摘要
目的评价远程生活方式干预对超重及肥胖人群体重及相关指标管理的效果。方法选取2015年5月至2018年12月在深圳市人民医院健康管理科参加远程生活方式干预的400例超重及肥胖人群作为远程干预组,同时选取400例年龄及性别与之相匹配的超重及肥胖体检人群作为对照组。营养师与远程干预组建立个人微信小群,运用微信平台对其进行远程生活方式干预,包括设定体重控制目标,对基于照片的食物日志及时反馈,给予运动指导及心理支持。对照组接受个性化的饮食和运动处方,但未接受远程干预。应用倾向性评分匹配法调整数据后,利用单因素和多因素logistic回归模型分析两组1年后的体重及相关指标管理效果。结果经过1年的干预,共获得有效数据755例(远程干预组371例,对照组384例),倾向性匹配后保留有效数据446例(远程干预组223例,对照组223例)。远程干预组的体质指数(BMI)、收缩压、空腹血糖、三酰甘油、总胆固醇、低密度脂蛋白、血尿酸分别为(24.85±2.52)kg/m^(2)、(110.21±10.53)mmHg(1 mmHg=0.133 kPa)、(4.96±0.65)mmol/L、(1.25±0.82)mmol/L、(4.87±1.11)mmol/L、(2.88±0.74)mmol/L、(306.01±95.66)mmol/L,均明显低于对照组的(27.76±2.28)kg/m^(2)、(121.14±14.07)mmHg、(5.10±0.87)mmol/L、(1.54±0.83)mmol/L、(5.28±0.96)mmol/L、(3.13±0.80)mmol/L、(355.16±92.68)mmol/L(均P<0.05)。干预后,BMI减低4%~12%时,干预措施均为影响因素(均P<0.05),远程干预组BMI降低12%的概率为对照组的112.486倍(95%CI:16.852~890.266);同时,初始BMI为BMI恢复正常的影响因素,初始BMI每减少1 kg/m^(2),其恢复正常的概率为减少前的4.76倍(95%CI:3.222~5.057)。结论远程生活方式干预对于超重及肥胖人群的体重及相关指标管理有一定效果,其对超重及轻度肥胖的人减重效果显著,但对中重度肥胖人群的干预效果有限。
Objective To evaluate the effect of remote lifestyle intervention on the management of weight and related indicators in the overweight and obese population.Methods A total of 400 individuals with overweight or obesity who participated in remote lifestyle intervention in the Health Management Department of Shenzhen People′s Hospital from May 2015 to December 2018 were included as the remote intervention group,and 400 individuals with overweight and obesity who matched their age and gender were selected as the control group.Dietician established individual WeChat groups with the remote intervention group,and the WeChat platform was used to conduct remote lifestyle intervention for them,including setting weight control goals,giving timely feedback to the food log based on photos,providing exercise guidance and psychological support.The control group received personalized diet and exercise prescriptions,but did not receive remote intervention.After adjusting the data by propensity score matching method,univariate and multivariate logistic regression models were used to analyze the management effect of weight and related indicators in the two groups after one year.Results After one year of intervention,effective data were obtained from a total of 755 cases(371 cases in the remote intervention group and 384 cases in the control group),and effective data were retained from 446 cases(223 cases in the remote intervention group and 223 cases in the control group)after bias matching.The body mass index(BMI),systolic blood pressure,fasting blood glucose,triglyceride,total cholesterol,low-density lipoprotein,and serum uric acid of the remote intervention group[(24.85±2.52)kg/m^(2),(110.21±10.53)mmHg,(4.96±0.65)mmol/L,(1.25±0.82)mmol/L,(4.87±1.11)mmol/L,(2.88±0.74)mmol/L,and(306.01±95.66)mmol/L respectively]were significantly lower than that of the control group[(27.76±2.28)kg/m^(2),(121.14±14.07)mmHg,(5.10±0.87)mmol/L,(1.54±0.83)mmol/L,(5.28±0.96)mmol/L,(3.13±0.80)mmol/L,(355.16±92.68)mmol/L respectively](all P<0.05).After intervention,intervention was consistently being influencing factors when BMI was reduced by 4%―12%,(P<0.05).The probability of a 12%reduction in BMI in the remote intervention group was 112.486 times higher than that in the control group(95%CI:16.852-890.266).At the same time,the initial BMI was an influential factor for the restoration of normal BMI.For every 1 kg/m^(2) decrease in the initial BMI,the probability of restoration of normal BMI was 4.76 times higher than that before the decrease(95%CI:3.222-5.057).Conclusions Remote lifestyle intervention has a certain effect on the management of weight and related indicators in the overweight and obese populations.It has significant effect on weight loss of overweight and mildly obese people,but has limited effect on moderate and severe obese people.
作者
何慧
吴伟晴
彭锐
郑泓
赵莉
He Hui;Wu Weiqing;Peng Rui;Zheng Hong;Zhao Li(Department of Health Management,Shenzhen People′s Hospital,Shenzhen 518020,China)
出处
《中华健康管理学杂志》
CAS
CSCD
2021年第2期151-157,共7页
Chinese Journal of Health Management
关键词
超重
肥胖
教育
远程
倾向性评分
Overweight
Obesity
Education,distance
Propensity score
