Table 4 Effect of adherence on 12-month changes (Δ) in anthropometric, hepatic, and cardiometabolic indicators among children with MetS (GEE model; n = 300).

From: A COM-B-guided lifestyle intervention reduces metabolic syndrome in overweight and obese adolescents: a multiphase study in Vietnam

Δ Indicator

Effect size (β)

95% CI

p-value

Δ Weight (kg)

–2.01

–2.45 to − 1.56

< 0.001

Δ Height (cm)

+ 0.96

+ 0.55 to + 1.37

< 0.001

Δ BMI (kg/m²)

–1.04

–1.19 to − 0.90

< 0.001

Δ Waist circumference (cm)

–1.74

–2.27 to − 1.20

< 0.001

Δ Hip circumference (cm)

–0.71

–1.06 to − 0.36

< 0.001

Δ Systolic BP (mmHg)

–1.29

–2.35 to − 0.24

0.017

Δ Diastolic BP (mmHg)

–0.55

–1.31 to + 0.22

0.163

Δ WHR

–0.01

–0.02 to − 0.01

< 0.001

Δ WHtR

–0.01

–0.02 to − 0.01

< 0.001

Δ Fasting glucose (mg/dL)

–0.07

–0.16 to + 0.02

0.143

Δ ALT (U/L)

–1.24

–3.36 to + 0.89

0.254

Δ AST (U/L)

–0.89

–1.88 to + 0.10

0.079

Δ HbA1c (%)

–0.08

–0.14 to − 0.02

0.010

Δ CAP (dB/m)

–7.65

–13.10 to − 2.20

0.006

Δ Triglycerides (mmol/L)

–0.42

–0.55 to − 0.29

< 0.001

Δ HDL-C (mmol/L)

+ 0.06

+ 0.03 to + 0.09

< 0.001

  1. Δ indicates post-intervention minus baseline. Regression coefficients (β) represent the mean change in Δ per 1-point increase in the adherence score (0–6); negative β denotes a greater reduction with higher adherence, positive β denotes an increase. Estimates were obtained from generalized estimating equations (GEE) with robust standard errors and clustering at the school level, adjusted for age, sex, grade, study site (rural/peri-urban/urban), and household income; missing data were handled by multiple imputation under a missing-at-random assumption (see Methods). Two-sided p < 0.05 was considered statistically significant.
  2. BMI, body mass index; BP, blood pressure; WHR, waist-to-hip ratio; WHtR, waist-to-height ratio; ALT, alanine aminotransferase; AST, aspartate aminotransferase; HbA1c, glycated hemoglobin; CAP, controlled attenuation parameter; HDL-C, high-density lipoprotein cholesterol.