National Institute of Public Health, University of Southern Denmark, 1455 Copenhagen, Denmark.
Competence Network for IBD, 24103 Kiel, Germany.
Nutrients. 2024 Sep 23;16(18):3220. doi: 10.3390/nu16183220.
This study investigated potential subgroups of children within the Kiel Obesity Prevention Study (KOPS) for differing treatment effects for the outcome measures of overweight or obesity at 4 years. The KOPS study delivered a multicomponent school intervention to cohorts of children in Kiel but found no overall effect on the weight status outcome. However, KOPS authors suggested there may be subgroup variations in treatment effect. Data were collected as part of the KOPS for samples of 6-year-olds between 1996 and 2001, with 4-year follow-up measurements between 2000 and 2004.
The present study conducted a post hoc subgroup analysis of the odds of obesity or overweight at 4-year follow-up compared to normal weight ( = 1646). A generalized linear mixed-effects model, including a treatment-subgroup interaction term, was used to estimate subgroups as a moderator of the treatment effects on the outcomes of obesity or overweight at 4-year follow-up.
The findings indicated several subgroup-treatment interaction effects relating to physical activity indicators. TV or PC not being one of a child's top 3 activities at baseline was associated with a significantly decreased odds ratio of obesity at 4 years in the intervention group (OR, 0.04; 95% CI, 0.004 to 0.45) compared to the non-intervention group (OR, 0.96; 95% CI, 0.29 to 3.14), = 0.02. Weekly activity in a sports club at baseline was associated with a decreased odds ratio of overweight at 4 years in the intervention group (OR, 0.38; 95% CI, 0.16 to 0.85) compared to the non-intervention group (OR, 0.91; 95% CI, 0.70 to 1.17). This was a significant difference ( = 0.04).
These findings suggest that children's baseline physical activity may impact treatment effects on the outcomes of overweight and obesity, creating opportunities to increase the effectiveness of interventions on preventing obesity.
本研究旨在为基尔肥胖预防研究（KOPS）中的儿童群体进行潜在亚组分析，以研究不同亚组对肥胖或超重结局的治疗效果，随访时间为 4 年。KOPS 研究对基尔的儿童队列实施了一项多组分的学校干预，但未发现该措施对体重状况结局的总体影响。然而，KOPS 研究作者认为，治疗效果可能存在亚组差异。本研究的数据来自于 1996 年至 2001 年间 6 岁儿童的 KOPS 样本，在 2000 年至 2004 年间进行了 4 年的随访测量。
本研究对 4 年随访时肥胖或超重与正常体重的比值（n = 1646）进行了事后亚组分析。采用广义线性混合效应模型，包括治疗-亚组交互项，来估计亚组作为治疗效果对 4 年随访时肥胖或超重结局的调节因素。
研究结果表明，一些与身体活动指标相关的亚组-治疗交互作用。在基线时，电视或电脑不是儿童前 3 大活动之一，与干预组肥胖的比值比显著降低（OR，0.04；95%CI，0.004 至 0.45）相比，非干预组（OR，0.96；95%CI，0.29 至 3.14），p = 0.02。在基线时每周参加运动俱乐部的活动与干预组 4 年时超重的比值比降低相关（OR，0.38；95%CI，0.16 至 0.85）相比，非干预组（OR，0.91；95%CI，0.70 至 1.17）。这是一个显著的差异（p = 0.04）。
这些发现表明，儿童的基线身体活动可能影响治疗效果超重和肥胖的结局，为提高干预措施预防肥胖的有效性提供了机会。
