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超重和肥胖患者减重干预对脂质参数的影响。

Effect on the lipid parameters of an intervention to reduce weight in overweight and obese patients.

作者信息

Tárraga Marcos M Loreto, Panisello Royo Josefa María, Carbayo Herencia Julio A, Rosich Domenech Nuria, Alins Presas Josep, Tárraga López Pedro J

机构信息

Residencia geriátrica Los Álamos, Albacete, España.

Medicina Interna, Fundación Fomento de la Salud (Fufosa), Barcelona, España.

出版信息

Clin Investig Arterioscler. 2017 May-Jun;29(3):103-110. doi: 10.1016/j.arteri.2017.01.002. Epub 2017 Mar 17.

Abstract

OBJECTIVE

To assess the effect on lipid parameters most associated with excess weight (triglycerides [TG], cholesterol, and high density lipoprotein [HDL-C]) of an intervention to reduce weight in overweight and obese patients.

METHODS

A randomised, controlled, double blind clinical trial, with three groups, and a follow-up of 12 months. Patients included in the study were randomised into three intervention groups: Obesity motivational intervention group with previously trained nurse (G1), lower intensity consultation, non-motivational group, with digital platform support (G2), and a third group that received a recommendation to lose weight and usual follow-up (G3). The anthropometric variables measured were height, weight, and abdominal/waist circumference, and laboratory results, total cholesterol, TG and HDL cholesterol).

RESULTS

The study include 176 patients, of whom 60 were randomised to G1, 61 to G2, and 59 to G3. All groups significantly decreased body weight at the end of the study, with a decrease in G1 (-5.6kg), followed by G2 (-4.3kg), and G3 (-1.7kg), with an overall mean loss of -3.9kg. There was a also significant decrease (P<.05) in total cholesterol and TG, and an increased HDL-C. These changes were more marked in the G1 group (the group that lost more weight). The clinical relevance indicators that were significant were: in the case of TG: G1/G3: relative risk: 1.42 (95% CI: 1.11-1.80); relative risk reduction: 41.7% (11.4-80.2); absolute risk reduction: 25% (9.2-40.8) and NNT: 5 (3-11). In the case of G1/G2 HDL-C: relative risk: 1.32 (1.07-1.63); relative risk reduction: 32.2% (7.4-62.6); absolute risk reduction: 21.1% (6.4-35.8) and NNT: 5 (3-16).

CONCLUSIONS

Weight reduction is accompanied by favorable changes in the lipid parameters related to overweight and obesity, being more intense the greater the weight loss.

摘要

目的

评估一项针对超重和肥胖患者的减重干预措施对与超重最相关的血脂参数(甘油三酯[TG]、胆固醇和高密度脂蛋白[HDL-C])的影响。

方法

一项随机、对照、双盲临床试验,分为三组,随访12个月。纳入研究的患者被随机分为三个干预组:由经过预先培训的护士进行的肥胖动机干预组(G1)、低强度咨询、无动机组且有数字平台支持(G2),以及第三组,该组接受减重建议并进行常规随访(G3)。测量的人体测量学变量包括身高、体重和腹/腰围,以及实验室检查结果,即总胆固醇、TG和HDL胆固醇)。

结果

该研究纳入176名患者,其中60名被随机分配至G1组,61名至G2组,59名至G3组。在研究结束时,所有组的体重均显著下降,G1组下降幅度为(-5.6kg),其次是G2组(-4.3kg),G3组(-1.7kg),总体平均减重-3.9kg。总胆固醇和TG也显著下降(P<0.05),HDL-C升高。这些变化在G1组(减重更多的组)中更为明显。具有显著意义的临床相关性指标为:在TG方面:G1/G3:相对风险:1.42(95%CI:1.11-1.80);相对风险降低:41.7%(11.4-80.2);绝对风险降低:25%(9.2-40.8),所需治疗人数(NNT):5(3-11)。在G1/G2 HDL-C方面:相对风险:1.32(1.07-1.63);相对风险降低:32.2%(7.4-62.6);绝对风险降低:21.1%(6.4-35.8),NNT:5(3-16)。

结论

体重减轻伴随着与超重和肥胖相关的血脂参数的有利变化,体重减轻越多变化越明显。

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