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限食辟谷试验干预观察和基于比例风险回归模型的 限食降压的预后估计

Effects of a Fasting Bibu Trial and Prognosis Estimation of Blood Pressure Reduction Based on the Proportional Hazards Model

  • 摘要: 随着人们物质生活水平的提高及生活方式的改变, 高血压等慢性病的患病率呈快速增长趋 势。多项动物和人体试验研究表明, 一定程度限制摄入热量(限食干预)正在成为一种可有效控制体 重、降低肥胖率、改善血压的治疗方法。该研究报告了一项在中国进行的 149 人限食辟谷试验, 受 试人群在连续 5 天的限食干预后体重、身体质量指数、腰围等生理指标对比基线值均出现显著下降 (P<0.001)。其中, 处于高血压状态的受试者(包括 2 级和 1 级高血压)在干预后收缩压和舒张压的 下降幅度分别为 11.2 mmHg(95% 置信区间为 7.5~14.9 mmHg, P<0.001)和 7.2 mmHg(95% 置信区间为 4.7~9.7 mmHg, P<0.001), 正常血压的受试者收缩压和舒张压均未出现明显变化。在此基础上, 该 研究进一步通过比例风险回归模型实现对个体进行限食干预后降压效果的预后估计, 并绘制出直观 方便、易于使用的列线图, 模型经内部重采样 1 000 次校正后的一致性指数(C-index)为 0.891。

     

    Abstract: With the improvement of people’s material lives and changes in lifestyles, the prevalence of chronic diseases such as hypertension has shown a rapidly growing trend. Numerous animal and human fasting trials have reported that fasting has been emerging as an effective tool to control weight and lower blood pressure, having a profound health benefit. In a fasting trial involving 149 participants in China, the subjects’ body weight, BMI (body mass index) and waist circumference all significantly decreased from baseline after 5 consecutive days of fasting intervention (P<0.001). The magnitude of systolic and diastolic blood pressure (BP) reduction in subjects with hypertension was -11.2 mmHg (-14.9 to -7.5 mmHg, 95% CI (confidence intervals), P<0.001) and -7.2 mmHg (-9.7 to -4.7, 95% CI, P<0.001) after 5-day fasting intervention, respectively. No significant reduction occurred in systolic and diastolic BP of participants with normal BP. Then we implemented a further assessment of antihypertensive effects during the period of fasting trial by developing an easy-to-use nomogram based on proportional hazards regression, and the nomogram in our study achieved a bootstrap-corrected concordance index (C-index) of 0.891.

     

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