Influences of weight loss on long-term diabetes outcomes
Influences of weight loss on long-term diabetes outcomes
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DOI：
10.1017/s0029665108006022
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发表时间：
2008-02-01
影响因子：
7
通讯作者：
Aucott, Lorna S.
中科院分区：
文献类型：
--
作者：
Aucott, Lorna S.
随着肥胖症的流行，2型糖尿病(T2 DM)的发病率不断上升，86%的T2 DM患者超重，超过一半的患者肥胖。有文献强调，超重或肥胖会增加患糖尿病的风险。肥胖患者的体重减轻与临床改善有关，尽管这一证据大多来自短期研究。作为健康技术评估系统回顾的一部分，在肥胖者中调查了体重减轻对糖尿病相关结果指标变化的长期(2年)影响，或非糖尿病患者患糖尿病的风险。1966至2001年间发表的11项研究符合纳入标准(高加索人、BMI和GT；28 kg/m(2)、成人、无饮食紊乱、体重减轻和糖尿病结局指标的变化)。这些研究的结果表明，从长远来看，有意识的减肥可以降低患糖尿病的风险，而那些患有T2 DM的参与者通常会减少临床症状和死亡风险。这些结果得到了自本综述以来发表的文献的验证和加强。作为预防肥胖增长经济综合研究的六个阶段项目的一部分，也进行了类似的系统评估。这项综述排除了BMI>；34 kg/m(2)，仅限于生活方式干预(或有意减肥)。获得的与糖尿病相关的信息有限，只有严重的重量循环练习导致的糖尿病死亡率没有显著增加的趋势。其他结果表明体重减轻与空腹血糖之间存在关系，但由于参与群体的异质性以及与糖尿病相关的定义的缺乏，这种关系并未正式确定。总而言之，减肥对超重、肥胖和病态肥胖参与者的长期糖尿病结局是有益的。对于那些超重或只是肥胖的人来说，几乎没有研究证据，这表明未来在预防肥胖和糖尿病方面的研究领域。
Increasing rates of type 2 diabetes (T2DM) follow the obesity 'epidemic', with 86% of patients with T2DM being overweight and over half being obese. Literature has highlighted that being overweight or obese increases the risk of diabetes. Weight loss for obese patients is associated with clinical improvements, although this evidence is mostly from short-term studies. As part of a Health Technology Assessment systematic review the long-term (>= 2 years) effects of weight loss on change in diabetes-related outcome measures for those with diabetes, or risk of developing diabetes for those without diabetes, was investigated in obese individuals. Eleven studies published between 1966 and 2001 fulfilled the inclusion criteria (Caucasian, BMI > 28 kg/m(2), adults, no eating disorders, weight loss and changes in diabetes-outcome measures). Results of these studies indicated that intentional weight loss reduces the risk of developing diabetes in the long term and those participants with T2DM often have reduced clinical symptoms and mortality risk. These results have been verified and enhanced by literature published since this review. A similar systematic review was conducted as part of a six-phase project, the PRevent Obesity GRowing Economic Synthesis Study. This review excluded BMI > 34 kg/m(2) and was restricted to lifestyle interventions (or intentional weight loss). Limited information relating to diabetes was gained, with only a non-significant increasing trend for mortality from diabetes for severe weight cycling practices being suggested. Other results indicated a relationship between weight loss and fasting plasma glucose, but because of the heterogeneity of participation groups and lack of definition in relation to diabetes this relationship was not formalised. In summary, weight loss is beneficial for long-term diabetes outcomes for overweight, obese and morbidly-obese participants. There is little research evidence for those individuals who are overweight or just obese, indicating areas of future research in terms of prevention of both obesity and diabetes.