University of Pennsylvania, Philadelphia, Pennsylvania, USA.
University of Pennsylvania School of Nursing, Philadelphia, Pennsylvania, USA.
Obesity (Silver Spring). 2019 Apr;27(4):581-590. doi: 10.1002/oby.22411.
This study examined end-of-trial health outcomes in participants in the Action for Health in Diabetes (Look AHEAD) trial who had bariatric surgery during the approximately 10-year randomized intervention.
Data were obtained from the Look AHEAD public access database of 4,901 individuals with type 2 diabetes and overweight/obesity who were assigned to intensive lifestyle intervention (ILI) or a diabetes support and education (DSE) control group. Changes in outcomes in participants who had bariatric surgery were compared with those in participants with BMI ≥ 30 kg/m who remained in the ILI and DSE groups.
A total of 99 DSE and 97 ILI participants had bariatric surgery. At randomization, these 196 participants were significantly younger and more likely to be female and to have higher BMI than the remaining ILI (N = 1,972) and DSE (N = 2,009) participants. At trial's end, surgically treated participants lost 19.3% of baseline weight, compared with 5.8% and 3.3% for the ILI and DSE groups, respectively, and were more likely to achieve partial or full remission of their diabetes.
The large, sustained improvements in weight and diabetes observed in this self-selected sample of surgically treated participants are consistent with results of multiple randomized trials.
本研究调查了行动研究糖尿病中的试验参与者(Look AHEAD)在大约 10 年的随机干预期间接受减肥手术的健康结局。
数据来自 Look AHEAD 公共访问数据库,该数据库包含 4901 名 2 型糖尿病和超重/肥胖患者,他们被分配到强化生活方式干预(ILI)或糖尿病支持和教育(DSE)对照组。比较接受减肥手术的参与者的结局变化与继续接受 ILI 和 DSE 组的 BMI≥30 kg/m2的参与者的结局变化。
共有 99 名 DSE 和 97 名 ILI 参与者接受了减肥手术。在随机分组时,这些 196 名参与者比剩余的 ILI(N=1972)和 DSE(N=2009)参与者更年轻,更可能是女性,BMI 更高。在试验结束时,手术治疗组的参与者体重减轻了 19.3%,而 ILI 和 DSE 组分别减轻了 5.8%和 3.3%,并且更有可能部分或完全缓解糖尿病。
在这个自我选择的手术治疗参与者样本中,观察到的体重和糖尿病的持续大幅度改善与多项随机试验的结果一致。