Greater Improvement in Obesity Among Children With Prediabetes in a Clinical Weight Management Program.
Greater Improvement in Obesity Among Children With Prediabetes in a Clinical Weight Management Program.
复制标题
临床体重管理计划显着改善糖尿病前期儿童的肥胖状况。
DOI：
10.1089/chi.2022.0234
复制
发表时间：
2023
期刊：
影响因子：
--
通讯作者：
Rosas,LisaG
中科院分区：
文献类型：
--
作者：
Tester,JuneM;Xiao,Lan;Chau,CourtneyA;Tinajero-Deck,Lydia;Srinivasan,Shylaja;Rosas,LisaG
背景：在对肥胖进行医疗管理的个体中，有一系列的反应。这项纵向数据的回顾分析考虑了体重管理诊所中8-17岁儿童(8-17岁)中确诊的糖尿病前期与随后体重变化的关系。方法：分析包括733名超重和肥胖(但不包括糖尿病)的患者(2008-2016年共2687人次)，这些患者的转诊实验室在90天内包括糖化血红蛋白A1c(HbA1c)。混合效应模型检验了基线糖尿病前期(血清HbA1c 5.7%-6.4%)和BMI第95个百分位数的增长曲线(%BMIp95)之间的关系。随机效应(个体生长曲线)和固定效应(糖尿病前期状态、开始年龄和BMIp95%、性别、种族/民族、自首次访问以来的线性斜率和二次项)被建模。结果：BMIp95的平均百分比为125.5%(SD22.5)，对应于严重肥胖，35%的人有糖尿病前期。与本诊所的同龄人相比，糖尿病前期儿童调整后的BMIp95每月下降幅度更大(斜率：−0.62，标准差0.10，p<； 0.001)。结论：与糖化血红蛋白正常的同龄人相比，糖尿病前期儿童的体重改善更大。
Background:There is a range of responses among individuals seen for medical management of their obesity. This retrospective analysis of longitudinal data considers the relationship between identified prediabetes and subsequent weight change among children (8–17 years) in a weight management clinic.Methods:Analysis included 733 patients (2687 visits in 2008–2016) with overweight and obesity (but not diabetes) whose referral laboratories included a hemoglobin A1c (HbA1c) within 90 days. Mixed-effects modeling examined the association between baseline prediabetes (serum HbA1c 5.7%–6.4%) and growth curve of percentage of the 95th percentile for BMI (%BMIp95). Random effects (individual growth curves) and fixed effects (prediabetes status, starting age and %BMIp95, sex, race/ethnicity, and linear slope and quadratic term of months since the initial visit) were modeled. Interactions between prediabetes and elapsed time estimated the influence of a recent prediabetic-range HbA1c on weight during the subsequent 12 months.Results:Mean %BMIp95 was 125.5% (SD 22.5), corresponding to severe obesity, and 35% had prediabetes. Adjusted monthly decrease in %BMIp95 was stronger for children with prediabetes compared with the peers in this clinic (slope: −0.62, standard error 0.10,p< 0.001).Conclusion:There was greater weight improvement among children with prediabetes compared with their peers with normal HbA1c.