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体重减轻 5%可改善肥胖男性的血压和血脂谱,并改善肥胖女性的血糖:一项为期四年的随访观察研究。

Body Weight Reduction of 5% Improved Blood Pressure and Lipid Profiles in Obese Men and Blood Glucose in Obese Women: A Four-Year Follow-up Observational Study.

机构信息

1 Department of Diabetology and Metabolism, Tokyo Women's Medical University School of Medicine, Tokyo, Japan.

2 Department of Internal Medicine, Yoyogi Hospital, Tokyo, Japan.

出版信息

Metab Syndr Relat Disord. 2019 Jun;17(5):250-258. doi: 10.1089/met.2018.0115. Epub 2019 Mar 6.

Abstract

Body weight reduction (BWR) of at least 3% in obese Japanese individuals through lifestyle interventions has improved the risk factors for cardiovascular disease (CVD). We aimed to assess the relation between body weight change (BWC) and CVD risk change and to identify lifestyle improvement related to BWR in obese Japanese individuals. Subjects were 2579 health checkup examinees without medicated diabetes, hypertension or dyslipidemia, and a body mass index ≥25 kg/m who completed lifestyle questionnaires in 2008 and 2012. The 4-year changes in fasting plasma glucose (FPG), glycated hemoglobin (HbA1c), lipids, and blood pressure (BP) levels were compared across the five groups based on the 4-year BWC, and presented as <-5%, -5% to -3%, -3% to -1%, -1% to 1%, and ≥1%. Multivariable logistic regression models were used to calculate odds ratios (ORs) and 95% confidence intervals (CI) for lifestyle improvement related to BWR. Comparing the groups to the reference group (BWC ranging from -1% to +1%), we observed that FPG and HbA1c levels were lower in women in the <-5% group; BP levels were also lower in the <-5% group; triglyceride levels had improved in the <-3% group, and low-density lipoprotein cholesterol levels in the <-5% group; high-density lipoprotein cholesterol levels had improved in men in the <-5% group. In men, the adjusted OR (95% CI) for BWR related to lifestyle improvement pertaining to "over 30 min exercise" was 2.6 (2.0-3.6). In women, the adjusted ORs for BWR related to "walking or physical activity," "drinking alcohol," and "drinking more than a glass of sake" were 1.7 (1.1-2.7), 1.9 (1.1-3.5), and 1.8 (1.1-3.0), respectively. A 5% BWR improved FPG and HbA1c levels in obese women, and BP and lipid levels in obese men. Improvements in exercise and alcohol consumption habits were associated with BWR in this population.

摘要

体重减轻(BWR)至少 3%的肥胖日本个体通过生活方式干预改善了心血管疾病(CVD)的风险因素。我们旨在评估体重变化(BWC)与 CVD 风险变化之间的关系,并确定与肥胖日本个体的 BWR 相关的生活方式改善。研究对象为 2579 名健康体检受检者,他们没有服用糖尿病、高血压或血脂异常药物,且体质指数≥25kg/m,他们在 2008 年和 2012 年完成了生活方式问卷。根据 4 年 BWC,比较了五个组别的空腹血糖(FPG)、糖化血红蛋白(HbA1c)、血脂和血压(BP)水平的 4 年变化,并表示为<-5%、-5%至-3%、-3%至-1%、-1%至 1%和≥1%。使用多变量逻辑回归模型计算与 BWR 相关的生活方式改善的比值比(OR)和 95%置信区间(CI)。将各组与参考组(BWC 范围在-1%至+1%之间)进行比较,我们发现<-5%组的女性 FPG 和 HbA1c 水平较低;<-5%组的 BP 水平也较低;-3%组的甘油三酯水平得到改善,-5%组的低密度脂蛋白胆固醇水平得到改善;-5%组的男性高密度脂蛋白胆固醇水平得到改善。在男性中,与“超过 30 分钟运动”相关的 BWR 相关的生活方式改善的调整 OR(95%CI)为 2.6(2.0-3.6)。在女性中,与 BWR 相关的“散步或体育活动”、“饮酒”和“饮酒超过一杯清酒”的调整 OR 分别为 1.7(1.1-2.7)、1.9(1.1-3.5)和 1.8(1.1-3.0)。体重减轻 5%可改善肥胖女性的 FPG 和 HbA1c 水平,以及肥胖男性的 BP 和血脂水平。该人群中运动和饮酒习惯的改善与 BWR 相关。

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