Suppr超能文献

二甲双胍或生活方式干预在糖尿病预防计划结果研究中的长期体重减轻效果。

Long-Term Weight Loss With Metformin or Lifestyle Intervention in the Diabetes Prevention Program Outcomes Study.

机构信息

Pennington Biomedical Research Center, Louisiana State University System, Baton Rouge, Louisiana (J.W.A., K.M.G.).

Western Psychiatric Institute and Clinic, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania (E.M.V.).

出版信息

Ann Intern Med. 2019 May 21;170(10):682-690. doi: 10.7326/M18-1605. Epub 2019 Apr 23.

Abstract

BACKGROUND

Identifying reliable predictors of long-term weight loss (LTWL) could lead to improved weight management.

OBJECTIVE

To identify some predictors of LTWL.

DESIGN

The DPP (Diabetes Prevention Program) was a randomized controlled trial that compared weight loss with metformin, intensive lifestyle intervention (ILS), or placebo. Its Outcomes Study (DPPOS) observed patients after the masked treatment phase ended. (ClinicalTrials.gov: NCT00004992 and NCT00038727).

SETTING

27 DPP and DPPOS clinics.

PARTICIPANTS

Of the 3234 randomly assigned participants, 1066 lost at least 5% of baseline weight in the first year and were followed for 15 years.

MEASUREMENTS

Treatment assignment, personal characteristics, and weight.

RESULTS

After 1 year, 289 (28.5%) participants in the metformin group, 640 (62.6%) in the ILS group, and 137 (13.4%) in the placebo group had lost at least 5% of their weight. After the masked treatment phase ended, the mean weight loss relative to baseline that was maintained between years 6 and 15 was 6.2% (95% CI, 5.2% to 7.2%) in the metformin group, 3.7% (CI, 3.1% to 4.4%) in the ILS group, and 2.8% (CI, 1.3% to 4.4%) in the placebo group. Independent predictors of LTWL included greater weight loss in the first year in all groups, older age and continued metformin use in the metformin group, older age and absence of either diabetes or a family history of diabetes in the ILS group, and higher fasting plasma glucose levels at baseline in the placebo group.

LIMITATION

Post hoc analysis; examination of nonrandomized subsets of randomized groups after year 1.

CONCLUSION

Among persons with weight loss of at least 5% after 1 year, those originally randomly assigned to metformin had the greatest loss during years 6 to 15. Older age and the amount of weight initially lost were the most consistent predictors of LTWL maintenance.

PRIMARY FUNDING SOURCE

National Institutes of Health.

摘要

背景

确定长期减重(LTWL)的可靠预测因素可能会改善体重管理。

目的

确定 LTWL 的一些预测因素。

设计

DPP(糖尿病预防计划)是一项随机对照试验,比较了减重与二甲双胍、强化生活方式干预(ILS)或安慰剂的效果。其结局研究(DPPOS)在掩蔽治疗阶段结束后观察患者。(ClinicalTrials.gov:NCT00004992 和 NCT00038727)。

地点

27 个 DPP 和 DPPOS 诊所。

参与者

在 3234 名随机分配的参与者中,有 1066 名在第一年至少减轻了基线体重的 5%,并随访了 15 年。

测量

治疗分配、个人特征和体重。

结果

在第一年,二甲双胍组有 289 名(28.5%)、ILS 组有 640 名(62.6%)和安慰剂组有 137 名(13.4%)参与者至少减轻了 5%的体重。掩蔽治疗阶段结束后,与基线相比,在第 6 年至第 15 年期间保持的平均体重减轻量,二甲双胍组为 6.2%(95%CI,5.2%至 7.2%),ILS 组为 3.7%(CI,3.1%至 4.4%),安慰剂组为 2.8%(CI,1.3%至 4.4%)。LTWL 的独立预测因素包括所有组中第一年更大的体重减轻量、二甲双胍组中年龄更大和持续使用二甲双胍、ILS 组中年龄更大和没有糖尿病或糖尿病家族史以及安慰剂组中基线时更高的空腹血糖水平。

局限性

事后分析;第 1 年后对随机分组的非随机子集进行检查。

结论

在第 1 年至少减轻 5%体重的人群中,最初随机分配到二甲双胍组的人在第 6 年至第 15 年期间体重减轻最多。年龄较大和最初体重减轻量是 LTWL 维持的最一致预测因素。

