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Intervention effects on sex hormone binding globulin (SHBG) and estradiol changes were attenuated with adjustment for change in overall body fat, while there was less attenuation adjusting for intra-abdominal fat change.
The difference was increased slightly by adjustment for change in BMI (β = -0.31, 95% CI -0.51, -0.11).
However, neither adjustment for change in body weight nor change in waist circumference over follow-up materially impacted risk estimates (data not shown).
In the analysis of 10-year modelled cardiovascular risk, participants with a prior cardiovascular disease event were excluded (n = 86) and models included adjustment for change in lipid-lowering, anti-hypertensive and glucose-lowering medication.
Furthermore, the benefit of diuretic compared to beta-blocker persisted after adjustment for change in BP from baseline, suggesting that the protective effects conferred by diuretic therapy are independent of changes in BP.
The potential confounders were age (years), gender, smoking status, excess ethanol intake (≥44 g/day), BMI, and baseline Hb level (Model 1), and further adjustment for change in BMI before and after the disaster (Model 2).
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Adjustment for changes in total daily insulin dose did not change the conclusions for HbA1c.
The adjustment for changes in insulin doses did not seem to significantly influence the overall result for HbA1c.
The unaffected conclusions for HbA1c after adjustment for changes in insulin-dose, suggest that other changes in, for example, life-style, could have masked a glucose-lowering effect of metformin therapy.
In contrast, as depicted in Figure 6 all exercise groups had a reduction in waist circumference compared with the control group and these decreases were largely unchanged by adjustment for changes in weight.
After adjustment for changes in body fat, intervention effects attenuated or disappeared.
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Justyna Jupowicz-Kozak
CEO of Professional Science Editing for Scientists @ prosciediting.com