体重减轻 5%是预测 1 年内发生肥胖相关心血管疾病风险因素的重要指标，也是降低肥胖相关心血管疾病风险因素的 5 年最佳临界点：日本肥胖与代谢综合征研究。

Five percent weight loss is a significant 1-year predictor and an optimal 5-year cut-off for reducing the number of obesity-related cardiovascular disease risk components: the Japan Obesity and Metabolic Syndrome Study.

机构信息

Department of Endocrinology, Metabolism, and Hypertension Research, Clinical Research Institute, NHO Kyoto Medical Center, Kyoto, Japan.

Department of General Internal Medicine, Fushimi Momoyama General Hospital, Kyoto, Japan.

出版信息

Front Endocrinol (Lausanne). 2024 Mar 27;15:1343153. doi: 10.3389/fendo.2024.1343153. eCollection 2024.

DOI:10.3389/fendo.2024.1343153

PMID:38601201

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11005029/

Abstract

OBJECTIVE

This study aimed to identify the amount of weight loss needed in patients with obesity to improve metabolic syndrome (MetS), a risk factor for cardiovascular disease (CVD), over a long period of time.

METHODS

A total of 576 patients with obesity were enrolled in this study. Effects of continuous physician-supervised weight loss on the cumulative MetS components excluding abdominal circumference (defined as obesity-related CVD risk score) were investigated during a 5-year follow-up period. The extent of weight loss required to reduce the obesity-related CVD risk components was assessed using receiver operating characteristic (ROC) curve analyses.

RESULTS

Of the 576 participants, 266 completed 5-year follow-up, with 39.1% and 24.1% of them achieving ≥5.0% and ≥7.5% weight loss at the 5-year follow-up, respectively. The area under the ROC curve for reducing the obesity-related CVD risk components was 0.719 [0.662-0.777] at 1 year and 0.694 [0.613-0.775] at 5 years. The optimal cut-off value for weight loss was 5.0% (0.66 sensitivity and 0.69 specificity) and the value with 0.80 specificity was 7.5% (0.45 sensitivity) at 5 years. Greater reductions in weight were associated with greater improvements in the obesity-related CVD risk score at all follow-up periods (-trend <0.001). Obesity-related CVD risk score was significantly improved by 5.0-7.5% and ≥7.5% weight loss at 1 year ( = 0.029 and < 0.001, respectively) and ≥7.5% weight loss at 5 years ( = 0.034).

CONCLUSIONS

A weight loss of ≥5.0% at 1 year and ≥7.5% at 5 years could reduce the number of obesity-related CVD risk components in patients with obesity.

摘要

目的

本研究旨在确定肥胖患者需要减轻多少体重才能在长时间内改善代谢综合征（MetS），这是心血管疾病（CVD）的一个风险因素。

方法

共纳入 576 例肥胖患者。在 5 年随访期间，研究了持续接受医生监督的减肥对排除腹围的累积 MetS 成分（定义为肥胖相关 CVD 风险评分）的影响。使用受试者工作特征（ROC）曲线分析评估减轻肥胖相关 CVD 风险成分所需的减肥程度。

结果

在 576 名参与者中，有 266 名完成了 5 年随访，其中分别有 39.1%和 24.1%的人在 5 年随访时实现了≥5.0%和≥7.5%的体重减轻。ROC 曲线分析显示，1 年时降低肥胖相关 CVD 风险成分的曲线下面积为 0.719（0.662-0.777），5 年时为 0.694（0.613-0.775）。体重减轻的最佳截断值为 5.0%（0.66 灵敏度和 0.69 特异性），5 年时特异性为 0.80 的值为 7.5%（0.45 灵敏度）。在所有随访期间，体重减轻幅度越大，肥胖相关 CVD 风险评分的改善程度越大（趋势<0.001）。1 年时体重减轻 5.0%-7.5%和≥7.5%（=0.029 和<0.001）以及 5 年时体重减轻≥7.5%（=0.034）均可显著改善肥胖相关 CVD 风险评分。