Department of Clinical Research, Sun Yat-sen University Cancer Center, Guangzhou, China.
State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, China.
Obes Facts. 2021;14(1):108-120. doi: 10.1159/000512294. Epub 2020 Dec 22.
The impact of heterogeneity on gender difference for achieving clinically meaningful weight loss (cmWL) remains unclear. Here, we explored the potential gender differences in factors associated with cmWL.
A total of 60,668 participants with body mass index (BMI) ≥25 kg/m2 at study entry and available BMI values at follow-up were included in this study. cmWL was defined as a weight loss of ≥5% from the study entry to follow-up. The associations of social-demographic factors, personal history of chronic diseases, lifestyle behaviors, and history of BMI with cmWL were evaluated using logistic regression models.
During a median follow-up of 9.13 years, 26.6% of the participants had a cmWL (30.8% for females vs. 23.1% in males; p < 0.001). Participants with older age, obesity at study entry, being more physical activity compared to 10 years ago, being relapsed smokers or consistent current smokers, having a history of chronic diseases (i.e., diabetes, osteoporosis, and stroke), cancer diagnosis during the study period, and more than 10-year follow-up were more likely to achieve cmWL in both males and females (all p < 0.05). The new smoking quitters and participants with less active in physical activity compared to 10 years ago were less likely to achieve cmWL in both males and females (all p < 0.05). Specifically, males with a history of emphysema were more likely to reach cmWL, and for females, those being overweight at 20 years old and current drinkers were more likely to reach cmWL (p < 0.05). Sensitivity analyses demonstrated similar results.
Age, BMI status, physical activity, smoking status, family income, and health status were independent factors in males and females for weight management. However, further well-designed prospective studies are warranted to confirm our findings.
体重减轻达到临床意义（cmWL）的异质性对性别差异的影响尚不清楚。本研究旨在探讨与 cmWL 相关的因素中可能存在的性别差异。
共纳入 60668 名研究初诊 BMI（体重指数）≥25kg/m2且随访时 BMI 值可获取的参与者。cmWL 定义为从研究初诊到随访时体重减轻≥5%。采用 logistic 回归模型评估社会人口学因素、慢性病史、生活方式行为以及 BMI 史与 cmWL 的相关性。
中位随访 9.13 年期间，26.6%的参与者达到 cmWL（女性为 30.8%，男性为 23.1%；p＜0.001）。与男性相比，年龄较大、研究初诊时肥胖、与 10 年前相比体力活动更多、既往吸烟者或持续吸烟者、患有慢性疾病（即糖尿病、骨质疏松症和中风）、研究期间被诊断为癌症、随访时间超过 10 年的参与者更有可能实现 cmWL（均 p＜0.05）。与男性相比，新戒烟者和与 10 年前相比体力活动较少的参与者不太可能实现 cmWL（均 p＜0.05）。具体而言，男性中患有肺气肿者更有可能达到 cmWL，而对于女性，20 岁时超重且目前饮酒者更有可能达到 cmWL（p＜0.05）。敏感性分析得出了相似的结果。
年龄、BMI 状态、体力活动、吸烟状况、家庭收入和健康状况是男性和女性进行体重管理的独立因素。然而，需要进一步进行精心设计的前瞻性研究来证实我们的发现。
