Jalali-Farahani Sara, Amiri Parisa, Akbar Hasti Masihay, Cheraghi Leila, Karimi Mehrdad, Azizi Fereidoun
Research Center for Social Determinants of Health, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, P.O. Box: 19395-4763, Tehran, Iran.
Department of Epidemiology and Biostatistics, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Int J Behav Med. 2018 Feb;25(1):131-140. doi: 10.1007/s12529-017-9680-1.
This study aimed to determine effects of community-based healthy lifestyle education on the incidence of metabolic syndrome (MetS) in Tehranian children considering parental factors during a 13-year follow-up.
This study was conducted within the framework of the Tehran Lipid and Glucose Study (TLGS) on 1603 healthy children, aged 8-18 years, who had complete parental data. Parental factors including MetS, education, age, occupation, and smoking were considered to distinguish parental clusters which could potentially predispose children to MetS. Lifestyle interventions were aimed at achieving healthy dietary patterns and increasing physical activity. Cluster analysis and survival Cox model were used to determine potential low and high risk parental clusters and the effect of intervention on the hazard of MetS in children respectively.
In a model adjusted for children's age and sex, the hazard of the MetS incidence was 36% higher in children from high-risk parental cluster than those from low-risk parental cluster (HR = 1.36, 95% CI = 1.07-1.73). Moreover, the intervention group showed a 39% lower risk for MetS incidence (HR = 0.61, 95% CI = 0.44-0.85) compared to controls, during the first 6 years after baseline assessment (short term), although the risk lowering effect of the intervention was not maintained long term.
A healthy lifestyle education was successful in reducing the short-term risk of MetS in children. To identify ways of maintaining long-term results, further research is definitely warranted.
This study was funded by National Research Council and Planning and Management Organization and has been reviewed and approved by the Iranian registry of clinical trials (ISRCTN52588395).
本研究旨在确定在为期13年的随访中，考虑到父母因素，基于社区的健康生活方式教育对德黑兰儿童代谢综合征（MetS）发病率的影响。
本研究在德黑兰脂质与葡萄糖研究（TLGS）框架内，对1603名8至18岁、有完整父母数据的健康儿童进行。考虑父母因素，包括代谢综合征、教育程度、年龄、职业和吸烟情况，以区分可能使儿童易患代谢综合征的父母群体。生活方式干预旨在实现健康的饮食模式并增加身体活动。分别使用聚类分析和生存Cox模型来确定潜在的低风险和高风险父母群体以及干预对儿童代谢综合征发病风险的影响。
在根据儿童年龄和性别进行调整的模型中，来自高风险父母群体的儿童患代谢综合征的风险比来自低风险父母群体的儿童高36%（风险比=1.36，95%置信区间=1.07-1.73）。此外，在基线评估后的前6年（短期），干预组患代谢综合征的风险比对照组低39%（风险比=0.61，95%置信区间=0.44-0.85），尽管干预的风险降低效果未长期维持。
健康生活方式教育成功降低了儿童患代谢综合征的短期风险。为确定维持长期效果的方法，确实有必要进行进一步研究。
本研究由国家研究委员会及规划与管理组织资助，并已通过伊朗临床试验注册中心审查与批准（ISRCTN52588395）。