主要资金来源

美国国立卫生研究院。

相似文献

1
Long-Term Weight Loss With Metformin or Lifestyle Intervention in the Diabetes Prevention Program Outcomes Study.
Ann Intern Med. 2019 May 21;170(10):682-690. doi: 10.7326/M18-1605. Epub 2019 Apr 23.
2
10-year follow-up of diabetes incidence and weight loss in the Diabetes Prevention Program Outcomes Study.
Lancet. 2009 Nov 14;374(9702):1677-86. doi: 10.1016/S0140-6736(09)61457-4. Epub 2009 Oct 29.
3
Metformin for diabetes prevention: insights gained from the Diabetes Prevention Program/Diabetes Prevention Program Outcomes Study.
Diabetologia. 2017 Sep;60(9):1601-1611. doi: 10.1007/s00125-017-4361-9. Epub 2017 Aug 2.
5
Long-term effects of lifestyle and metformin interventions in DPP on bone density.
Osteoporos Int. 2021 Nov;32(11):2279-2287. doi: 10.1007/s00198-021-05989-1. Epub 2021 Jun 4.
7
Association of Intensive Lifestyle and Metformin Interventions With Frailty in the Diabetes Prevention Program Outcomes Study.
J Gerontol A Biol Sci Med Sci. 2021 Apr 30;76(5):929-936. doi: 10.1093/gerona/glaa295.
8
Effects of Long-term Metformin and Lifestyle Interventions on Cardiovascular Events in the Diabetes Prevention Program and Its Outcome Study.
Circulation. 2022 May 31;145(22):1632-1641. doi: 10.1161/CIRCULATIONAHA.121.056756. Epub 2022 May 23.
10
Impact of lifestyle intervention and metformin on health-related quality of life: the diabetes prevention program randomized trial.
J Gen Intern Med. 2012 Dec;27(12):1594-601. doi: 10.1007/s11606-012-2122-5. Epub 2012 Jun 13.

引用本文的文献

2
Immunometabolic Interactions in Obesity: Implications for Therapeutic Strategies.
Biomedicines. 2025 Jun 10;13(6):1429. doi: 10.3390/biomedicines13061429.
3
Weight Loss in Midlife, Chronic Disease Incidence, and All-Cause Mortality During Extended Follow-Up.
JAMA Netw Open. 2025 May 1;8(5):e2511825. doi: 10.1001/jamanetworkopen.2025.11825.
4
Mitochondria and the Repurposing of Diabetes Drugs for Off-Label Health Benefits.
Int J Mol Sci. 2025 Jan 3;26(1):364. doi: 10.3390/ijms26010364.
5
Diabetes and obesity: leveraging heterogeneity for precision medicine.
Eur Heart J. 2024 Dec 23;45(48):5146-5155. doi: 10.1093/eurheartj/ehae746.
6
Four-year follow-up of weight loss maintenance using electronic medical record data: The PROPEL trial.
Obes Sci Pract. 2024 Oct 19;10(5):e70017. doi: 10.1002/osp4.70017. eCollection 2024 Oct.
7
ASN Kidney Health Guidance on the Management of Obesity in Persons Living with Kidney Diseases.
J Am Soc Nephrol. 2024 Nov 1;35(11):1574-1588. doi: 10.1681/ASN.0000000512. Epub 2024 Sep 18.
8
Making the Most of to Curb the Diabetes Epidemic: Early Evidence of Success Delivering the Same Intervention to Latinas at Risk for and With Diabetes.
Clin Med Insights Endocrinol Diabetes. 2024 Sep 14;17:11795514241274696. doi: 10.1177/11795514241274696. eCollection 2024.
9
Long-Term Use of Metformin and Vitamin B12 Deficiency in Diabetes.
Curr Drug Saf. 2025;20(3):258-270. doi: 10.2174/0115748863308106240816044733.
10
Metabolic disorders in prediabetes: From mechanisms to therapeutic management.
World J Diabetes. 2024 Mar 15;15(3):361-377. doi: 10.4239/wjd.v15.i3.361.

本文引用的文献

1
8. Pharmacologic Approaches to Glycemic Treatment: .
Diabetes Care. 2018 Jan;41(Suppl 1):S73-S85. doi: 10.2337/dc18-S008.
2
Proportional Feedback Control of Energy Intake During Obesity Pharmacotherapy.
Obesity (Silver Spring). 2017 Dec;25(12):2088-2091. doi: 10.1002/oby.21978. Epub 2017 Oct 25.
3
Pharmacotherapy for Patients with Obesity.
Clin Chem. 2018 Jan;64(1):118-129. doi: 10.1373/clinchem.2017.272815. Epub 2017 Oct 20.
5
Fifty Years of Behavioral/Lifestyle Interventions for Overweight and Obesity: Where Have We Been and Where Are We Going?
Obesity (Silver Spring). 2017 Nov;25(11):1867-1875. doi: 10.1002/oby.21914. Epub 2017 Sep 25.
6
Patient predictors of weight loss following a behavioral weight management intervention among US Veterans with severe obesity.
Eat Weight Disord. 2018 Oct;23(5):587-595. doi: 10.1007/s40519-017-0425-6. Epub 2017 Aug 29.
7
The mechanisms of action of metformin.
Diabetologia. 2017 Sep;60(9):1577-1585. doi: 10.1007/s00125-017-4342-z. Epub 2017 Aug 3.
8
The effects of metformin on gut microbiota and the immune system as research frontiers.
Diabetologia. 2017 Sep;60(9):1662-1667. doi: 10.1007/s00125-017-4352-x. Epub 2017 Aug 2.

文献AI研究员

20分钟写一篇综述,助力文献阅读效率提升50倍。

立即体验

用中文搜PubMed

大模型驱动的PubMed中文搜索引擎

马上搜索

文档翻译

学术文献翻译模型,支持多种主流文档格式。

立即体验