Ulm University, Institute of General Medicine, Ulm, Germany; Beuth University of Applied Sciences, Institute for Distance Learning, Berlin, Germany; Ulm University of Applied Sciences, Department of Computer Science, Ulm, Germany; Ulm University, Institute of Medical Systems Biology, Ulm, Germany.
Dtsch Arztebl Int. 2018 Jul 23;115(29-30):487-493. doi: 10.3238/arztebl.2018.0487.
Abdominal obesity, an accumulation of fat in the abdominal region, is a risk factor for several non-communicable diseases. This review aims to identify non-surgical treatment options for abdominal obesity in adults. Interventions with behavioral, dietary, physical activity, or pharmaceutical components were compared to control conditions.
A systematic literature research for randomized controlled trials was conducted in Medline, Embase, and the Cochrane Central Register of Controlled Trials according to a prespecified and registered protocol (PROSPERO CRD42017057898).
Out of 2954 articles, 15 studies with 2918 participants remained after applying inclusion and exclusion criteria. Altogether the programs achieved a -2.65cm (95% confidence interval (CI) [-3.77, -1.53]) reduction in waist circumference (WC), as a measure of abdominal obesity. Eight behavioral interventions reduced WC by -1.88cm (95% CI [-2.55, -1.22]), and six combined interventions with behavioral plus dietary and/or physical activity components by -4.11cm (95% CI [-6.17, -2.05]). The only pharmaceutical trial did not find any effect on WC.
Overall, the identified interventions showed a moderate effect on WC. One reason may be that in most studies WC was a secondary outcome parameter, while only a small number of interventions primarily targeted abdominal obesity. Further research regarding the treatment of abdominal obesity is urgently needed.
腹部肥胖是腹部脂肪堆积，是多种非传染性疾病的危险因素。本综述旨在确定成人腹部肥胖的非手术治疗方法。将具有行为、饮食、身体活动或药物成分的干预措施与对照条件进行比较。
根据预先规定和注册的方案（PROSPERO CRD42017057898），在 Medline、Embase 和 Cochrane 中央对照试验注册库中进行了随机对照试验的系统文献检索。
在 2954 篇文章中，经过纳入和排除标准后，有 15 项研究共 2918 名参与者符合条件。所有方案的腰围（WC）均减少了 -2.65cm（95%置信区间（CI）[-3.77，-1.53]），作为腹部肥胖的衡量标准。8 项行为干预措施使 WC 减少了 -1.88cm（95% CI [-2.55，-1.22]），而 6 项结合了行为加饮食和/或身体活动成分的综合干预措施则使 WC 减少了 -4.11cm（95% CI [-6.17，-2.05]）。唯一的药物试验没有发现 WC 有任何影响。
总的来说，所确定的干预措施对 WC 有中度影响。一个原因可能是在大多数研究中，WC 是次要的结果参数，而只有少数干预措施主要针对腹部肥胖。迫切需要进一步研究腹部肥胖的治疗方法。
