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肥胖且哮喘控制不佳人群的在线减重干预

An Online Weight Loss Intervention for People With Obesity and Poorly Controlled Asthma.

机构信息

Department of Medicine, Larner College of Medicine, University of Vermont, Burlington, Vt.

Department of Health Promotion Sciences, Mel and Enid Zuckerman College of Public Health, Tucson, Ariz; Asthma and Airway Disease Research Center, University of Arizona, Tucson, Ariz.

出版信息

J Allergy Clin Immunol Pract. 2022 Jun;10(6):1577-1586.e3. doi: 10.1016/j.jaip.2022.02.040. Epub 2022 Mar 15.

Abstract

BACKGROUND

Weight loss might improve asthma control in people with obesity. However, people with asthma might have particular challenges losing weight and the amount of weight loss needed to improve asthma control is not clear.

OBJECTIVES

To pilot-test an online weight loss intervention and to estimate the impact of weight loss on asthma control.

METHODS

We performed a 6-month, single-arm, futility trial of an online weight loss intervention at 2 centers. To reject the assumption of futility, 9 or more participants had to lose at least 5% of their body weight. We also assessed the association between weight loss (≥5%) and asthma outcomes.

RESULTS

Forty-three participants (85% women) started the weight loss intervention. The median and interquartile range for the body mass index was 40.3 kg/m (range 34.7-46.8 kg/m), and 14 (range 12-17 kg/m) for the Asthma Control Test score. At 6 months, 10 participants (23%; 95% CI 12%-39%) lost at least 5% of their initial weight. Weight loss of at least 5% was associated with a clinically and statistically significant improvements in their Asthma Control Test (median [interquartile range] increase of 3 [1 to 7]; P < .05), Marks Asthma Quality of Life Score (-9.5 [-18 to -3]; P = .008), and their general health-related quality of life score (RAND-36; improved by 9.4 [2.8 to 22.5]; P =.014).

CONCLUSIONS

An online weight loss intervention has the potential to meet U.S. Food and Drug Administration guidance for product evaluation (at least a 5% weight loss in 35% of people) for treating obesity, and is associated with a clinically significant improvement in asthma control, quality of life, and overall health-related quality of life.

摘要

背景

减肥可能会改善肥胖人群的哮喘控制。然而,哮喘患者可能在减肥方面面临特殊挑战,并且不清楚改善哮喘控制所需的减肥量。

目的

对在线减肥干预措施进行试点测试,并估计减肥对哮喘控制的影响。

方法

我们在 2 个中心进行了为期 6 个月的单臂、无效性试验,对在线减肥干预措施进行了测试。为了拒绝无效假设,必须有 9 名或更多参与者减轻至少 5%的体重。我们还评估了体重减轻(≥5%)与哮喘结果之间的关联。

结果

43 名参与者(85%为女性)开始了减肥干预措施。体重指数中位数和四分位距为 40.3kg/m(范围 34.7-46.8kg/m),哮喘控制测试评分中位数和四分位距为 14(范围 12-17kg/m)。6 个月时,10 名参与者(23%;95%CI 12%-39%)减轻了初始体重的至少 5%。体重减轻至少 5%与哮喘控制测试(中位数[四分位距]增加 3[1 至 7];P<0.05)、Marks 哮喘生活质量评分(-9.5[-18 至-3];P=0.008)和一般健康相关生活质量评分(RAND-36;提高 9.4[2.8 至 22.5];P=0.014)的显著临床和统计学改善相关。

结论

在线减肥干预措施有可能满足美国食品和药物管理局的产品评估指南(至少 35%的人减轻 5%的体重),用于治疗肥胖症,并与哮喘控制、生活质量和整体健康相关生活质量的显著临床改善相关。

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