Participation in a multicomponent lifestyle intervention for people with obesity improves glycated hemoglobin (HbA1c)

Mathias Høgsholt, Signe Kierkegaard-Brøchner, U. Sørensen, Lene Bastrup Lange, L. S. Mortensen, Jens Meldgaard Bruun
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Abstract

Obesity is associated with compromised glucose metabolism. Hence, it is of interest to investigate if the lifestyle interventions used in the LIBRA-cohort, which aimed at not only weight loss, but also patient well-being, could also help obese patients improve glucose metabolism by evidence of reduced HbA1c. The aim of the study was to retrospectively investigate if patients who were referred to a lifestyle intervention for obesity, were able to alter HbA1c.Patients with a BMI≥30 undergoing a 6-month lifestyle intervention, who also completed physical and mental health surveys and whose baseline and 6-month blood samples were available, were included in the analysis. For changes in HbA1c and body weight a clinically relevant change of 5≥mmom/mol and 5%≥, respectively, was chosen. Participants were divided into groups according to their baseline HbA1c level: “Diabetes”: HbA1c of ≥6.5% (≥48 mmol/mol), “Prediabetes”: HbA1c of 5.7% to 6.4% (39-47.99 mmol/mol) or “Normal” HbA1c <5.7% (<39 mmol/mol).180 patients met the stated inclusion criteria and these patients were divided into groups (median age (25th;75th quartile): Diabetes: n=47, age 54 (43;60), 51% women, Prediabetes: n=68, age 60 (50;66), 71% women and Normal: n=65, median age 61 (50;66), 85% women. Significant reductions were found in all three groups and specifically in the diabetes group HbA1c was reduced (mean [95%CI]) -5[-8;-2] mmol/mol from baseline to the end of the intervention. Furthermore, 35% of patients with prediabetes normalized their HbA1c (<39) and 30% patients with diabetes reduced their HbA1c <48. All groups had clinically relevant (≥5%) reductions in body weight (p<0.01). There was an association between body weight reduction and HbA1c reduction in the diabetes group (p<0.01). All groups reported improvements in physical health (p<0.01).In this retrospective cohort study, all patients achieved clinically relevant weight loss after participation in the lifestyle intervention and obese patients with diabetes achieved clinically relevant reductions in HbA1c after 6-months. More than 1/3 of patients with prediabetes normalized their HbA1c.
参与针对肥胖症患者的多成分生活方式干预可改善糖化血红蛋白 (HbA1c)
肥胖与糖代谢受损有关。因此,研究 LIBRA 队列中使用的生活方式干预措施(不仅旨在减轻体重,还旨在改善患者健康)是否也能通过降低 HbA1c 的证据帮助肥胖患者改善糖代谢是很有意义的。这项研究的目的是回顾性调查因肥胖而接受生活方式干预的患者是否能够改变 HbA1c。BMI 指数≥30 的患者接受了为期 6 个月的生活方式干预,同时还完成了身体和心理健康调查,并提供了基线和 6 个月的血液样本,这些患者都被纳入了分析范围。HbA1c 和体重的临床相关变化分别为 5≥mmom/mol 和 5%≥。根据参与者的 HbA1c 基线水平将其分为几组:"糖尿病组HbA1c≥6.5%(≥48 mmol/mol),"糖尿病前期":180 名患者符合规定的纳入标准,这些患者被分为几组(年龄中位数(第 25 分位;第 75 分位):糖尿病:47 人,年龄 54(43;60)岁,51% 为女性;糖尿病前期:68 人,年龄 60(50;66)岁,71% 为女性;正常:65 人,中位年龄 61(50;66)岁,85% 为女性。所有三组患者的 HbA1c 均有显著降低,特别是糖尿病组,从基线到干预结束,HbA1c 降低了(平均值[95%CI])-5[-8;-2] mmol/mol。此外,35% 的糖尿病前期患者 HbA1c 降至正常值(<39),30% 的糖尿病患者 HbA1c 降至 <48。所有组别的体重都有临床意义上的(≥5%)下降(p<0.01)。在糖尿病组,体重减轻与 HbA1c 降低之间存在关联(p<0.01)。在这项回顾性队列研究中,所有患者在参与生活方式干预后都实现了临床相关的体重减轻,肥胖糖尿病患者在 6 个月后实现了临床相关的 HbA1c 降低。超过 1/3 的糖尿病前期患者 HbA1c 恢复正常。
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