ABSTRACT
Fundamento y objetivo: La evolución clínica y psicológica de los pacientes con sobrepeso u obesidad sigue generando controversias. El objetivo del estudio es conocer el impacto de la pérdida de peso sobre la evolución de las alteraciones tanto clínicas, metabólicas como psicológicas en los pacientes con sobrepeso u obesidad. Pacientes y método: Estudiamos una cohorte de 192 pacientes elegidos aleatoriamente. Todos ellos fueron caracterizados clínica y bioquímicamente. Para el estudio psicopatológico se emplearon cuestionarios auto-administrados y validados en población española: el cuestionario de Goldberg (GHQ-28) y la escala de bulimia y atracones del cuestionario Eating Disorder Inventary (EDI). Para el análisis estadístico se utilizó el programa estadístico SPSS 15.0. Los datos son expresados como medias (desviación estándar). Resultados: La pérdida de peso fue de 3,77 (4,85)kilogramos, equivalente a un 3,8 (4,86)% del peso total, el diámetro de la cintura se redujo en 3,78 (5,89) centímetros, la tensión arterial sistólica se redujo en 3,36 (15,61) mmHg y la diastólica en 2.15 (11,26) mmHg. Disminuyeron de forma significativa los niveles de glucosa 7,37 (21,23) mg/dl, la insulinemia 2,773 (8,749) UI/ml, el índice HOMA-IR 0,925 (2,728), los triglicéridos 12,59 (82,95) mg/dl y el ácido úrico 0,172 (1,13) mg/dl. También disminuyeron significativamente las transaminasas GOT y GPT [2,39(9,38) U/L y 4,95 (16,40) U/L, respectivamente]. El GHQ-28 inicial fue patológico en el 44,8% de los pacientes estudiados, y a los seis meses de tratamiento, la puntuación del GHQ-28 mejoró en el 20,8% (p < 0,001). La puntuación global de la subescala de bulimia del EDI al inicio fue 1,02 (1,91), disminuyendo significativamente a los seis meses a 0,65 (1,49); p < 0,002. Conclusión: La disminución de peso mejora no sólo los parámetros clínicos y bioquímicos de riesgo cardiovascular y la resistencia insulínica, sino que también mejora la puntuación en la escala Goldberg, con un mayor impacto en aquellos con el cuestionario GHQ-28 más patológico al inicio de la intervención (AU)
Introduction and objective: The clinical evolution and psychological well-being of patients with overweight or obesity is still a matter of controversy. The aim of this study is to know the impact of the loss of weight on the evolution of the alterations both clinical and metabolic as psychological in patients with overweight or obesity. Patients and method: We studied a cohort of 192 patients randomly chosen. All of them were characterized clinically and biochemically. Autoadministered questionnaires were used which were already validated in the Spanish population:the General Health Questionnaire (GHQ-28), and bulimia subescale, the Eating Disorder Inventary (EDI). For the statistical analysis using the statistical program SPSS 15.0. Data are expressed as mean (standard deviation). Results: The weight loss was 3.77 (4.85) kilograms, equivalent to a 3.8 (4.86)% of the total weight, the diameter of the waist was reduced by 3.78 (5.89) centimeters, systolic blood pressure was reduced by 3.36 (15.61) mmHg and diastolic in 2.15 (11.26) mmHg. We also found a decreased significantly of glucose levels 7.37(21.23) mg/dl, insulin levels 2.773 (8.749) IU/ml, HOMA-IR index 0.925 (2.728), triglycerides 12.59 (82.95) mg/dl and uric acid 0.172 (1.13) mg/dl. The basal score of the GHQ-28 was pathological in 44,8% of the studied patients, and after six months of treatment, it improved in 20,8% of the patients (p < 0,001). The EDI bulimia subscale score at the beginning of the treatment was 1,02 (SD 1,91), improving after six months of treatment to 0,65 (SD 1,49) p < 0,002. Conclusion: The decrease in weight improves not only clinical parameters and biochemical cardiovascular risk and insulin resistance, but also improves the scale score Goldberg, with higher impact on those with worse baseline GHQ-28 scores (AU)
Subject(s)
Humans , Weight Loss , Overweight/psychology , Obesity/psychology , Risk Factors , Psychometrics/instrumentation , Comorbidity , Evaluation of the Efficacy-Effectiveness of InterventionsABSTRACT
INTRODUCTION AND OBJECTIVE: The clinical evolution and psychological well-being of patients with overweight or obesity is still a matter of controversy. The aim of this study is to know the impact of the loss of weight on the evolution of the alterations both clinical and metabolic as psychological in patients with overweight or obesity. PATIENTS AND METHOD: We studied a cohort of 192 patients randomly chosen. All of them were characterized clinically and biochemically. Autoadministered questionnaires were used which were already validated in the Spanish population:the General Health Questionnaire (GHQ-28), and bulimia subescale, the Eating Disorder Inventary (EDI). For the statistical analysis using the statistical program SPSS 15.0. Data are expressed as mean (standard deviation). RESULTS: The weight loss was 3.77 (4.85) kilograms, equivalent to a 3.8 (4.86)% of the total weight, the diameter of the waist was reduced by 3.78 (5.89) centimeters, systolic blood pressure was reduced by 3.36 (15.61) mmHg and diastolic in 2.15 (11.26) mmHg. We also found a decreased significantly of glucose levels 7.37(21.23) mg/dl, insulin levels 2.773 (8.749) IU/ml, HOMA-IR index 0.925 (2.728), triglycerides 12.59 (82.95) mg/dl and uric acid 0.172 (1.13) mg/dl. The basal score of the GHQ-28 was pathological in 44,8% of the studied patients, and after six months of treatment, it improved in 20,8% of the patients (p < 0,001). The EDI bulimia subscale score at the beginning of the treatment was 1,02 (SD 1,91), improving after six months of treatment to 0,65 (SD 1,49) p < 0,002. CONCLUSION: The decrease in weight improves not only clinical parameters and biochemical cardiovascular risk and insulin resistance, but also improves the scale score Goldberg, with higher impact on those with worse baseline GHQ-28 scores.
