肥胖症临床试验干预的转变

Fujii H, Yukawa K, Sato H
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摘要

目的:早期的研究表明,从营养和运动方面改变生活习惯是控制代谢综合征最有效的措施,这一发现可能反映在注册临床试验的数量上。本文旨在验证这一假设,并对近期与肥胖相关的临床试验趋势进行探索性分析。设计与方法:在国际临床试验注册平台(ICTRP)注册的临床试验数据中,我们使用1478组肥胖患者数据集进行分析(截至2016年8月)。本研究是探索性分析,旨在检验一些假设,并确定总体趋势。目标假设如下。在针对肥胖患者的临床试验中,旨在验证生活方式改变效果的试验数量逐年增加。结果:针对肥胖的临床试验比例逐年上升。我们清楚地发现,使用生活方式干预的临床试验数量正在增加(p<0.05)。我们进行了一项楔形检验,以检验各国之间在干预措施方面是否存在差异,结果发现,针对肥胖患者的临床试验在美国、法国和荷兰相对更频繁地进行,而在日本、中国、印度和澳大利亚/新西兰,这些临床试验相对较少。BMI≥25的人群比例与针对肥胖患者的临床试验比例的相关系数为0.55,相关性中等。结论:在本研究中,我们发现针对肥胖的临床试验导致了每年的研究结果的积累,这些研究结果表明改变生活方式是控制肥胖最有效的方法,并且这些临床试验的进行频率相对高于其他临床试验。在未来,一旦发现更有效的方法,它也将更频繁地用于其他临床试验。根据国家的分析结果,我们发现肥胖作为一个更严重的健康问题存在的国家倾向于开展更多针对肥胖的临床试验。
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Transition of Intervention of Clinical Trials for Obesity
Objectives: Earlier studies have revealed that modification of lifestyle habits from the aspects of nutrition and exercise is the most effective measure to control metabolic syndrome, and this finding may be reflected in the number of registered clinical trials. This paper aims to test this assumption and conduct exploratory analysis of the recent trends in clinical trials related to obesity.Design and methods: Of the clinical trial data registered with the International Clinical Trial Registry Platform (ICTRP), we used 1,478 data sets of obese patients for analysis (available as of August 2016). This study is exploratory analysis, aiming to test some hypotheses and identify the overall tendency. The target hypotheses are as follows. Among clinical trials targeting obese patients, the number of those intended to verify the effect of lifestyle modification has been increasing year by year.Results: The percentage of clinical trials targeting obesity has been increasing year by year. We clearly found that the number of clinical trials using lifestyle intervention has been increasing (p<0.05). We conducted a chisquared test to examine whether there is any difference in terms of interventions among countries, and found that while clinical trials targeting obese patients were relatively more frequently conducted in the United States, France, and the Netherlands, these clinical trials were relatively less frequent in Japan, China, India, and Australia/New Zealand. The coefficient of correlation between the ratio of people with BMI 25 or higher and the percentage of clinical trials targeting obese patients is 0.55, suggesting a moderate correlation.Conclusion: In this study, we found that clinical trials conducted targeting obesity have led to the accumulation on a yearly basis of study results showing that lifestyle modification is the most effective way to control obesity, and that these clinical trials have been relatively more frequently conducted than other clinical trials. In the future, once a more effective method is discovered, it will be more frequently used in other clinical trials as well. According to the analysis results by country, we found that countries where obesity exists as a more serious health problem tend to conduct more clinical trials targeting obesity.
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