Effect of a lifestyle intervention on weight change in south Asian individuals in the UK at high risk of type 2 diabetes: a family-cluster randomised controlled trial
Effect of a lifestyle intervention on weight change in south Asian individuals in the UK at high risk of type 2 diabetes: a family-cluster randomised controlled trial
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DOI：
10.1016/s2213-8587(13)70204-3
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发表时间：
2014-03-01
影响因子：
44.5
通讯作者：
Murray, Gordon D.
中科院分区：
文献类型：
--
作者：
Bhopal, Raj S.;Douglas, Anne;Murray, Gordon D.
背景南亚裔人群对2型糖尿病的易感性已经确定，但几乎没有基于试验的干预证据来解决这个问题。我们评估了南亚人在UK.Methods的体重控制和体力活动干预，我们做了这个非盲试验在两个国家卫生服务（NHS）地区在苏格兰（英国）。在2007年7月1日至2009年10月31日期间，我们招募了印度和巴基斯坦血统的男性和女性，年龄在35岁或以上，男性腰围90 cm或更大，女性腰围80 cm或更大，并且通过口服葡萄糖耐量试验确定葡萄糖耐量受损或空腹血糖受损。将家庭随机分配（使用随机数生成器程序，随机大小的排列区组，按地点[爱丁堡或格拉斯哥]、种族[印度或巴基斯坦]和家庭中参与者人数[1人vs 1人以上]分层）至干预组或对照组。同一家庭的受试者未单独随机分配。干预组在3年内接受了15次营养师的访问，对照组在同一时期接受了4次访问。主要结局是3年时的体重变化。分析是通过修改的意向治疗，不包括死亡或失访的参与者。我们使用线性回归模型来提供3年时基线调整体重的平均差异。该试验已注册，编号ISRCTN25729565。结果在1319名接受口服葡萄糖耐量试验筛查的患者中，196人（15%）患有葡萄糖耐量受损或空腹血糖受损，171人进入试验。参与者被随机分配到156个家庭群中（78个家庭，85名参与者被分配到干预组; 78个家庭，86名参与者被分配到对照组）。152个家庭的167名（98%）参与者完成了试验。干预组的平均体重减轻为1.13 kg（SD 4.12），而平均体重增加0.51 kg（3.65）在对照组中，校正后的平均差异为-1.64 kg（95%CI-2.83至-0.44）。解释作为生活方式改变策略的一部分，体重的适度中期变化是可以实现的，可以控制或预防肥胖相关疾病。
Background The susceptibility to type 2 diabetes of people of south Asian descent is established, but there is little trial-based evidence for interventions to tackle this problem. We assessed a weight control and physical activity intervention in south Asian individuals in the UK.Methods We did this non-blinded trial in two National Health Service (NHS) regions in Scotland (UK). Between July 1, 2007, and Oct 31, 2009, we recruited men and women of Indian and Pakistani origin, aged 35 years or older, with waist circumference 90 cm or greater in men or 80 cm or greater in women, and with impaired glucose tolerance or impaired fasting glucose determined by oral glucose tolerance test. Families were randomised (using a random number generator program, with permuted blocks of random size, stratified by location [Edinburgh or Glasgow], ethnic group [Indian or Pakistani], and number of participants in the family [one vs more than one]) to intervention or control. Participants in the same family were not randomised separately. The intervention group received 15 visits from a dietitian over 3 years and the control group received four visits in the same period. The primary outcome was weight change at 3 years. Analysis was by modified intention to treat, excluding participants who died or were lost to follow-up. We used linear regression models to provide mean differences in baseline-adjusted weight at 3 years. This trial is registered, number ISRCTN25729565.Findings Of 1319 people who were screened with an oral glucose tolerance test, 196 (15%) had impaired glucose tolerance or impaired fasting glucose and 171 entered the trial. Participants were in 156 family clusters that were randomised (78 families with 85 participants were allocated to intervention; 78 families with 86 participants were allocated to control). 167 (98%) participants in 152 families completed the trial. Mean weight loss in the intervention group was 1.13 kg (SD 4.12), compared with a mean weight gain of 0.51 kg (3.65) in the control group, an adjusted mean difference of -1.64 kg (95% CI -2.83 to -0.44).Interpretation Modest, medium-term changes in weight are achievable as a component of lifestyle-change strategies, which might control or prevent adiposity-related diseases.