Exploring the effectiveness of an 18-month weight management intervention in adults with Down syndrome using propensity score matching.
Exploring the effectiveness of an 18-month weight management intervention in adults with Down syndrome using propensity score matching.
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DOI：
10.1111/jir.12713
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发表时间：
2020-03
期刊：
影响因子：
--
通讯作者：
Donnelly JE
中科院分区：
文献类型：
--
作者：
Ptomey LT;Willis EA;Sherman JR;White DA;Donnelly JE
唐氏综合症（DS）是美国最常见的出生缺陷之一，与高水平的超重和肥胖有关。可能导致高水平肥胖的成年DS患者的独特特征是：甲状腺功能减退症的发生率高、肌张力差、步态改变和静息代谢率较低。由于这些因素，尚不清楚在没有DS的智力残疾（IDD）成人中有效的相同体重管理干预措施是否在DS患者中同样有效。因此，该次要分析的目的是比较参加18个月体重管理试验的DS和非DS相关IDD受试者之间体重、饮食和体力活动的变化。我们使用倾向评分法来调整超重/肥胖成人的基线变量，有和没有DS参与了一项为期18个月的有效性试验，6个月的体重减轻和12个月的体重维持。参与者遵循两种降低热量饮食计划之一，每周进行150分钟的中等至剧烈强度的体力活动（MVPA），并记录每日饮食摄入量。一名健康教育工作者每月与参与者和一名护理人员进行家访，就干预依从性提供反馈。在符合入选标准的124名参与者中，21名被诊断为DS，103名被诊断为非DS相关IDD。21名DS参与者中有20名成功匹配。在18个月时，DS（−5.2%）和非DS相关IDD（−6.8%）参与者的体重减轻具有临床意义，组间无差异（p=0.53）。在DS和非DS相关IDD组中，在18个月干预期间均观察到EI显著降低，仅在12个月时存在组间差异（分别为1119和1492 kcal/d; p=0.003）。尽管在整个干预过程中，两组的MVPA都没有增加，但在18个月内，与DS患者相比，非DS相关IDD患者的MVPA水平更高。在18个月的干预期间，DS参与者的体重减轻了临床意义上的体重。与非DS相关IDD患者相比，DS患者在18个月的干预期间体重减轻量相似，EI下降相似，MVPA较少。尽管DS患者的生理因素可能导致肥胖，但针对IDD患者设计的体重管理干预措施在该人群中可能同样有效。
Down syndrome (DS) is one of the most common birth defects in the US associated with high levels of overweight and obesity. Unique characteristics of adults with DS that may contribute to the high levels of obesity are: high rates of hypothyroidism, poor muscle tone, altered gait, and lower resting metabolic rate. Due to these factors, it is unknown if the same weight management interventions that are effective in adults with intellectual disabilities (IDD) without DS, are as effective in those with DS. Therefore, the purpose of this secondary analysis was to compare changes in weight, diet, and physical activity between participants with DS and non-DS related IDD participating in an 18-month weight management trial. We used propensity score methods to adjust baseline variables of overweight/obese adults with and without DS participating in an 18-month effectiveness trial with 6 months weight loss and 12 months weight maintenance. Participants followed one of two reduced calorie diet plans, obtain 150 min of moderate-to-vigorous intensity physical activity (MVPA) per week, and log dietary intake daily. A health educator held monthly at-home visits with participants and a caregiver to give feedback on intervention compliance. Out of the 124 participants that met criteria for inclusion, 21 were diagnosed with DS and 103 with non-DS related IDD. Twenty out of 21 participants with DS were successfully matched. Clinically significant weight loss was seen at 18 months in participants with DS (−5.2%) and non-DS related IDD (−6.8%), with no difference between groups (p=0.53). Significant reductions in EI were seen across the 18-month intervention in both DS and non-DS related IDD groups with between group differences at 12 months only (1119 vs. 1492 kcals/day, respectively; p=0.003). Although MVPA did not increase in either group across the intervention, those with non-DS related IDD had higher levels of MVPA compared to those with DS across the 18 months. Participants with DS lost a clinically significant amount of weight across the 18-month intervention. Compared to those with non-DS related IDD, those with DS lost similar amounts of weight, had similar decreases in EI, and participated in less MVPA across the 18-month intervention. Although individuals with DS have physiological factors that may contribute to obesity, weight management interventions designed for individuals with IDD may be equally effective in this population.
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影响因子：
3.3
作者：
Adolfsson, Paivi;Sydner, Ylva Mattsson;Andersson, Agneta
通讯作者：
Andersson, Agneta
DOI：
10.1111/jar.12367
发表时间：
2018-01
期刊：
Journal of applied research in intellectual disabilities : JARID
影响因子：
--
作者：
Doherty AJ;Jones SP;Chauhan U;Gibson JME
通讯作者：
Gibson JME
影响因子：
2
作者：
Austin, Peter C.
通讯作者：
Austin, Peter C.
影响因子：
1.9
作者：
Gutierrez-Vilahu, Lourdes;Masso-Ortigosa, Nuria;Rey-Abella, Ferran
通讯作者：
Rey-Abella, Ferran
影响因子：
5.1
作者：
Basil, Janet S.;Santoro, Stephanie L.;Saal, Howard M.
通讯作者：
Saal, Howard M.