Effect of an Intensive Weight-Loss Lifestyle Intervention on Kidney Function: A Randomized Controlled Trial
Effect of an Intensive Weight-Loss Lifestyle Intervention on Kidney Function: A Randomized Controlled Trial
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DOI：
10.1159/000513664
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发表时间：
2021-02-08
影响因子：
4.2
通讯作者：
Salas-Salvado, Jordi
中科院分区：
文献类型：
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作者：
Diaz-Lopez, Andres;Becerra-Tomas, Nerea;Salas-Salvado, Jordi
简介：目前缺乏大型随机试验来测试包括地中海饮食 (MedDiet) 在内的多因素减肥生活方式干预措施对肾功能的影响。在这里，我们评估了采用减少能量的 MedDiet (erMedDiet) 加上增加体力活动 (PA) 的强化减肥干预措施对肾功能的 1 年疗效。方法：随机对照“PREvencion con DIeta MEDiterranea-Plus”(PREDIMED-Plus) 试验在西班牙 23 个中心（包括 208 个初级保健诊所）进行。 2013 年 9 月至 2016 年 12 月期间，超重/肥胖 (n = 6,719) 55-75 岁患有代谢综合征的成年人被随机分配 (1:1) 接受强化减肥生活方式干预，包括 erMedDiet、PA 促进和行为支持（干预）或常规护理建议，以坚持能量不受限的 MedDiet（对照）。主要结局是估计肾小球滤过率的 1 年变化（肾小球滤过率）。次要结局是尿白蛋白与肌酐比值 (UACR) 的变化、中度/重度 eGFR 受损的发生率 (= 30 mg/g) 以及中度 (45 至
Introduction: Large randomized trials testing the effect of a multifactorial weight-loss lifestyle intervention including Mediterranean diet (MedDiet) on renal function are lacking. Here, we evaluated the 1-year efficacy of an intensive weight-loss intervention with an energy-reduced MedDiet (erMedDiet) plus increased physical activity (PA) on renal function. Methods: Randomized controlled "PREvencion con DIeta MEDiterranea-Plus" (PREDIMED-Plus) trial is conducted in 23 Spanish centers comprising 208 primary care clinics. Overweight/obese (n = 6,719) adults aged 55-75 years with metabolic syndrome were randomly assigned (1:1) to an intensive weight-loss lifestyle intervention with an erMedDiet, PA promotion, and behavioral support (intervention) or usual-care advice to adhere to an energy-unrestricted MedDiet (control) between September 2013 and December 2016. The primary outcome was 1-year change in estimated glomerular filtration rate (eGFR). Secondary outcomes were changes in urine albumin-to-creatinine ratio (UACR), incidence of moderately/severely impaired eGFR (= 30 mg/g), and reversion of moderately (45 to