MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Cambridge, UK.
Primary Care Unit, University of Cambridge School of Clinical Medicine, Cambridge, UK.
Diabetes Obes Metab. 2020 Nov;22(11):2069-2076. doi: 10.1111/dom.14123. Epub 2020 Jul 15.
To examine the impact of open-group behavioural weight-management programmes on the risk of diabetes among those with a body mass index (BMI) of ≥28 kg/m and those with non-diabetic hyperglycaemia (NDH).
This was a secondary analysis of data from the WRAP trial, in which participants (N = 1267; aged ≥18 years, BMI ≥ 28 kg/m ) were randomized to brief intervention (BI; self-help booklet), a weight-management programme (WW; formerly Weight Watchers) for 12 weeks, or WW for 52 weeks. We used multinomial logistic regression to examine the effect of intervention group on the risk of hyperglycaemia and diabetes at 12 months in all participants with glycaemic status at both time points (N = 480; 38%) and those with NDH at baseline (N = 387; 31%). We used mixed effects models and linear fixed effects models to examine the effect of intervention group on body weight and HbA1c at 12 months in people with NDH.
There was a 61% relative reduction in the risk of NDH at the 12-month follow-up (12 weeks vs. BI: relative risk ratio [RRR] = 0.39 [95% CI 0.18, 0.87], P = .021; 52 weeks vs. BI: RRR = 0.38 [95% CI 0.17, 0.86], P = .020). For intervention effects on the risk of diabetes, confidence intervals were wide and overlapped 1 [12 weeks vs. BI: RRR = 0.49 [95% CI 0.12, 1.96], P = .312; 52 weeks vs. BI: RRR = 0.40 [95% CI 0.10, 1.63], P = .199). Participants with hyperglycaemia at baseline in the weight-management programme were more probable to have normoglycaemia at the 12-month follow-up [12-week programme vs. BI: RRR = 3.57 [95% CI 1.24, 10.29], P = .019; 52-week programme vs. BI: RRR = 4.14 [95% CI 1.42, 12.12], P = .009).
Open-group behavioural weight-management programmes can help to prevent the development of NDH in people with overweight and obesity and to normalize glycaemia in people with NDH.
探讨开放式团体行为体重管理项目对身体质量指数（BMI）≥28kg/m²人群和非糖尿病高血糖（NDH）人群糖尿病风险的影响。
这是 WRAP 试验的二次分析，参与者（N=1267；年龄≥18 岁，BMI≥28kg/m²）被随机分配至简短干预（BI；自助手册）、12 周体重管理项目（WW；前身为 Weight Watchers）或 52 周 WW。我们使用多项逻辑回归检验了在所有具有血糖状态的参与者（n=480；38%）和基线时患有 NDH 的参与者（n=387；31%）在 12 个月时干预组对高血糖和糖尿病风险的影响。我们使用混合效应模型和线性固定效应模型检验了在患有 NDH 的人群中，干预组对体重和 HbA1c 的影响。
在 12 个月随访时，NDH 的风险降低了 61%（12 周 vs BI：相对风险比[RRR] = 0.39[95%CI 0.18, 0.87]，P=0.021；52 周 vs BI：RRR = 0.38[95%CI 0.17, 0.86]，P=0.020）。对于糖尿病风险的干预效果，置信区间较宽且相互重叠[12 周 vs BI：RRR = 0.49[95%CI 0.12, 1.96]，P=0.312；52 周 vs BI：RRR = 0.40[95%CI 0.10, 1.63]，P=0.199]。在体重管理项目中基线时患有高血糖的参与者在 12 个月随访时更有可能恢复正常血糖[12 周项目 vs BI：RRR = 3.57[95%CI 1.24, 10.29]，P=0.019；52 周项目 vs BI：RRR = 4.14[95%CI 1.42, 12.12]，P=0.009]。
开放式团体行为体重管理项目有助于预防超重和肥胖人群发生 NDH，并使 NDH 患者的血糖正常化。
