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遵循结构化的减肥方案与慢性肾脏病肥胖患者的收缩压降低有关。

Compliance with a structured weight loss program is associated with reduced systolic blood pressure in obese patients with chronic kidney disease.

机构信息

Diabetes and Nutritional Sciences Division, King's College London, London, UK.

出版信息

Am J Hypertens. 2012 Sep;25(9):1024-9. doi: 10.1038/ajh.2012.80. Epub 2012 Jun 21.

Abstract

BACKGROUND

The effectiveness of lifestyle-based weight loss programs in obese patients with chronic disease has not been widely studied. This study examined the effectiveness of a weight management program (WMP), and sought to determine factors associated with successful weight loss in obese patients with chronic kidney disease (CKD).

METHODS

In this prospective cohort study, all patients with a body mass index (BMI) of >30 kg/m(2) referred to our clinic from January 2005 to December 2008 and who commenced a structured WMP of an energy-reduced renal diet, exercise, and pharmacotherapy were included in the analyses. Changes in body weight and associated variables up to 24 months were assessed with intention-to-treat mixed linear models and predictors of weight loss were identified with multiple linear regression.

RESULTS

One hundred and thirty-five patients (56% male), of mean age 52.2 years and BMI 36.4 kg/m(2) commenced the WMP. Significant weight loss was achieved for all patients at 6, 12, 18, and 24 months. Weight loss at 12 months was predicted by compliance and age, but not by baseline BMI, blood pressure (BP), stage of CKD or pharmacotherapy use. Greater compliance was associated with decreased systolic BP, with no change in mean antihypertensive medication dose.

CONCLUSIONS

Significant weight loss was achieved, demonstrating the effectiveness of the WMP, and compliance with a structured program improved weight loss and systolic BP.

摘要

背景

生活方式为基础的减肥计划在患有慢性病的肥胖患者中的有效性尚未得到广泛研究。本研究考察了体重管理计划(WMP)的有效性,并试图确定与慢性肾脏病(CKD)肥胖患者成功减肥相关的因素。

方法

在这项前瞻性队列研究中,我们纳入了 2005 年 1 月至 2008 年 12 月期间因 BMI >30kg/m² 而被转介至我们诊所的所有患者,并开始进行能量减少的肾脏饮食、运动和药物治疗的结构化 WMP。采用意向治疗混合线性模型评估体重变化和相关变量,采用多元线性回归确定体重减轻的预测因素。

结果

135 名(56%为男性)平均年龄为 52.2 岁、BMI 为 36.4kg/m²的患者开始了 WMP。所有患者在 6、12、18 和 24 个月时均取得显著的体重减轻。12 个月时的体重减轻与依从性和年龄相关,而与基线 BMI、血压(BP)、CKD 分期或药物治疗无关。更高的依从性与收缩压降低相关,而平均降压药物剂量没有变化。

结论

本研究取得了显著的体重减轻,证明了 WMP 的有效性,并且与结构化计划的依从性提高了体重减轻和收缩压。

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