在近期被诊断患有 2 型糖尿病的个体中，客观测量和自我报告的健康行为变化的预测因素：ADDITION-Plus 试验队列的纵向研究结果。
Predictors of change in objectively measured and self-reported health behaviours among individuals with recently diagnosed type 2 diabetes: longitudinal results from the ADDITION-Plus trial cohort.
机构信息
The Primary Care Unit, Cambridge Institute of Public Health, University of Cambridge, Robinson Way, Cambridge CB2 0SR, UK.
出版信息
Int J Behav Nutr Phys Act. 2013 Oct 23;10:118. doi: 10.1186/1479-5868-10-118.
BACKGROUND
There is limited evidence about predictors of health behaviour change in people with type 2 diabetes. The aim of this study was to assess change in health behaviours over one year and to identify predictors of behaviour change among adults with screen-detected and recently clinically diagnosed diabetes.
METHODS
ADDITION-Plus was a randomised controlled trial of a behaviour change intervention among 478 patients (40-69 years). Physical activity and diet were measured objectively (physical activity at 1 year) and by self-report at baseline and one year. Associations between baseline predictors and behaviour change were quantified using multivariable linear regression.
RESULTS
Participants increased their plasma vitamin C and fruit intake, reduced energy and fat intake from baseline to follow-up. Younger age, male sex, a smaller waist circumference, and a lower systolic blood pressure at baseline were associated with higher levels of objectively measured physical activity at one year. Greater increases in plasma vitamin C were observed in women (beta-coefficient [95% CI]: beta = -5.52 [-9.81, -1.22]) and in those with screen-detected diabetes (beta = 6.09 [1.74, 10.43]). Younger age predicted a greater reduction in fat (beta = -0.43 [-0.72, -0.13]) and energy intake (beta = -6.62 [-13.2, -0.05]). Patients with screen-detected diabetes (beta = 74.2 [27.92, 120.41]) reported a greater increase in fruit intake. There were no significant predictors of change in self-reported physical activity. Beliefs about behaviour change and diabetes did not predict behaviour change.
CONCLUSIONS
Older patients, men and those with a longer duration of diabetes may need more intensive support for dietary change. We recommend that future studies use objective measurement of health behaviours and that researchers add predictors beyond the individual level. Our results support a focus on establishing healthy lifestyle changes early in the diabetes disease trajectory.
背景
目前关于 2 型糖尿病患者健康行为改变的预测因素的证据有限。本研究旨在评估成年人在屏幕检测和最近临床诊断为糖尿病后一年的健康行为变化，并确定行为改变的预测因素。
方法
ADDITION-Plus 是一项针对行为改变干预的随机对照试验，共纳入 478 名患者（40-69 岁）。在基线和一年时，通过客观测量（一年时的体力活动）和自我报告来测量体力活动和饮食。使用多变量线性回归来量化基线预测因素与行为改变之间的关联。
结果
参与者的血浆维生素 C 和水果摄入量增加，从基线到随访时能量和脂肪摄入量减少。年龄较小、男性、腰围较小以及基线收缩压较低与一年时的体力活动水平较高有关。女性（β系数[95%CI]：β=-5.52[-9.81，-1.22]）和屏幕检测糖尿病患者（β=6.09[1.74，10.43]）的血浆维生素 C 增加幅度更大。年龄较小预测脂肪（β=-0.43[-0.72，-0.13]）和能量摄入（β=-6.62[-13.2，-0.05]）的降幅更大。屏幕检测糖尿病患者（β=74.2[27.92，120.41]）报告水果摄入量增加幅度更大。行为改变和糖尿病的信念并不能预测行为改变。
结论
较年长的患者、男性和糖尿病病程较长的患者可能需要更强化的饮食改变支持。我们建议未来的研究使用健康行为的客观测量，并在个体水平之外增加预测因素。我们的研究结果支持在糖尿病病程早期关注建立健康的生活方式改变。
Zotero 插件