Trief Paula M, Cibula Donald, Delahanty Linda M, Weinstock Ruth S
Department of Psychiatry and Behavioral Sciences, SUNY Upstate Medical University, New York, USA; Department of Medicine, SUNY Upstate Medical University, New York, USA.
Obesity (Silver Spring). 2014 Dec;22(12):2532-8. doi: 10.1002/oby.20916. Epub 2014 Sep 24.
To examine the relationships between elevated depression symptoms (EDS) or stress and weight loss in SHINE, a telephonic, primary-care based, translation of the Diabetes Prevention Program.
N = 257 adults with metabolic syndrome were randomized to individual (IC) or group (CC) phone participation. Weight, depression, anti-depressant use (ADMs), and stress (baseline, 6 months, 1 and 2 years) were assessed. Univariate analyses used linear and logistic regression, t tests for continuous variables and exact tests for categorical variables. Stratified analyses assessed modifiers of effects of depression/stress on weight loss.
Approximately 35% reported EDS, with no change over time. Approximately 28% of all participants used ADMs. Participants with EDS had lower mean % weight loss and a smaller % who achieved ≥5% weight loss. Participants with EDS were less likely to be "completers" (40.1% vs. 61.5%, P = 0.002), coached (48.0% vs. 60.7%, P = 0.049), or log diet/activity (19.4% vs. 42.7%, P < 0.001), behaviors related to weight loss. Results were similar for high stress. ADM use had no independent effect on weight loss.
Individuals with metabolic syndrome and EDS and/or high stress were less likely to lose significant weight. Pre-intervention depression and stress screening to intervene may improve weight loss.
在糖尿病预防计划的电话远程初级保健项目SHINE中，研究抑郁症状加重（EDS）或压力与体重减轻之间的关系。
将257名患有代谢综合征的成年人随机分为个人电话参与组（IC）或小组电话参与组（CC）。评估体重、抑郁、抗抑郁药使用情况（ADMs）和压力（基线、6个月、1年和2年）。单变量分析采用线性和逻辑回归，连续变量用t检验，分类变量用精确检验。分层分析评估抑郁/压力对体重减轻影响的调节因素。
约35%的人报告有EDS，且随时间无变化。所有参与者中约28%使用ADMs。患有EDS的参与者平均体重减轻百分比更低，且体重减轻≥5%的百分比更小。患有EDS的参与者更不可能成为“完成者”（40.1%对61.5%，P = 0.002）、接受指导（48.0%对60.7%，P = 0.049）或记录饮食/活动情况（19.4%对42.7%，P < 0.001），这些都是与体重减轻相关的行为。高压力情况的结果相似。ADM的使用对体重减轻没有独立影响。
患有代谢综合征且有EDS和/或高压力的个体体重显著减轻的可能性较小。干预前进行抑郁和压力筛查以进行干预可能会改善体重减轻情况。
