Department of Nutrition, School of Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.
Obesity (Silver Spring). 2011 Oct;19(10):2063-8. doi: 10.1038/oby.2011.41. Epub 2011 Mar 10.
The objective of this study was to compare cardiovascular disease (CVD) risk factor levels in adults with a history of weight loss to levels in adults who did not lose weight, after both groups subsequently experienced an approximate 1-year interval of weight maintenance. Extant data from the Aerobics Center Longitudinal Study (ACLS) were used to identify 5,151 adults who were weight maintainers (maintained weight within ± 3.0% over two consecutive periods of ~1 year) or weight-loss maintainers (lost >3.0- <5.0% or ≥ 5.0% of body weight in the first interval and maintained that loss in the second interval). Mixed models regression was used to accommodate repeated measures and adjust for gender, age, smoking, cardiorespiratory fitness, decade of clinic visit, interval length, and BMI at the time of risk factor measurement. Coefficients from the model were used to calculate the adjusted risk factor levels in the three groups. Differences in total cholesterol (-3.8 mg/dl, 95% confidence interval: -5.5, -2.0), low-density lipoprotein (LDL) cholesterol (-3.0 mg/dl, confidence interval: -4.8, -1.1), triglycerides (-6.1 mg/dl, confidence interval: -10.6, -1.7) and diastolic blood pressure (-0.8 mg/dl, confidence interval: -1.4, -0.3) indicated that levels were slightly more favorable in the ≥ 5.0% weight-loss maintenance group than weight maintenance group. Levels were similar for glucose, high-density lipoprotein (HDL) cholesterol and systolic blood pressure. This work indicates that, when adjusted for covariates including current BMI, adults with a history of weight loss may have CVD risk factors to levels as good, or perhaps even better than, those observed in adults who maintain their weight.
本研究旨在比较有减重史的成年人与体重未减轻的成年人的心血管疾病(CVD)风险因素水平,两组人群在经历了大约 1 年的体重维持期后,其体重均维持在±3.0%的范围内。利用有氧运动中心纵向研究(ACLS)的现有数据,确定了 5151 名体重维持者(连续两次约 1 年的时间内体重维持在±3.0%的范围内)或体重减轻维持者(首次间隔期体重减轻>3.0-<5.0%或≥5.0%,且在第二次间隔期维持了该体重减轻量)。采用混合模型回归来适应重复测量,并根据性别、年龄、吸烟、心肺适应能力、就诊的十年期、间隔时间和危险因素测量时的 BMI 进行调整。模型的系数用于计算三组的调整后风险因素水平。总胆固醇(-3.8mg/dl,95%置信区间:-5.5,-2.0)、低密度脂蛋白胆固醇(-3.0mg/dl,置信区间:-4.8,-1.1)、甘油三酯(-6.1mg/dl,置信区间:-10.6,-1.7)和舒张压(-0.8mg/dl,置信区间:-1.4,-0.3)的差异表明,≥5.0%体重减轻维持组的水平略优于体重维持组。血糖、高密度脂蛋白胆固醇和收缩压的水平相似。本研究表明,当调整包括当前 BMI 在内的协变量后,有减重史的成年人的 CVD 风险因素水平可能与那些体重维持者一样好,甚至更好。