两年初级保健生活方式干预对心脏代谢风险因素的影响:一个集群随机试验
Christoph Höchsmann1, James L Dorling1, Corby K Martin1
1Pennington Biomedical Research Center, Baton Rouge, LA (C.H., J.L.D., C.K.M., R.L.N., J.W.A., C.A.M., K.D.D., E.F.M., W.D.J., D.Z., P.T.K.).
Circulation
|February 9, 2021
概括
初级保健中的强化生活方式干预 (ILI) 显著改善了服务不足的人群的体重减轻和心脏代谢健康. 这种方法为管理肥胖和相关疾病提供了实际解决方案.
科学领域:
- 肥胖药物
- 主要护理干预措施
- 心脏代谢健康
背景情况:
- 强化生活方式干预 (ILI) 对于肥胖和心脏代谢风险管理是有效的.
- 由于在学术中心的入口有限,初级保健机构对于广泛实施ILI至关重要.
- 基于初级保健的生活方式的有效干预仍然是一个挑战.
研究的目的:
- 在初级保健环境中评估实用性ILI的有效性.
- 在24个月内评估ILI对心脏代谢风险因素的影响.
- 在一个种族多样化,低收入的肥胖人口中检查干预的有效性.
主要方法:
- 在PROPEL试验中,18个初级保健诊所被随机分为常规护理或ILI.
- 参与了803名肥胖成人 (67%为黑人,84%为女性).
- 在临床上接受了24个月的高强度生活方式指导.
主要成果:
- 与通常治疗相比,ILI组的参与者在24个月内显著减肥 (- 4. 51%).
- ILI组在12个月和24个月的HDL胆固醇中显示出更大的降低.
- ILI组的总HDL胆固醇比率和代谢综合征严重程度有显著的改善.
结论:
- 由健康教练在初级保健中进行的实用性ILI有效改善了心脏代谢健康.
- 在24个月的时间里,该干预在缺乏服务的人群中产生了临床相关的结果.
- 这种方法符合国家指导方针,并在现实世界初级保健环境中证明了可行性.
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