A School-Based Intervention for Diabetes Risk Reduction.

被引：248

作者：

Baranowski, T. ^{[2
]}

Adams, L. ^{[2
]}

Baranowski, J. ^{[2
]}

Canada, A. ^{[2
]}

Cullen, K. W. ^{[2
]}

Dobbins, M. H. ^{[2
]}

Jago, R. ^{[2
]}

Oceguera, A. ^{[2
]}

Rodriguez, A. X. ^{[2
]}

Speich, C. ^{[2
]}

Tatum, L. T. ^{[2
]}

Thompson, D. ^{[2
]}

White, M. A. ^{[2
]}

Williams, C. G. ^{[2
]}

Goldberg, L. ^{[3
]}

Cusimano, D. ^{[3
]}

DeBar, L. ^{[3
]}

Elliot, D. ^{[3
]}

Grund, H. M. ^{[3
]}

Kuehl, K. ^{[3
]}

McCormick, S. ^{[3
]}

Moe, E. ^{[3
]}

Roullet, J. B. ^{[3
]}

Stadler, D. ^{[3
]}

Foster, G. D. ^{[1
]}

Brown, J.

Creighton, B.

Faith, M.

Ford, E. G.

Glick, H.

Kumanyika, S.

Nachmani, J.

Rosen, J.

Rosen, L.

Sherman, S.

Solomon, S.

Virus, A.

Volpe, S. L.

Willi, S.

Cooper, D. ^{[4
]}

Bassin, S. ^{[4
]}

Bruecker, S. ^{[4
]}

Ford, D. ^{[4
]}

Galassetti, P. ^{[4
]}

Greenfield, S. ^{[4
]}

Hartstein, J. ^{[4
]}

Krause, M. ^{[4
]}

Opgrand, N. ^{[4
]}

Rodriguez, Y. ^{[4
]}

Schneider, M. ^{[4
]}

机构：

[1] Temple Univ, Ctr Obes Res & Educ, Philadelphia, PA 19140 USA

[2] Baylor Coll Med, Houston, TX 77030 USA

[3] Oregon Hlth & Sci Univ, Portland, OR 97201 USA

[4] Univ Calif Irvine, Irvine, CA 92717 USA

[5] Univ N Carolina, Chapel Hill, NC USA

[6] Univ Pittsburgh, Pittsburgh, PA 15260 USA

[7] Univ Texas Hlth Sci Ctr San Antonio, San Antonio, TX 78229 USA

[8] Childrens Hosp Los Angeles, Los Angeles, CA USA

[9] Univ Michigan, Ann Arbor, MI 48109 USA

[10] Univ So Calif, Los Angeles, CA 90089 USA

[11] Ctr Dis Control & Prevent, Atlanta, GA 30333 USA

[12] George Washington Univ, Washington, DC 20052 USA

[13] Univ Washington, NW Lipid Metab Lab, Seattle, WA 98195 USA

[14] Univ Washington, Diabet Res Lab, Seattle, WA 98195 USA

[15] Univ Calif San Diego, San Diego, CA 92103 USA

[16] Univ Chicago, Chicago, IL 60637 USA

[17] Univ Tennessee Hlth Sci Ctr, Knoxville, TN 37996 USA

[18] Cincinnati Childrens Hosp Med Ctr, Cincinnati, OH USA

[19] Wake Forest Univ, Winston Salem, NC 27109 USA

[20] Univ S Carolina, Columbia, SC 29208 USA

[21] Univ Florida, Gainesville, FL 32611 USA

来源：

NEW ENGLAND JOURNAL OF MEDICINE | 2010年 / 363卷 / 05期

基金：

美国国家卫生研究院;

关键词：

INSULIN-RESISTANCE; GLUCOSE-LEVELS; OBESITY; PREVENTION; RATIONALE; HEALTHY; DESIGN; ADOLESCENTS; PREVALENCE; STRATEGIES;

D O I：

10.1056/NEJMoa1001933

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Background: We examined the effects of a multicomponent, school-based program addressing risk factors for diabetes among children whose race or ethnic group and socioeconomic status placed them at high risk for obesity and type 2 diabetes. Methods: Using a cluster design, we randomly assigned 42 schools to either a multicomponent school-based intervention (21 schools) or assessment only (control, 21 schools). A total of 4603 students participated (mean [+/-SD] age, 11.3+/-0.6 years; 54.2% Hispanic and 18.0% black; 52.7% girls). At the beginning of 6th grade and the end of 8th grade, students underwent measurements of body-mass index (BMI), waist circumference, and fasting glucose and insulin levels. Results: There was a decrease in the primary outcome -- the combined prevalence of overweight and obesity -- in both the intervention and control schools, with no significant difference between the school groups. The intervention schools had greater reductions in the secondary outcomes of BMI z score, percentage of students with waist circumference at or above the 90th percentile, fasting insulin levels (P=0.04 for all comparisons), and prevalence of obesity (P=0.05). Similar findings were observed among students who were at or above the 85th percentile for BMI at baseline. Less than 3% of the students who were screened had an adverse event; the proportions were nearly equivalent in the intervention and control schools. Conclusions: Our comprehensive school-based program did not result in greater decreases in the combined prevalence of overweight and obesity than those that occurred in control schools. However, the intervention did result in significantly greater reductions in various indexes of adiposity. These changes may reduce the risk of childhood-onset type 2 diabetes. (Funded by the National Institutes of Health and the American Diabetes Association; ClinicalTrials.gov number, NCT00458029.) N Engl J Med 2010;363:443-53.

引用

页码：443 / 453

页数：11

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