Behaviour change, weight loss and remission of Type 2 diabetes: a community-based prospective cohort study
Behaviour change, weight loss and remission of Type 2 diabetes: a community-based prospective cohort study
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DOI：
10.1111/dme.14122
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发表时间：
2019-09-26
影响因子：
3.5
通讯作者：
Griffin, S. J.
中科院分区：
文献类型：
--
作者：
Dambha-Miller, H.;Day, A. J.;Griffin, S. J.
目的量化行为改变与2型糖尿病诊断后体重减轻之间的关系，以及5年随访时糖尿病缓解的可能性。方法我们从Add-Cambridge试验中对867名40-69岁的新诊断糖尿病患者进行前瞻性队列研究。参与者在2002至2006年间通过逐步筛查确定，并在基线和诊断后一年接受体重变化、体力活动(EPAQ2问卷)、饮食(血浆维生素C和自我报告)和饮酒(自我报告)的评估。糖尿病确诊5年后，用糖化血红蛋白(1c)检测病情缓解情况。我们构建了对数二项回归模型，以量化诊断后第一年和随后1-5年的行为变化和体重变化之间的关系，以及5年随访时的缓解。结果随访5年，257例(30%)患者糖尿病得到缓解。与保持相同体重的人相比，那些在确诊后第一年体重减轻=10%的人有显著更高的缓解可能性[风险比1.77(95%可信区间1.32至2.38；p=10%体重减轻也与缓解相关[风险比2.43(95%可信区间1.78至3.31)；疾病轨迹早期p=10%与5年缓解可能性翻一番]。这是在没有密集的生活方式干预或极端的卡路里限制的情况下实现的。应该更多地关注使人们在诊断出2型糖尿病后实现减肥。
Aim To quantify the association between behaviour change and weight loss after diagnosis of Type 2 diabetes, and the likelihood of remission of diabetes at 5-year follow-up. Method We conducted a prospective cohort study in 867 people with newly diagnosed diabetes aged 40-69 years from the ADDITION-Cambridge trial. Participants were identified via stepwise screening between 2002 and 2006, and underwent assessment of weight change, physical activity (EPAQ2 questionnaire), diet (plasma vitamin C and self-report), and alcohol consumption (self-report) at baseline and 1 year after diagnosis. Remission was examined at 5 years after diabetes diagnosis via HbA(1c) level. We constructed log binomial regression models to quantify the association between change in behaviour and weight over both the first year after diagnosis and the subsequent 1-5 years, as well as remission at 5-year follow-up. Results Diabetes remission was achieved in 257 participants (30%) at 5-year follow-up. Compared with people who maintained the same weight, those who achieved >= 10% weight loss in the first year after diagnosis had a significantly higher likelihood of remission [risk ratio 1.77 (95% CI 1.32 to 2.38; p= 10% weight loss was also associated with remission [risk ratio 2.43 (95% CI 1.78 to 3.31); p= 10% early in the disease trajectory was associated with a doubling of the likelihood of remission at 5 years. This was achieved without intensive lifestyle interventions or extreme calorie restrictions. Greater attention should be paid to enabling people to achieve weight loss following diagnosis of Type 2 diabetes.