沙特阿拉伯成人超重和肥胖管理临床实践指南。
The Saudi clinical practice guideline for the management of overweight and obesity in adults.
作者信息
Alfadda Assim A, Al-Dhwayan Madhawi M, Alharbi Abdulhameed A, Al Khudhair Basema K, Al Nozha Omar M, Al-Qahtani Nawal M, Alzahrani Saad H, Bardisi Wedad M, Sallam Reem M, Riva John J, Brożek Jan L, Schünemann Holger J, Moore Ainsley
机构信息
Obesity Research Center,College of Medicine, King Saud University, Riyadh, Kingdom of Saudi Arabia. E-mail.
出版信息
Saudi Med J. 2016 Oct;37(10):1151-62. doi: 10.15537/smj.2016.10.14353.
OBJECTIVE
To assist healthcare providers in evidence-based clinical decision-making for the management of overweight and obese adults in Saudi Arabia.
METHODS
The Ministry of Health, Riyadh, Kingdom of Saudi Arabia assembled an expert Saudi panel to produce this clinical practice guideline in 2015. In collaboration with the methodological working group from McMaster University, Hamilton, Canada, using the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) approach, which describes both the strength of recommendation and the quality of evidence
RESULTS
After identifying 11 questions, corresponding recommendations were agreed upon as guidance for the management of overweight and obese adults. These included strong recommendations in support of lifestyle interventions rather than usual care alone, individualized counseling interventions rather than generic educational pamphlets, physical activity rather than no physical activity, and physical activity in addition to diet rather than diet alone. Metformin and orlistat were suggested as conditional recommendations for the management of overweight and obesity in adults. Bariatric surgery was recommended, conditionally, for the management of obese adults (body mass index of ≥40 or ≥35 kg/m2 with comorbidities).
CONCLUSIONS
The current guideline includes recommendation for the non-pharmacological, pharmacological, and surgical management of overweight and obese adults. In addition, the panel recommends conducting research priorities regarding lifestyle interventions and economic analysis of drug therapy within the Saudi context, as well as long term benefits and harms of bariatric surgery.
目的
协助沙特阿拉伯的医疗服务提供者在对超重和肥胖成年人的管理中进行循证临床决策。
方法
沙特阿拉伯利雅得卫生部于2015年组建了一个沙特专家小组来制定本临床实践指南。与加拿大汉密尔顿麦克马斯特大学的方法学工作组合作，采用推荐分级、评估、制定与评价（GRADE）方法，该方法描述了推荐强度和证据质量。
结果
在确定了11个问题后，相应的建议被一致认可，作为超重和肥胖成年人管理的指导。这些建议包括强烈支持生活方式干预而非单纯常规护理、个性化咨询干预而非通用教育手册、体育活动而非不进行体育活动，以及除饮食外进行体育活动而非仅靠饮食。二甲双胍和奥利司他被建议作为成年人超重和肥胖管理的有条件推荐。对于肥胖成年人（体重指数≥40或≥35 kg/m²且伴有合并症），有条件地推荐进行减肥手术。
结论
当前指南包括对超重和肥胖成年人的非药物、药物和手术管理的建议。此外，专家小组建议在沙特背景下开展关于生活方式干预和药物治疗经济分析的研究重点，以及减肥手术的长期益处和危害。
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