患有高血压的参与者试图减肥的多变量调整比值比（AOR）为1.11（95%置信区间[CI]：1.05 - 1.17），患有糖尿病的参与者为1.02（95%CI：0.90 - 1.15），同时患有这两种疾病的参与者为1.18（95%CI：1.07 - 1.29）（以两种疾病都没有的参与者作为对照）。在78446名试图减肥的参与者中，仅患有高血压的参与者中有23%以及同时患有高血压和糖尿病的参与者中有28%报告在控制体重时采用了低脂/低热量（LF/LC）饮食，这一比例显著高于两种疾病都没有的参与者中的19%（所有比较经邦费罗尼校正后P<0.017）。同时患有这两种疾病的参与者在控制体重时采用体育活动的比例显著低于两种疾病都没有的参与者（6%对12%，P<0.01）。经过多变量调整后，同时患有这两种疾病的参与者采用LF/LC饮食加体育活动来减肥的AOR为1.46（95%CI：1.15 - 1.84）。仅采用LF/LC饮食来减肥的AOR，在同时患有这两种疾病的参与者中为1.72（95%CI：1.35 - 2.20），在仅患有高血压的参与者中为1.21（95%CI：1.03 - 1.40）。
已确诊患有高血压和/或糖尿病的超重/肥胖患者中试图减肥的比例仍然不理想，并且这些患者的体重控制策略差异很大。
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