Department of Internal Medicine, Mayo Clinic Rochester, Rochester, MN, USA.
Am Heart J. 2010 Nov;160(5):934-42. doi: 10.1016/j.ahj.2010.07.023.
Despite the association of central obesity with adverse outcomes, most patients with cardiovascular disease (CVD) are unable to successfully lose weight. We undertook this analysis to evaluate the effect of motivational factors, and clinical factors, including physician diagnosis of overweight, on weight loss in patients with CVD and central obesity in the United States.
We used data from the National Health and Nutrition Examination Survey 1999 to 2004. Waist circumference ≥ 102 cm in men and ≥ 88 cm in women were used to classify central obesity. We examined demographic, motivational and clinical determinants of attempted and successful weight loss using multivariable logistic regression. Successful weight loss was defined as ≥ 5% weight loss in the preceding year. There were 907 respondents with CVD and central obesity of which 78% were aware of their overweight status and 80% were desirous to weigh less. Despite this awareness and desire, only 49% of centrally obese adults had attempted weight loss in the last year. Only 62% (n = 584) reported that they had been informed that they were overweight by a physician. On multivariable analysis, physician diagnosis of overweight was a significant predictor of weight loss attempts (OR 2.42, 95% CI 1.44-4.09, P = .006) and successful weight loss (OR 2.70, 95% CI 1.40-5.19, P = .001).
In a nationally representative sample of adults with CVD and central obesity, physician diagnosis of overweight status emerged as a significant predictor of attempted and successful weight loss.
尽管中心性肥胖与不良结局相关,但大多数心血管疾病(CVD)患者无法成功减重。我们进行此项分析旨在评估激励因素和临床因素(包括医生对超重的诊断)对美国 CVD 和中心性肥胖患者减重的影响。
我们使用了 1999 年至 2004 年全国健康和营养调查的数据。男性腰围≥102cm,女性腰围≥88cm 用于分类中心性肥胖。我们使用多变量逻辑回归检查了尝试和成功减重的人口统计学、激励和临床决定因素。成功减重定义为前一年体重减轻≥5%。共有 907 名患有 CVD 和中心性肥胖的受访者,其中 78%意识到自己超重,80%希望体重减轻。尽管有这种意识和愿望,但只有 49%的中心性肥胖成年人在过去一年中尝试过减肥。只有 62%(n=584)报告说他们曾被医生告知超重。在多变量分析中,医生对超重的诊断是减重尝试的一个显著预测因素(OR 2.42,95%CI 1.44-4.09,P=0.006)和成功的减重(OR 2.70,95%CI 1.40-5.19,P=0.001)。
在一个具有 CVD 和中心性肥胖的代表性全国性成年人样本中,医生对超重状况的诊断是减重尝试和成功的一个显著预测因素。