Michaud Tzeyu L, Almeida Fabio A, Porter Gwenndolyn C, Kittel Carol A, Schwab Robert J, Brito Fabiana A, Wilson Kathryn E, Katula Jeffrey A, Castro Sweet Cynthia, Estabrooks Paul A, Dressler Emily V
Department of Health Promotion, University of Nebraska Medical Center, Omaha, NE, USA; Center for Reducing Health Disparities, University of Nebraska Medical Center, Omaha, NE, USA.
Department of Health Promotion, University of Nebraska Medical Center, Omaha, NE, USA.
Prim Care Diabetes. 2023 Apr;17(2):148-154. doi: 10.1016/j.pcd.2023.01.007. Epub 2023 Jan 23.
To examine changes in cardiovascular disease (CVD) risk outcomes of overweight/obese adults with prediabetes.
Using data from a randomized control trial of digital diabetes prevention program (d-DPP) with 599 participants. We applied the atherosclerotic CVD (ASCVD) risk calculator to predict 10-year CVD risk for d-DPP and small education (comparison) groups. Between-group risk changes at 4 and 12 months were compared using a repeated measures linear mixed-effect model. We examined within-group differences in proportion of participants over time for specific CVD risk factors using generalized estimating equations.
We found no differences between baseline 10-year ASCVD risk. Relative to the comparison group, the d-DPP group experienced greater reductions in predicted 10-year ASCVD risk at each follow-up visit and a significant group difference at 4 months (-0.96%; 95% confidence interval: -1.58%, -0.34%) (but not at 12 months). Additionally, we observed that the d-DPP group experienced a decreased proportion of individuals with hyperlipidemia (18% and 16% from baseline to 4 and 12 months), high-risk total cholesterol (8% from baseline to 12 months), and being insufficiently active (26% and 22% from baseline to 4 and 12 months at follow-up time points.
Our findings suggest that a digitally adapted DPP may promote the prevention of cardiometabolic disease among overweight/obese individuals with prediabetes. However, given the lack of maintenance of effect on ASCVD risk at 12 months, there may also be a need for additional interventions to sustain the effect detected at 4 months.
研究糖尿病前期超重/肥胖成年人的心血管疾病（CVD）风险结果变化。
使用一项数字糖尿病预防计划（d-DPP）随机对照试验中的599名参与者的数据。我们应用动脉粥样硬化性心血管疾病（ASCVD）风险计算器来预测d-DPP组和小教育（对照组）组的10年CVD风险。使用重复测量线性混合效应模型比较4个月和12个月时组间风险变化。我们使用广义估计方程研究特定CVD风险因素随时间变化的组内差异。
我们发现基线10年ASCVD风险之间没有差异。相对于对照组，d-DPP组在每次随访时预测的10年ASCVD风险降低幅度更大，在4个月时有显著的组间差异（-0.96%；95%置信区间：-1.58%，-0.34%）（但在12个月时没有）。此外，我们观察到d-DPP组血脂异常个体比例下降（从基线到4个月和12个月分别为18%和16%），高危总胆固醇比例下降（从基线到12个月为8%），以及活动不足个体比例下降（随访时间点从基线到4个月和12个月分别为26%和22%）。
我们的研究结果表明，数字化调整的DPP可能促进糖尿病前期超重/肥胖个体预防心脏代谢疾病。然而，鉴于12个月时对ASCVD风险的影响缺乏持续性，可能还需要额外的干预措施来维持在4个月时检测到的效果。
