吸烟者戒烟后体重增加：荟萃分析
2012/12/13
摘要
目的：在获得持续戒断12个月以上的吸烟者和未经治疗或使用药物辅助戒断的吸烟者中，描述体重增加及其变化情况。
设计：荟萃分析。
数据来源：检索临床对照试验中心注册数据库（CENTRAL）和Cochrane有关戒烟干预措施（尼古丁替代治疗、尼古丁部分激动剂、抗抑郁药治疗和运动）的临床试验，寻找有关一线治疗（尼古丁替代治疗、安非他酮、瓦伦尼克林）和运动治疗的随机临床试验，其中研究报道吸烟者的体重变化。同时检索CENTRAL，寻找有关戒断后针对体重增加采取干预措施的临床试验。
综述方法：对于戒断的吸烟者，如果临床试验包含基线状态至随访期间的体重变化，则入选。我们采用随机效应倒方差模型计算平均值和95%可信区间，以及基线状态至戒断后1、2、3、6和12个月后的体重变化标准差的平均值。采用随机效应荟萃回归分析，研究亚组差异。
结果：62项研究入选。在未治疗的戒烟者，戒断后1、2、3、6和12个月，平均体重增加为1.12 kg（95%CI 0.76-1.47）、2.26 kg（1.98-2.54）、2.85 kg（2.42-3.28）、4.23 kg（3.69-4.77）和4.67 kg（3.96-5.38）。采用平均值和加权的标准差，在戒断12个月后，16%、37%、34%和13%未治疗的戒烟者分别体重下降、体重增加小于5 kg、体重增加5-10 kg和体重增加超过10 kg。不同药物戒烟的吸烟者，体重增加相似。关心体重增加和不关心体重增加的吸烟者，体重变化相似。
结论：戒烟与戒烟后12个月平均体重增加4-5 kg相关，体重增加主要出现在戒烟后的3个月。体重变化的变异较大，约16%的戒烟者体重下降，而13%的戒烟者体重增加超过10 kg。
（陈欣 审校）
BMJ. 2012 Jul 10;345:e4439. doi: 10.1136/bmj.e4439.
Weight gain in smokers after quitting cigarettes: meta-analysis.
Aubin HJ, Farley A, Lycett D, Lahmek P, Aveyard P.
Source
Centre d’Enseignement, de Recherche et de Traitement des Addictions, Hôpital Paul Brousse, AP-HP, Univ Paris-Sud, INSERM U669, 94804 Villejuif, France.
Abstract
OBJECTIVE: To describe weight gain and its variation in smokers who achieve prolonged abstinence for up to 12 months and who quit without treatment or use drugs to assist cessation.
DESIGN: Meta-analysis.
DATA SOURCES: We searched the Central Register of Controlled Trials (CENTRAL) and trials listed in Cochrane reviews of smoking cessation interventions (nicotine replacement therapy, nicotinic partial agonists, antidepressants, and exercise) for randomised trials of first line treatments (nicotine replacement therapy, bupropion, and varenicline) and exercise that reported weight change. We also searched CENTRAL for trials of interventions for weight gain after cessation.
REVIEW METHODS: Trials were included if they recorded weight change from baseline to follow-up in abstinent smokers. We used a random effects inverse variance model to calculate the mean and 95% confidence intervals and the mean of the standard deviation for weight change from baseline to one, two, three, six, and 12 months after quitting. We explored subgroup differences using random effects meta-regression.
RESULTS: 62 studies were included. In untreated quitters, mean weight gain was 1.12 kg (95% confidence interval 0.76 to 1.47), 2.26 kg (1.98 to 2.54), 2.85 kg (2.42 to 3.28), 4.23 kg (3.69 to 4.77), and 4.67 kg (3.96 to 5.38) at one, two, three, six, and 12 months after quitting, respectively. Using the means and weighted standard deviations, we calculated that at 12 months after cessation, 16%, 37%, 34%, and 13% of untreated quitters lost weight, and gained less than 5 kg, gained 5-10 kg, and gained more than 10 kg, respectively. Estimates of weight gain were similar for people using different pharmacotherapies to support cessation. Estimates were also similar between people especially concerned about weight gain and those not concerned.
CONCLUSION: Smoking cessation is associated with a mean increase of 4-5 kg in body weight after 12 months of abstinence, and most weight gain occurs within three months of quitting. Variation in weight change is large, with about 16% of quitters losing weight and 13% gaining more than 10 kg.
BMJ. 2012 Jul 10;345:e4439. doi: 10.1136/bmj.e4439.
