Birch Laura, Perry Rachel, Hunt Linda P, Matson Rhys, Chong Amanda, Beynon Rhona, Shield Julian Ph
NIHR Bristol Biomedical Research Centre-Nutrition theme, Level 3 University Hospitals Bristol Education Centre, Bristol, UK.
University Hospitals Bristol NHS Foundation Trust, Level 6 University Hospitals Bristol Education Centre, Bristol, UK.
BMJ Open. 2019 Aug 30;9(8):e028231. doi: 10.1136/bmjopen-2018-028231.
Using meta-regression this paper sets out the minimum change in body mass index-SD score (BMI-SDS) required to improve adiposity as percentage body fat for children and adolescents with obesity.
Meta-regression.
Studies were identified as part of a large-scale systematic review of the following electronic databases: AMED, Embase, MEDLINE via OVID, Web of Science and CENTRAL via Cochrane library.
Individuals aged 4-19 years with a diagnosis of obesity according to defined BMI thresholds.
Studies of lifestyle treatment interventions that included dietary, physical activity and/or behavioural components with the objective of reducing obesity were included. Interventions of <2 weeks duration and those that involved surgical and/or pharmacological components (eg, bariatric surgery, drug therapy) were excluded.
To be included in the review, studies had to report baseline and post-intervention BMI-SDS or change measurements (primary outcome measures) plus one or more of the following markers of metabolic health (secondary outcome measures): adiposity measures other than BMI; blood pressure; glucose; inflammation; insulin sensitivity/resistance; lipid profile; liver function. This paper focuses on adiposity measures only. Further papers in this series will report on other outcome measures.
This paper explores the potential impact of BMI-SDS reduction in terms of change in percentage body fat. Thirty-nine studies reporting change in mean percentage body fat were analysed. Meta-regression demonstrated that reduction of at least 0.6 in mean BMI-SDS ensured a mean reduction of percentage body fat mass, in the sense that the associated 95% prediction interval for change in mean percentage body fat was wholly negative.
Interventions demonstrating reductions of 0.6 BMI-SDS might be termed successful in reducing adiposity, a key purpose of weight management interventions.
CRD42016025317.
本文采用meta回归分析，确定肥胖儿童和青少年的体重指数标准差评分（BMI-SDS）的最小变化，以改善体脂百分比。
meta回归分析。
这些研究是作为对以下电子数据库的大规模系统评价的一部分而确定的：医学文摘数据库（AMED）、Embase、通过OVID检索的MEDLINE、科学网（Web of Science）以及通过Cochrane图书馆检索的Cochrane系统评价数据库（CENTRAL）。
根据定义的BMI阈值诊断为肥胖的4至19岁个体。
纳入旨在减轻肥胖的生活方式治疗干预研究，包括饮食、体育活动和/或行为成分。持续时间少于2周的干预措施以及涉及手术和/或药物成分（如减肥手术、药物治疗）的干预措施被排除。
为纳入本综述，研究必须报告基线和干预后的BMI-SDS或变化测量值（主要结局指标），以及以下一种或多种代谢健康标志物（次要结局指标）：除BMI外的体脂测量值；血压；血糖；炎症；胰岛素敏感性/抵抗；血脂谱；肝功能。本文仅关注体脂测量值。本系列的其他论文将报告其他结局指标。
本文探讨了BMI-SDS降低对体脂百分比变化的潜在影响。分析了39项报告平均体脂百分比变化的研究。meta回归分析表明，平均BMI-SDS至少降低0.6可确保平均体脂质量降低，因为平均体脂百分比变化的相关95%预测区间完全为负。
BMI-SDS降低0.6的干预措施可被视为成功减轻肥胖，这是体重管理干预的一个关键目标。
CRD42016025317。
