Changes in metabolic and cardiovascular risk factors after 12 weeks, 1 year and 5 years of intensive lifestyle intervention in real-world clinical practice
| All participants | Group A | Group B | |||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Baseline | 12 weeks | 1 year | 5 years | Baseline | 12 weeks | 1 year | 5 years | Baseline | 12 weeks | 1 year | 5 years | p Value | |
| Body weight (lbs) | 238.6±40.8 | 216.9±37.8*** | 222.8±39.9*** | 226.8±40.5*** | 228.0±36.6 | 213.3±35.8*** | 225.6±37.8*** | 222.5±36.8 *** | 249±43.0 | 224.4±39.3*** | 220.3±41.9*** | 230.6±43.4*** | <0.001 |
| A1C (%) | 7.5±1.2 | 6.5±0.9*** | 7.2±1.4* | 7.7±1.7 | 7.5±1.3 | 6.7±0.9*** | 7.7±1.4 | 8.0±1.9* | 7.4±1.2 | 6.4±0.9*** | 6.8±1.2*** | 7.3±1.5 | <0.05 |
| Systolic blood pressure (mm Hg) | 128.1±14.7 | 121.7±13.5*** | 125.1±14.7* | 126.5±15.5 | 126.3±14.1 | 122.0±12.8* | 128.8±13.1 | 126.8±17.0 | 129.8±15.2 | 121.5±14.1*** | 121.7±15.3*** | 126.3±14.2 | NS |
| Diastolic blood pressure (mm Hg) | 75.6±8.2 | 73.2±9.2** | 73.5±8.9** | 74.1±9.0 | 75.6±8.7 | 74.1±7.4 | 76.4±8.4 | 74.7±8.9* | 75.7±7.8 | 72.3±10.6* | 70.8±8.6*** | 73.5±9.0 | NS |
| Blood pressure medications (n) | 1.4±1.2 | 1.4±1.2 | 1.5±1.3 | 1.6±1.3* | 1.3±1.3 | 1.4±1.3 | 1.5±1.4* | 1.6±1.3** | 1.5±1.2 | 1.5±1.1 | 1.4±1.1 | 1.5±1.2 | NS |
| Total cholesterol (mg/dL) | 166.7±32.4 | 148.3±31.7*** | 162.1±32.3 | 164.7±34.4 | 165.2±31.3 | 151.0±28.8*** | 165.3±35.3 | 167.0±36.2 | 168.0±33.6 | 146.0±34.1*** | 159.2±29.4* | 162.6±32.9 | NS |
| LDL-cholesterol (mg/dL) | 99.1±29.8 | 87.0±28.8*** | 93.6±27.8* | 87.4±29.6*** | 97.1±28.1 | 87.8±26.5** | 94.5±28.9 | 86.9±34.2* | 100.9±31.3 | 87.2±31.4*** | 92.8±27.0* | 87.9±25.1** | NS |
| HDL-cholesterol (mg/dL) | 43.3±10.0 | 42.5±10.7 | 47.5±13.0*** | 50.2±15.4*** | 44.6±10.2 | 44.1±10.8 | 49.3±14.2*** | 52.1±15.0*** | 42.2±9.9 | 40.3±9.3 | 45.9±11.7*** | 48.6±15.6*** | NS |
| Triglycerides (mg/dL) | 137.9±73.2 | 101.9±49.0*** | 122.8±62.7* | 157.0±78.0* | 128.2±60.3 | 101.2±46.9*** | 130.3±63.1 | 159.6±73.6** | 146.5±82.4 | 102.5±51.2*** | 116.0±61.9*** | 154.8±82.1 | NS |
| Serum creatinine (mg/dL) | 0.92±0.19 | 0.93±0.18*** | 0.92±0.21 | 0.87±0.25** | 0.91±0.20 | 0.93±0.21 | 0.91±0.19 | 0.88±0.27 | 0.92±0.18 | 0.92±0.17 | 0.93±0.22 | 0.87±0.24* | NS |
| Blood urea nitrogen (mg/dL) | 17.4±5.5 | 17.4±5.6 | 18.1±6.3 | 18.1±7.4 | 16.9±4.8 | 18.2±6.6 | 17.3±0.51 | 18.2±6.5 | 17.9±6.1 | 17.2±5.9 | 18.9±7.2 | 18.1±8.1 | NS |
| Urinary microalbumin/creatinine ratio (mcg/mg) | 30.0±56.7 | 18.2±26.9** | 27.2±88.1 | 44.4±169.8 | 22.5±26.4 | 16.8±22.4* | 21.1±38.6 | 32.1±58.5 | 36.4±73.2 | 19.1±29.9* | 32.8±116.2 | 55.7±229.1 | NS |
| Medications for CVD risk factors (n) | 4.5±1.9 | 4.7±1.9 | 4.7±1.9 | 4.8±1.9* | 4.3±2.0 | 4.6±2.0 | 4.8±2.0** | 4.7±1.9* | 4.6±1.9 | 4.7±1.9 | 4.6±1.9 | 4.8±1.8 | NS |
| Diabetes medications (n) | 2.2±1.1 | 2.2±1.1 | 2.2±1.3 | 2.2±1.0 | 2.0±1.1 | 2.1±1.2 | 2.0±1.1 | 2.1±1.0 | 2.3±1.1 | 2.3±1.1 | 2.3±1.1 | 2.3±1.0 | NS |
| Patients on insulin (%) | 42.5 | 39.5 | 39.5 | 47.4 | 37.7 | 37.7 | 37.7 | 50.5 | 47.1 | 47.1 | 47.1 | 44.1 | NS |
All participants N=129. Group A n=61 (participants maintained <7% weight loss at 1 year). Group B n=68 (participants maintained ≥7% weight loss at 1 year). Medications for CVD risk factors=diabetes, hypertension and dyslipidemia.
*p<0.05, **p<0.01, ***p<0.001, (versus baseline in the same group). p=group A versus group B at 5 years.
NS, non-significant.