目的：在获得持续戒断12个月以上的吸烟者和未经治疗或使用药物辅助戒断的吸烟者中，描述体重增加及其变化情况。
设计：荟萃分析。
数据来源：检索临床对照试验中心注册数据库（CENTRAL）和Cochrane有关戒烟干预措施（尼古丁替代治疗、尼古丁部分激动剂、抗抑郁药治疗和运动）的临床试验，寻找有关一线治疗（尼古丁替代治疗、安非他酮、瓦伦尼克林）和运动治疗的随机临床试验，其中研究报道吸烟者的体重变化。同时检索CENTRAL，寻找有关戒断后针对体重增加采取干预措施的临床试验。
综述方法：对于戒断的吸烟者，如果临床试验包含基线状态至随访期间的体重变化，则入选。我们采用随机效应倒方差模型计算平均值和95%可信区间，以及基线状态至戒断后1、2、3、6和12个月后的体重变化标准差的平均值。采用随机效应荟萃回归分析，研究亚组差异。
结果：62项研究入选。在未治疗的戒烟者，戒断后1、2、3、6和12个月，平均体重增加为1.12 kg（95%CI 0.76-1.47）、2.26 kg（1.98-2.54）、2.85 kg（2.42-3.28）、4.23 kg（3.69-4.77）和4.67 kg（3.96-5.38）。采用平均值和加权的标准差，在戒断12个月后，16%、37%、34%和13%未治疗的戒烟者分别体重下降、体重增加小于5 kg、体重增加5-10 kg和体重增加超过10 kg。不同药物戒烟的吸烟者，体重增加相似。关心体重增加和不关心体重增加的吸烟者，体重变化相似。
结论：戒烟与戒烟后12个月平均体重增加4-5 kg相关，体重增加主要出现在戒烟后的3个月。体重变化的变异较大，约16%的戒烟者体重下降，而13%的戒烟者体重增加超过10 kg。
（陈欣 审校）
BMJ. 2012 Jul 10;345:e4439. doi: 10.1136/bmj.e4439.
Weight gain in smokers after quitting cigarettes: meta-analysis.
Aubin HJ, Farley A, Lycett D, Lahmek P, Aveyard P.
Source
Centre d’Enseignement, de Recherche et de Traitement des Addictions, Hôpital Paul Brousse, AP-HP, Univ Paris-Sud, INSERM U669, 94804 Villejuif, France.
Abstract
OBJECTIVE: To describe weight gain and its variation in smokers who achieve prolonged abstinence for up to 12 months and who quit without treatment or use drugs to assist cessation.
DESIGN: Meta-analysis.
DATA SOURCES: We searched the Central Register of Controlled Trials (CENTRAL) and trials listed in Cochrane reviews of smoking cessation interventions (nicotine replacement therapy, nicotinic partial agonists, antidepressants, and exercise) for randomised trials of first line treatments (nicotine replacement therapy, bupropion, and varenicline) and exercise that reported weight change. We also searched CENTRAL for trials of interventions for weight gain after cessation.
REVIEW METHODS: Trials were included if they recorded weight change from baseline to follow-up in abstinent smokers. We used a random effects inverse variance model to calculate the mean and 95% confidence intervals and the mean of the standard deviation for weight change from baseline to one, two, three, six, and 12 months after quitting. We explored subgroup differences using random effects meta-regression.
RESULTS: 62 studies were included. In untreated quitters, mean weight gain was 1.12 kg (95% confidence interval 0.76 to 1.47), 2.26 kg (1.98 to 2.54), 2.85 kg (2.42 to 3.28), 4.23 kg (3.69 to 4.77), and 4.67 kg (3.96 to 5.38) at one, two, three, six, and 12 months after quitting, respectively. Using the means and weighted standard deviations, we calculated that at 12 months after cessation, 16%, 37%, 34%, and 13% of untreated quitters lost weight, and gained less than 5 kg, gained 5-10 kg, and gained more than 10 kg, respectively. Estimates of weight gain were similar for people using different pharmacotherapies to support cessation. Estimates were also similar between people especially concerned about weight gain and those not concerned.
CONCLUSION: Smoking cessation is associated with a mean increase of 4-5 kg in body weight after 12 months of abstinence, and most weight gain occurs within three months of quitting. Variation in weight change is large, with about 16% of quitters losing weight and 13% gaining more than 10 kg.
BMJ. 2012 Jul 10;345:e4439. doi: 10.1136/bmj.e4439.
上一篇：
戒烟治疗的疗效：来自国际烟草控制组织（ITC）
下一篇：
脑部刺激法治疗烟草依赖症
