Neighborhood deprivation and change in BMI among adults with type 2 diabetes: the Diabetes Study of Northern California (DISTANCE).
Neighborhood deprivation and change in BMI among adults with type 2 diabetes: the Diabetes Study of Northern California (DISTANCE).
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DOI：
10.2337/dc11-1866
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发表时间：
2013-05
期刊：
影响因子：
16.2
通讯作者：
Karter AJ
中科院分区：
文献类型：
--
作者：
Stoddard PJ;Laraia BA;Warton EM;Moffet HH;Adler NE;Schillinger D;Karter AJ
比较2型糖尿病成年人邻里剥夺与BMI变化的相关性。使用来自北方加州Kaiser Permanente糖尿病研究（DISTANCE）调查的数据，我们估计了3年内邻里剥夺与两种BMI变化指标之间的相关性：1）一种连续指标和2）一种分类指标，即临床上实质性的BMI下降或增加（≥基线BMI的7%）与稳定的BMI。样本包括13，609名成年人。平均而言，BMI几乎没有变化（-0.12，SD 3.07）;随访时，分别有17.0%和16.1%的患者有临床意义的BMI下降或增加。在调整后的模型中，邻里剥夺与成年人的BMI变化在邻里剥夺的最大与最小四分位数中呈正相关（β = 0.22，P = 0.02）。此外，相对于最少被剥夺的四分位数（Q1），社区剥夺更严重的四分位数的成年人更有可能经历实质性的BMI下降，（Q2相对风险比1.19，95% CI 1.00-1.41; Q3 1.20，1.02-1.42; Q4 1.30，1.08-1.55）或增益（第二季度1.25，1.04-1.49;第三季度1.24，1.04-1.49;第四季度1.45，1.20-1.75）。更大的社区剥夺与糖尿病成人的BMI变化以及临床上实质性的BMI下降或增加呈正相关。研究结果强调，在未来的纵向研究邻里剥夺和体重变化，这可能是特别真实的糖尿病患者的体重减轻和体重增加的健康影响的研究中，允许同时关联与增益和损失的重要性。
To compare associations between neighborhood deprivation and measures of BMI change among adults with type 2 diabetes. Using data from the Kaiser Permanente Diabetes Study of Northern California (DISTANCE) survey, we estimated the association between neighborhood deprivation and two measures of BMI change over 3 years: 1) a continuous measure and 2) a categorical measure of clinically substantive BMI loss or gain (≥7% of baseline BMI) versus stable BMI. The sample included 13,609 adults. On average, there was little change in BMI (−0.12, SD 3.07); 17.0 and 16.1% had clinically substantive BMI loss or gain, respectively, at follow-up. There was a positive association between neighborhood deprivation and BMI change for adults in the most versus least-deprived quartile of neighborhood deprivation (β = 0.22, P = 0.02) in adjusted models. In addition, relative to the least-deprived quartile (Q1), adults in more-deprived quartiles of neighborhood deprivation were more likely to experience either substantive BMI loss (Q2 relative risk ratio 1.19, 95% CI 1.00–1.41; Q3 1.20, 1.02–1.42; Q4 1.30, 1.08–1.55) or gain (Q2 1.25, 1.04–1.49; Q3 1.24, 1.04–1.49; Q4 1.45, 1.20–1.75). Greater neighborhood deprivation was positively associated with BMI change among adults with diabetes as well as with clinically substantive BMI loss or gain. Findings stress the importance of allowing for simultaneous associations with both gain and loss in future longitudinal studies of neighborhood deprivation and weight change, which may be particularly true for studies of patients with diabetes for whom both weight loss and gain have health implications.
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影响因子：
158.5
作者：
Knowler, WC;Barrett-Connor, E;Nathan, DM
通讯作者：
Nathan, DM
影响因子：
4.5
作者：
Gary-Webb TL;Baptiste-Roberts K;Pham L;Wesche-Thobaben J;Patricio J;Pi-Sunyer FX;Brown AF;Jones L;Brancati FL;Look AHEAD Research Group
通讯作者：
Look AHEAD Research Group
影响因子：
6.3
作者：
Lee, Rebecca E.;Cubbin, Catherine;Winkleby, Marilyn
通讯作者：
Winkleby, Marilyn
影响因子：
12.7
作者：
HIATT, RA;FRIEDMAN, GD
通讯作者：
FRIEDMAN, GD
DOI：
10.1016/s0889-8529(03)00071-9
发表时间：
2003-12-01
影响因子：
4.5
作者：
Maggio, CA;Pi-Sunyer, FX
通讯作者：
Pi-Sunyer, FX