Weight change in diabetes and glycemic and blood pressure control.
Weight change in diabetes and glycemic and blood pressure control.
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DOI：
10.2337/dc08-0426
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发表时间：
2008-10
期刊：
影响因子：
16.2
通讯作者：
Perrin, Nancy
中科院分区：
文献类型：
--
作者：
Feldstein, Adrianne C.;Nichols, Gregory A.;Smith, David H.;Stevens, Victor J.;Bachman, Keith;Rosales, A. Gabriela;Perrin, Nancy
目的：2型糖尿病患者的体重减轻是毋庸置疑的重要因素，来自社区环境的数据有限。我们在HMO评估了2型糖尿病患者的体重变化以及由此产生的血糖和血压控制情况。研究设计和方法--利用电子病历，这项回溯性队列研究确定了2,574名年龄在21-75岁之间的患者，他们在1997年至2002年期间被诊断为2型糖尿病。我们使用增长曲线分析估计3年的体重轨迹，使用聚类分析将相似的轨迹分成四类，比较类别特征，并按组预测超出目标的4年的A1C和血压。结果：体重轨迹组被定义为较高的稳定体重(n=418；16.2%)、较低的稳定体重(n=1,542；59.9%)、体重增加(n=300；11.7%)和体重下降(n=314；12.2%)。后者在18个月时平均体重减轻10.7公斤(−9.8%；P<；0.001)，36个月时几乎完全恢复。在调整了年龄、性别、基线控制和相关药物使用后，那些稳定体重较高、稳定体重较低或体重增加模式的人比那些体重减轻的人更有可能发生高于目标的A1C(优势比[OR]1.66[95%可信区间1.12-2.47]、1.52[1.08-2.14]和1.77[1.15-2.72])。那些体重稳定或体重增加模式较高的人比那些体重减轻的人更有可能血压高于目标(分别为1.83[1.31-2.57]和1.47[1.03-2.10])。结论--2型糖尿病新诊断后的体重减轻模式预示着，尽管体重回升，血糖和血压控制仍有改善。诊断后的最初阶段可能是应用减肥治疗以改善危险因素控制的关键时间。
OBJECTIVE—Weight loss in type 2 diabetes is undisputedly important, and data from community settings are limited. We evaluated weight change and resulting glycemic and blood pressure control in type 2 diabetic patients at an HMO. RESEARCH DESIGN AND METHODS—Using electronic medical records, this retrospective cohort study identified 2,574 patients aged 21–75 years who received a new diagnosis of type 2 diabetes between 1997 and 2002. We estimated 3-year weight trajectories using growth curve analyses, grouped similar trajectories into four categories using cluster analysis, compared category characteristics, and predicted year-4 above-goal A1C and blood pressure by group. RESULTS—The weight-trajectory groups were defined as higher stable weight (n = 418; 16.2%), lower stable weight (n = 1,542; 59.9%), weight gain (n = 300; 11.7%), and weight loss (n = 314; 12.2%). The latter had a mean weight loss of 10.7 kg (−9.8%; P < 0.001) by 18 months, with near-complete regain by 36 months. After adjusting for age, sex, baseline control, and related medication use, those with higher stable weight, lower stable weight, or weight-gain patterns were more likely than those who lost weight to have above-goal A1C (odds ratio [OR] 1.66 [95% CI 1.12–2.47], 1.52 [1.08–2.14], and 1.77 [1.15–2.72], respectively). Those with higher stable weight or weight-gain patterns were more likely than those who lost weight to have above-goal blood pressure (1.83 [1.31–2.57] and 1.47 [1.03–2.10], respectively). CONCLUSIONS—A weight-loss pattern after new diagnosis of type 2 diabetes predicted improved glycemic and blood pressure control despite weight regain. The initial period postdiagnosis may be a critical time to apply weight-loss treatments to improve risk factor control.
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影响因子：
168.9
作者：
Turner, RC;Holman, RR;Ward, JD
通讯作者：
Ward, JD
DOI：
10.1038/oby.2001.141
发表时间：
2001-11-01
期刊：
OBESITY RESEARCH
影响因子：
--
作者：
Hensrud, DD
通讯作者：
Hensrud, DD
影响因子：
105.7
作者：
Stratton, IM;Adler, AI;Holman, RR
通讯作者：
Holman, RR
DOI：
10.1136/ewjm.172.2.85
发表时间：
2000-02-01
期刊：
WESTERN JOURNAL OF MEDICINE
影响因子：
--
作者：
Brown, JB;Nichols, GA;Glauber, HS
通讯作者：
Glauber, HS
影响因子：
16.2
作者：
Chaudhry, ZW;Gannon, MC;Nuttall, FQ
通讯作者：
Nuttall, FQ