Weight in Secondary Prevention (WISP)

二级预防权重 (WISP)

• 批准号: 7140643
• 负责人: ADRIANNE C FELDSTEIN
• 金额: $ 16.05万
• 依托单位: KAISER FOUNDATION RESEARCH INSTITUTE
• 依托单位国家: 美国
• 财政年份: 2005
• 资助国家: 美国
• 起止时间: 2005-09-30 至 2008-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7140643
• 关键词: automated medical record system; body composition; body weight; clinical research; coronary disorder; disease /disorder prevention /control; health care cost /financing; health care service utilization; health services research tag; heart disorder diagnosis; human data; human subject; metabolism disorder diagnosis; noninsulin dependent diabetes mellitus; obesity; patient /disease registry; statistics /biometry

DESCRIPTION (provided by applicant): Patients with coronary artery disease (CAD) or type-2 diabetes mellitus (DM) sustain large burdens of excess cardiovascular morbidity, mortality, and health care costs. National data reveal that these patients make up about 10% of the adult population and account for the majority of obesity related health care costs. Eighty percent of CAD patients and 90% of DM patients are overweight or obese. Focusing on weight as a risk factor in the secondary prevention of adverse events in these patients, as this study does, is attractive because weight optimization has been shown to improve patient outcomes. This study proposes to use a unique dataset from two large population-based registries of patients with CAD or DM to describe body mass index (BMI) trajectories, patient characteristics associated with those trajectories, and the effect of the trajectories on health care costs. This study addresses the NIH goal of systematic observations of obesity-related behaviors in real world settings. It also addresses the broader long-term goal of designing improved energy balance programs targeted at the most appropriate patients in an effort to reduce future cardiovascular events and other BMI-related complications. Specific aims are, in adult patients with a new diagnosis of CAD or type 2 DM and who meet other study- defined eligibility criteria (n=10,000): 1) to estimate their BMI trajectories 1, 3, and 5 years post-diagnosis; 2) to determine which patient demographic and disease-related characteristics are significantly associated with their 1-, 3-, and 5-year post-diagnosis BMI trajectories; and 3) to examine the association of the 1-, 3-, and 5-year post-diagnosis BMI trajectories with total health care costs. All analyses will be conducted separately for those with newly diagnosed coronary artery disease and those with newly diagnosed type 2 diabetes mellitus. This study will use electronic data from Kaiser Permanente Northwest disease registries, electronic medical record, and other databases. The use of existing data from linked databases will allow conducting a low-cost evaluation of BMI trajectories using growth curve analysis techniques. This evaluation will provide community-based background information useful for determining how to most effectively apply weight management programs. Relevance: This study focuses on patients at highest risk for future health problems related to obesity or overweight-those with coronary artery disease and type 2 diabetes mellitus. Understanding which patients will need the most support to manage weight will allow us to design the most cost-effective future programs.

描述（由申请人提供）：患有冠状动脉疾病 (CAD) 或 2 型糖尿病 (DM) 的患者承受着过高的心血管发病率、死亡率和医疗保健费用的巨大负担。国家数据显示，这些患者约占成年人口的 10%，并占肥胖相关医疗费用的大部分。 80% 的 CAD 患者和 90% 的 DM 患者超重或肥胖。正如本研究所做的那样，将体重作为这些患者不良事件二级预防的危险因素是很有吸引力的，因为体重优化已被证明可以改善患者的预后。本研究建议使用来自两个大型 CAD 或 DM 患者登记的独特数据集来描述体重指数 (BMI) 轨迹、与这些轨迹相关的患者特征以及轨迹对医疗保健成本的影响。 这项研究实现了 NIH 系统观察现实世界中肥胖相关行为的目标。它还解决了更广泛的长期目标，即针对最合适的患者设计改进的能量平衡计划，以减少未来的心血管事件和其他与体重指数相关的并发症。 具体目标是，对于新诊断为 CAD 或 2 型 DM 且符合其他研究定义的资格标准的成年患者 (n=10,000)： 1) 估计诊断后 1 年、3 年和 5 年的 BMI 轨迹； 2) 确定哪些患者人口统计和疾病相关特征与其诊断后 1 年、3 年和 5 年 BMI 轨迹显着相关； 3) 检查诊断后 1 年、3 年和 5 年 BMI 轨迹与总医疗保健费用的关联。所有分析将分别针对新诊断的冠状动脉疾病患者和新诊断的 2 型糖尿病患者进行。 这项研究将使用来自 Kaiser Permanente 西北疾病登记处、电子病历和其他数据库的电子数据。使用链接数据库中的现有数据将允许使用生长曲线分析技术对 BMI 轨迹进行低成本评估。该评估将提供基于社区的背景信息，有助于确定如何最有效地应用体重管理计划。 相关性：本研究重点关注未来因肥胖或超重而出现健康问题风险最高的患者，即患有冠状动脉疾病和 2 型糖尿病的患者。了解哪些患者需要最多的支持来控制体重将使我们能够设计最具成本效益的未来计划。

项目成果

Weight change in diabetes and glycemic and blood pressure control.

• DOI: 10.2337/dc08-0426
• 发表时间: 2008-10
• 期刊: DIABETES CARE
• 影响因子: 16.2
• 作者: Feldstein, Adrianne C.;Nichols, Gregory A.;Smith, David H.;Stevens, Victor J.;Bachman, Keith;Rosales, A. Gabriela;Perrin, Nancy
• 通讯作者: Perrin, Nancy