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2型糖尿病高危个体中与体重减轻及糖耐量改善相关的生活方式干预成功的预测因素:芬兰糖尿病预防研究(FIN-D2D)项目

Predictors of success of a lifestyle intervention in relation to weight loss and improvement in glucose tolerance among individuals at high risk for type 2 diabetes: the FIN-D2D project.

作者信息

Rautio Nina, Jokelainen Jari, Saaristo Timo, Oksa Heikki, Keinänen-Kiukaanniemi Sirkka, Peltonen Markku, Vanhala Mauno, Korpi-Hyövälti Eeva, Moilanen Leena, Saltevo Juha, Niskanen Leo, Tuomilehto Jaakko, Uusitupa Matti

机构信息

Pirkanmaa Hospital District, Finland.

出版信息

J Prim Care Community Health. 2013 Jan;4(1):59-66. doi: 10.1177/2150131912444130. Epub 2012 May 14.

Abstract

AIM

The authors assessed the predictors of success of a lifestyle intervention (weight loss ≥ 5% and improved glucose tolerance) in individuals at high risk for type 2 diabetes in a 1-year follow-up in a primary health care setting.

METHODS

High-risk individuals for type 2 diabetes were identified by opportunistic screening in the implementation of the Finnish National Diabetes Prevention Program (FIN-D2D). All together, 3880 individuals participated in the 1-year follow-up. Sociodemographic characteristics, health status and behavior, family history of diabetes, clinical factors, and health care provider were considered possible predictors of lifestyle intervention success.

RESULTS

In sum, 19.3% of individuals lost at least 5% of weight, and 32.6% with abnormal glucose tolerance at baseline showed improvement in glucose tolerance. Abnormal glucose tolerance was the strongest predictor of weight loss and improvement in glucose tolerance. High attendance at lifestyle intervention visits, being outside of labor force, and high body mass index at baseline were also related to weight loss, and high education was related to improvement in glucose tolerance.

CONCLUSIONS

In "real-life settings," glucose tolerance status, number of intervention visits, employment status, education, and body mass index explained the success of lifestyle intervention. These factors may help in targeting interventions, although they may not be generalized to other cultural settings.

摘要

目的

作者在初级卫生保健机构进行的为期1年的随访中,评估了2型糖尿病高危个体生活方式干预成功(体重减轻≥5%且糖耐量改善)的预测因素。

方法

通过芬兰国家糖尿病预防计划(FIN-D2D)实施过程中的机会性筛查,确定2型糖尿病高危个体。共有3880名个体参与了1年的随访。社会人口学特征、健康状况与行为、糖尿病家族史、临床因素以及医疗服务提供者被视为生活方式干预成功的可能预测因素。

结果

总体而言,19.3%的个体体重减轻至少5%,基线时糖耐量异常的个体中有32.6%糖耐量得到改善。糖耐量异常是体重减轻和糖耐量改善的最强预测因素。生活方式干预就诊出勤率高、非劳动力状态以及基线时高体重指数也与体重减轻有关,而高学历与糖耐量改善有关。

结论

在“现实生活环境”中,糖耐量状态、干预就诊次数、就业状态、教育程度和体重指数解释了生活方式干预的成功。这些因素可能有助于确定干预目标,尽管它们可能不适用于其他文化背景。

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