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天津妊娠糖尿病预防计划的一年体重减轻:一项随机临床试验。

One-year weight losses in the Tianjin Gestational Diabetes Mellitus Prevention Programme: A randomized clinical trial.

机构信息

Tianjin Women's and Children's Health Center, Tianjin, China.

Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University, New Orleans, Louisiana.

出版信息

Diabetes Obes Metab. 2018 May;20(5):1246-1255. doi: 10.1111/dom.13225. Epub 2018 Feb 15.

Abstract

AIMS

To report the weight loss findings after the first year of a lifestyle intervention trial among women with gestational diabetes mellitus (GDM).

METHODS

A total of 1180 women with GDM were randomly assigned (1:1) to receive a 4-year lifestyle intervention (intervention group, n = 586) or standard care (control group, n = 594) between August 2009 and July 2011. Major elements of the intervention included 6 face-to-face sessions with study dieticians and two telephone calls in the first year, and two individual sessions and two telephone calls in each subsequent year.

RESULTS

Among 79% of participants who completed the year 1 trial, mean weight loss was 0.82 kg (1.12% of initial weight) in the intervention group and 0.09 kg (0.03% of initial weight) in the control group (P = .001). In a prespecified subgroup analysis of people who completed the trial, weight loss was more pronounced in women who were overweight (body mass index ≥24 kg/m ) at baseline: mean weight loss 2.01 kg (2.87% of initial weight) in the intervention group and 0.44 kg (0.52% of initial weight) in the control group (P < .001). Compared with those in the control group, women in the intervention group had a greater decrease in waist circumference (1.76 cm vs 0.73 cm; P = .003) and body fat (0.50% vs 0.05% increase; P = .001).

CONCLUSION

The 1-year lifestyle intervention led to significant weight losses after delivery in women who had GDM, and the effect was more pronounced in women who were overweight at baseline.

摘要

目的

报告妊娠期糖尿病(GDM)女性生活方式干预试验第一年的体重减轻结果。

方法

共有 1180 名 GDM 女性被随机分配(1:1)接受为期 4 年的生活方式干预(干预组,n = 586)或标准护理(对照组,n = 594),时间为 2009 年 8 月至 2011 年 7 月。干预的主要内容包括第一年 6 次与研究营养师面对面交流和 2 次电话交流,随后每年各 2 次个人交流和 2 次电话交流。

结果

在完成第一年试验的 79%的参与者中,干预组的平均体重减轻为 0.82kg(初始体重的 1.12%),对照组为 0.09kg(初始体重的 0.03%)(P =.001)。在完成试验的人群的预设亚组分析中,基线时超重(体重指数≥24kg/m)的女性体重减轻更为明显:干预组平均体重减轻 2.01kg(初始体重的 2.87%),对照组为 0.44kg(初始体重的 0.52%)(P <.001)。与对照组相比,干预组女性腰围(1.76cm 比 0.73cm;P =.003)和体脂(0.50%比 0.05%增加;P =.001)减少更多。

结论

GDM 女性产后 1 年的生活方式干预导致体重显著减轻,基线时超重的女性效果更为明显。

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