Body size and shape changes and the risk of diabetes in the diabetes prevention program
Body size and shape changes and the risk of diabetes in the diabetes prevention program
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DOI：
10.2337/db07-0009
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发表时间：
2007-06-01
期刊：
影响因子：
7.7
通讯作者：
Pi-Sunyer, F. Xavier
中科院分区：
文献类型：
--
作者：
Fujimoto, Wilfred Y.;Jablonski, Kathleen A.;Pi-Sunyer, F. Xavier
研究人员进行这项研究是为了验证这样一个假设，即随着体型和中心性肥胖的减少，2型糖尿病的风险会降低。糖尿病预防计划（DPP）招募了糖耐量受损的个体，并将其随机分配至安慰剂、二甲双胍或生活方式改变治疗组。在基线和第1年通过计算机断层扫描测量身高、体重、腰围以及L2-L3和L4-L5的皮下和内脏脂肪。考克斯比例风险模型按性别评估了758例受试者亚组在干预第1年发生糖尿病后，这些变量变化对后续随访的影响。生活方式减少L2-L3内脏脂肪（男性-24.3%，女性-18.2%）和L4-L5（男性-22.4%，女性-17.8%），L2-L3皮下脂肪（男性-15.7%，女性-11.4%）和L4-L5（男性-16.7%，女性-11.9%）、体重（男性-8.2%，女性-7.8%）、BMI（男性-8.2%，女性-7.8%）和腰围（男性-7.5%，女性-6.1%）。二甲双胍降低了男性的体重（-2.9%）和BMI（-2.9%），降低了女性的皮下脂肪（L2-L3为-3.6%，L4-L5为-4.7%）、体重（-3.3%）、BMI（-3.3%）和腰围（-2.8%）。在调整年龄和自我报告的种族后，生活方式干预降低的糖尿病风险与体重、BMI和中心体脂肪分布的减少有关。生活方式干预降低糖尿病风险可能是通过对全身脂肪和中心体脂肪的影响，但二甲双胍似乎与体脂肪无关。
The researchers conducted this study to test the hypothesis that risk of type 2 diabetes is less following reductions in body size and central adiposity. The Diabetes Prevention Program (DPP) recruited and randomized individuals with impaired glucose tolerance to treatment with placebo, metformin, or lifestyle modification. Height, weight, waist circumference, and subcutaneous and visceral fat at L2-L3 and L4-L5 by computed tomography were measured at baseline and at I year. Cox proportional hazards models assessed by sex the effect of change in these variables over the 1st year of intervention upon development of diabetes over subsequent follow-up in a subset of 758 participants. Lifestyle reduced visceral fat at L2-L3 (men -24.3%, women -18.2%) and at L4-L5 (men -22.4%, women -17.8%), subcutaneous fat at L2-L3 (men -15.7%, women -11.4%) and at L4-L5 (men -16.7%, women -11.9%), weight (men -8.2%, women -7.8%), BMI (men -8.2%, women -7.8%), and waist circumference (men -7.5%, women -6.1%). Metformin reduced weight (-2.9%) and BMI (-2.9%) in men and subcutaneous fat (-3.6% at L2-L3 and -4.7% at L4-L5), weight (-3.3%), BMI (-3.3%), and waist circumference (-2.8%) in women. Decreased diabetes risk by lifestyle intervention was associated with reductions of body weight, BMI, and central body fat distribution after adjustment for age and self-reported ethnicity. Reduced diabetes risk with lifestyle intervention may have been through effects upon both overall body fat and central body fat but with metformin appeared to be independent of body fat.