日本的密集健康指导计划对心血管风险因素的影响有限:回归不连续性分析
1Research Institute of Economy, Trade, and Industry, Chiyoda-ku, Kasumigaseki 1-3-1, Tokyo, 100-8901, Japan.
Public health
|May 21, 2024
概括
密集健康指导 (IHG) 对男性心血管风险因素的激励增强指导 (MEG) 显示出极少的额外益处,女性没有显著差异. 废除IHG可能不会对公众健康产生负面影响.
科学领域:
- 公共卫生 公共卫生
- 预防医学 预防医学
- 健康 行为 改变 改变
背景情况:
- 健康咨询计划的强度各不相同,但它们对心血管风险因素的差异性影响尚不清楚.
- 强化健康指导 (IHG) 和提高动机的指导 (MEG) 是日本针对代谢综合征高风险人群的特殊健康检查 (SHC) 计划的组成部分.
研究的目的:
- 为了比较IHG与MEG在改善心血管风险因素方面的有效性.
- 确定健康咨询的强度是否会影响其对代谢综合征指标的影响.
主要方法:
- 使用日本大型SHC结果数据库,采用了回归不连续性设计 (RDD).
- 分析包括了来自225,115个人 (2008-2017) 的541,809个观察结果.
- 将IHG或MEG归类是基于特定的三糖,HDL-C,FBG或HbA1c的截止值,结果在一年后进行评估.
主要成果:
- 与MEG相比,男性的BMI和腰围在IHG下略微显著降低,当甘油三或禁食血糖是决定性因素时.
- 在女性的IHG和MEG之间没有观察到BMI,腰围或其他心血管风险因素的显著差异.
- 在大多数心血管风险因素中,IHG对MEG的有效性在两性之间都是有限的.
结论:
- 密集的健康指导 (IHG) 对心血管风险因素提供了有限的额外益处,与较少密集的增强动机指导 (MEG) 相比.
- 这些发现表明,停止IHG可能对一般人口的心血管健康产生最小的不良影响.
- 根据这些比较有效性结果,可以重新评估指导计划强度的卫生政策.
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