Morales Knashawn H, Kumanyika Shiriki K, Fassbender Jennifer E, Good Jerene, Localio A Russell, Wadden Thomas A
Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA.
Obesity (Silver Spring). 2014 Dec;22(12):2632-40. doi: 10.1002/oby.20904. Epub 2014 Sep 24.
Differentiating trajectories of weight change and identifying associated baseline predictors can provide insights for improving behavioral obesity treatment outcomes.
Secondary, observational analyses using growth mixture models were conducted in pooled data for 604 black American, primarily female adults in three completed clinical trials. Covariates of identified patterns were evaluated.
The best fitting model identified three patterns over 2 years: 1) mean weight loss of approximately 2 kg (n = 519); 2) mean weight loss of approximately 3 kg at 1 year, followed by ∼4 kg regain (n = 61); and 3) mean weight loss of ∼20 kg at 1 year followed by ∼4 kg regain (n = 24, with 23 from one study). In final multivariate analyses, higher BMI predicted having pattern 2 (OR [95% CI]) 1.10 [1.03, 1.17]) or 3 (OR [95% CI] 1.42 [1.25, 1.63]), and higher dietary fat score was predictive of a lower odds of having patterns 2 (OR [95% CI] 0.37[0.15, 0.94]) or 3 (OR [95% CI] 0.23 [0.07, 0.79]).
Findings were consistent with moderate, clinically non-significant weight loss as the predominant pattern across all studies. Results underscore the need to develop novel and more carefully targeted and tailored approaches to facilitating weight loss in black American adults.
区分体重变化轨迹并确定相关的基线预测因素可为改善肥胖行为治疗结果提供见解。
在三项已完成的临床试验中,对604名主要为成年女性的美国黑人的汇总数据进行了二次观察分析,使用生长混合模型。评估已识别模式的协变量。
最佳拟合模型在2年内识别出三种模式:1)平均体重减轻约2千克(n = 519);2)1年时平均体重减轻约3千克,随后体重反弹约4千克(n = 61);3)1年时平均体重减轻约20千克,随后体重反弹约4千克(n = 24,其中23例来自一项研究)。在最终的多变量分析中,较高的BMI预测具有模式2(比值比[95%置信区间])1.10 [1.03, 1.17])或模式3(比值比[95%置信区间] 1.42 [1.25, 1.63]),较高的膳食脂肪评分预测具有模式2(比值比[95%置信区间] 0.37[0.15, 0.94])或模式3(比值比[95%置信区间] 0.23 [0.07, 0.79])的几率较低。
研究结果与适度的、临床无显著意义的体重减轻作为所有研究中的主要模式一致。结果强调需要开发新颖的、更有针对性和量身定制的方法来促进美国成年黑人的体重减轻。