糖尿病前期人群中生活方式干预的依从性评价方法

目的研究糖尿病前期人群中,生活方式干预的依从性评价方法。方法数据来源于“北京糖尿病前期逆转研究”于北京38家医院中开展的一个多中心临床试验。筛选BMI≥24kg／m^2人群501例,完成第1年所有随访。以体重达标率为参照标准,建立依从性评价指标。结果由热量摄入,蛋白质、脂肪、碳水化合物产热比,体育锻炼量5个部分构造依从评分指标,同时考虑了不同测量时间的权重。构造的依从评分指标模型为Y=∑4^52fi（3/6x1i＋2/6x2i＋1/6x3i＋x4i＋x5i）,权重f依次为0．1,0．2,0．3,0．4,1,1,1。依从评分指标以达到8分作为判断是否依从的标准,依从率为85．03％。结论依从评分指标通过将饮食、体育锻炼实际情况和标准情况进行比较,对依从情况进行量化,具有较好的稳定性和可操作性,也适用于BMI〈24kg／m^2人群。

A compliance evaluation model of lifestyle intervention in pre-diabetic population

Objective To explore a statistical model evaluate the compliance of lifestyle intervention in pre-diabetic population. Methods Data were collected from Beijing Pre-diabetes Reversion Project which was a prospective, multi-centric, randomized, medication double-blinded and placebo controlled clinical trial. It was carried out in 38 hospitals. 501 cases with a body mass index （BMI） greater than 24 kg/m2 were selected, and had have been followed up for at least one year with intensive lifestyle intervention arms. The statistical model to evaluate the compliance of lifstyle intervention in pre-diabetes with weight control rate was defined as weight loss more than 50/oo as a reference indicator. Results Five components, such as energy intake, energy supply ratio of protein, fat, carbohydrate and energy consumption by physical activity, were combined together to establish our statistical indicator. At the same time,we also gave a different weight for each visit at different period during follow-up. The model was defined as∑4^52fi（3/6x1i＋2/6x2i＋1/6x3i＋x4i＋x5i） ,When i= 1-7, weight f was 0. 1, 0. 2,0.3, 0.4, 1, 1, 1. If the adherence scores of patients reached 8, we believed that they adhered with the protocol of the lifestyle intervention. The adherence rate was 85.03% in the study. Conclusion Through comparing practical calories intake and energy consumption with the standard, this method successfully converts patients＇ adherence information to adherence scores. This method has great stability and operability, and also can be used in patients with BMI less than 24 kg/m^2.