基层医疗机构对移民妇女肥胖症的有效治疗

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摘要

背景美国成年人的肥胖率为 42%。随着美国移民人口的增加,据报道,美国移民的肥胖负担已接近或超过美国普通人口的肥胖负担。据我们所知,这是第一项报告美国移民肥胖症治疗情况的研究。该研究旨在评估在美国一家安全网学术健康中心接受初级保健服务的移民妇女的肥胖症治疗效果。方法这是对在初级保健机构接受虚拟体重管理就诊的患者进行的回顾性电子病历审查。采用自我报告的人体测量和人口统计学数据。主要结果是体重和体重指数从初诊到复诊的变化,以及体重与初诊体重的百分比变化。次要结果为体重减轻≥5%和≥10%。对独立的分类变量采用卡方检验或费雪精确检验。研究发现,参加计划的移民妇女体重平均减轻了 8.6 公斤(100.2-91.6,p < 0.01),相当于平均减轻了 8.7%。总体平均体重指数下降了 3.4 公斤/平方米(38.1-34.1,p < 0.01)。结论在基层医疗机构接受体重管理的移民妇女的体重和体重指数都有显著下降,其中相当一部分人的体重减轻达到了临床意义上的水平。今后需要进行大样本量的随机对照研究来证实这些发现。
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Effective medical treatment of obesity among immigrant women in primary care

Background

The prevalence of obesity among the general US adults is 42 %. With increasing immigrant population in the US, the obesity burden among immigrants in the US has been reported to approach or exceed that of the general US population. To our knowledge, this is the first study to report obesity treatment among immigrants in the US. The study aims to evaluate the effectiveness of obesity treatment among immigrant women in primary care at a safety-net academic health center in the US.

Methods

This was a retrospectively, electronic medical record chart review of patients who had virtual weight management visits in a primary care setting. Self-reported anthropometric and demographic data were used. Primary outcomes were changes in weight and BMI from initial to follow-up visits as well as bodyweight percentage change from initial weight. Secondary outcomes were ≥5 % and ≥10 % weight reduction. Chi-square or Fisher's exact tests were used for independent categorical variables. Paired t-tests were performed to evaluate the changes in weight and BMI.

Results

The study found average weight reduction of 8.6 kg (100.2–91.6, p < 0.01) which corresponds to an average of 8.7 % weight reduction among immigrant women in the program. The overall average BMI decreased by 3.4 kg/m2 (38.1–34.1, p < 0.01). In the study, 85 % lost 5 % or more, and 42 % lost 10 % or more of their initial weight.

Conclusion

Immigrant women followed for weight management in primary care lost significant weight and BMI, and significant proportion of them achieved clinically meaningful weight reduction. Future large sample size and randomized controlled studies are needed to confirm the findings.

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