Response heterogeneity to lifestyle intervention among Latino adolescents.
Response heterogeneity to lifestyle intervention among Latino adolescents.
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DOI：
10.1111/pedi.13120
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发表时间：
2020-12
影响因子：
3.4
通讯作者：
Shaibi GQ
中科院分区：
文献类型：
--
作者：
Peña A;McNeish D;Ayers SL;Olson ML;Vander Wyst KB;Williams AN;Shaibi GQ
研究拉美裔肥胖青少年对生活方式干预反应的异质性。我们对90名拉丁裔青少年(年龄15.4±0.9岁，女性56.7%)肥胖(BMI%98.1±1.5%)进行了二次数据分析，这些青少年参加了为期3个月的生活方式干预，并随访了一年。协方差模式混合模型(CPMM)通过2小时口服葡萄糖耐量试验确定由胰岛素敏感性变化定义的反应表型。使用单因素方差分析和卡方检验比较不同反应表型的基线特征。鉴定出三种不同的反应表型(ph1、ph2、ph3)。PH1表现出最强健的反应，即胰岛素敏感性随时间的增加最大(β±SE，线性0.52±0.17，p<；0.001；二次−0.03±0.01，p=0.001)。PH2无显著变化，而PH3表现出轻微的短期胰岛素敏感性增加，但不随时间而持续(线性0.08±0.03，p=0.002；二次−0.01±0.002，p=0.003)。基线时，PH3(1.1±0.4)是胰岛素抵抗最严重的表型，表现出最高的BMI%(98.5±1.1%)、2小时血糖浓度(144.0±2 7.5 mg/dl)和最低的β细胞功能(4.5±2.8)。拉美裔肥胖青年对生活方式干预的反应各不相同，这表明有必要采取精确的方法来满足高危青年的预防需求。
To characterize the heterogeneity in response to lifestyle intervention among Latino adolescents with obesity. We conducted secondary data analysis of 90 Latino adolescents (age 15.4±0.9 y, female 56.7%) with obesity (BMI% 98.1±1.5%) that were enrolled in a 3-month lifestyle intervention and were followed for a year. Covariance pattern mixture models (CPMM) identified response phenotypes defined by changes in insulin sensitivity as measured using a 2-hour oral glucose tolerance test. Baseline characteristics were compared across response phenotypes using one-way ANOVA and chi-square test. Three distinct response phenotypes (PH1, PH2, PH3) were identified. PH1 exhibited the most robust response defined by the greatest increase in insulin sensitivity over time (β±SE, linear 0.52±0.17, p<0.001; quadratic −0.03±0.01, p=0.001). PH2 showed non-significant changes, while PH3 demonstrated modest short-term increases in insulin sensitivity which were not sustained over time (linear 0.08±0.03, p=0.002; quadratic −0.01±0.002, p=0.003). At baseline, PH3 (1.1±0.4) was the most insulin resistant phenotype and exhibited the highest BMI% (98.5±1.1%), 2-hr glucose concentrations (144.0±27.5 mg/dl), and lowest beta-cell function as estimated by the oral disposition index (4.5±2.8). Response to lifestyle intervention varies among Latino youth with obesity and suggests that precision approaches are warranted to meet the prevention needs of high risk youth.
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