Data_Sheet_1_Cardiometabolic Effects of a 12-Month, COVID-19 Lockdown-Interrupted Lifestyle Education Program for Arab Adolescents.PDF

BackgroundChildhood obesity and pediatric metabolic syndrome (MetS) have steadily increased during the last decade in Saudi Arabia. Intervention programs to prevent cardiometabolic disorders in Arab youth are needed.
ObjectiveIn this multi-school intervention study which was disrupted by COVID-19-imposed lockdowns (September 2019–April 2021), a 12-month lifestyle education program focused on improving the cardiometabolic status of Arab adolescents was investigated.
MethodsA total of 2,677 Saudi students aged 12–18 years were recruited from 60 different secondary and preparatory year schools in Riyadh city, Saudi Arabia. The intervention was initially in-person counseling sessions and the subsequent sessions conducted virtually post-pandemic. Baseline anthropometrics and fasting blood samples for glucose, HbA1c, and lipid assessments were collected at baseline and after 12 months (704 participants).
ResultsOnly 704 out of 2,677 (73.7% dropout) completed the intervention. At baseline, 19.6% of the participants were overweight and 18.1% were obese. A modest but significant decrease in the prevalence of central obesity [11.2 vs. 6.7% (−4.5% change, p = 0.002)], hypertension [22.3 vs. 11.4% (−10.9% change, p < 0.001)], and low-HDL cholesterol [61.6 vs. 23.3% (−38.3% change, p < 0.001)] was noted. Consequently, the prevalence of hypertriglyceridemia increased from 22.7 to 56.3% (+ 33.6%, p < 0.001) overtime. Also, the proportion of subjects who were able to change their status from MetS to non-MetS was significantly more in overweight/obese at baseline than normal weight (16.9 vs. 3.6%, adjusted OR = 3.42, p < 0.001).
ConclusionInterrupted lifestyle education programs secondary to COVID-19-imposed lockdowns still provided modest effects in improving cardiometabolic indices of Arab adolescents. Given the high digital literacy of Arab youth, improving the delivery of virtual lifestyle education programs may prove beneficial.

背景：近十年来，沙特阿拉伯的儿童肥胖与儿童代谢综合征（Pediatric Metabolic Syndrome, MetS）患病率持续攀升，当前亟需针对阿拉伯青年群体制定可预防心血管代谢紊乱的干预项目。
研究目的：本项受2019年新冠疫情封控措施干扰的多校干预研究（2019年9月—2021年4月），旨在评估一项为期12个月、以改善阿拉伯青少年心血管代谢健康状况为目标的生活方式教育项目的效果。
研究方法：本研究从沙特阿拉伯利雅得市60所中学与预科学校招募了共计2677名年龄在12-18岁之间的沙特学生。干预初期采用线下咨询授课形式，疫情后阶段转为线上授课。研究分别在基线与12个月随访时（最终纳入704名参与者）收集受试者的基线人体测量学指标与空腹血液样本，用于检测血糖、糖化血红蛋白（Hemoglobin A1c, HbA1c）与血脂水平。
研究结果：2677名初始受试者中仅704人完成了全部干预流程（脱落率73.7%）。基线时，19.6%的参与者存在超重情况，18.1%达到肥胖标准。研究观察到中心性肥胖患病率、高血压患病率与低高密度脂蛋白胆固醇血症患病率均出现小幅但具有统计学意义的下降：中心性肥胖从11.2%降至6.7%（变化幅度-4.5%，p=0.002），高血压从22.3%降至11.4%（变化幅度-10.9%，p<0.001），低高密度脂蛋白胆固醇血症从61.6%降至23.3%（变化幅度-38.3%，p<0.001）。但高甘油三酯血症患病率则从22.7%升至56.3%（变化幅度+33.6%，p<0.001）。此外，基线时超重/肥胖人群中，成功从代谢综合征状态转为非代谢综合征状态的受试者比例显著高于体重正常人群（16.9% vs 3.6%，校正优势比=3.42，p<0.001）。
研究结论：受新冠疫情封控措施干扰而中断的生活方式教育项目，仍可对改善阿拉伯青少年的心血管代谢指标产生小幅积极效果。鉴于阿拉伯青年群体具备较高的数字素养，优化线上生活方式教育项目的实施方式或可带来更大获益。