Patterson Ruth E, Frank Laura L, Kristal Alan R, White Emily
Cancer Prevention Research Program, Fred Hutchinson Cancer Research Center, Seattle, Washington 98109-1024, USA.
Am J Prev Med. 2004 Dec;27(5):385-90. doi: 10.1016/j.amepre.2004.08.001.
Over 70% of older adults in the United States are overweight or obese. To examine the overall health burden of obesity in older adults, the Vitamins and Lifestyle cohort study of western Washington State recruited 73,003 adults aged 50 to 76 who completed a self-administered questionnaire on current height and weight, medical history, and risk factors.
Cross-sectional analysis of body mass index (BMI) and health conditions was performed using data collected in 2000 to 2002. Participants were categorized as normal weight, overweight, obese I, or obese II/III using BMI cut-points. Health conditions included 7 serious diseases, 2 conditions associated with cardiovascular disease risk, 23 medical conditions, and 11 health complaints. Odds ratios (ORs) from logistic regression models were used to examine associations of the four BMI categories with each health condition. Analyses were gender stratified and adjusted for age, education, race/ethnicity, and smoking status.
Among women, 34% were overweight, 16% in the obese I category, and 10% in obese categories II/III. Among men, 49% were overweight, 18% in the obese I category, and 6% in obese categories II/III. Overall, 37 of 41 conditions examined for women and 29 of 41 conditions examined for men were associated with increased levels of BMI (trend p <0.05 for all models). For women and men, respectively, the highest ORs comparing obese II/III to normal weight were diabetes (OR=12.5 and 8.3), knee replacement (OR=11.7 and 6.1), and hypertension (OR=5.4 and 5.6). Obesity also increased the odds of several rare diseases such as pancreatitis (OR=1.9 and 1.5) and health complaints such as chronic fatigue (OR=3.7 and 3.5) and insomnia (OR=3.5 and 3.1).
A broad range of diseases and health complaints are associated with obesity. Clinicians should be aware of the diverse ways in which being overweight or obese may affect the health of their patients when counseling them about weight loss.
美国超过70%的老年人超重或肥胖。为了研究肥胖对老年人整体健康的负担，华盛顿州西部的维生素与生活方式队列研究招募了73003名年龄在50至76岁之间的成年人，他们完成了一份关于当前身高和体重、病史及风险因素的自填问卷。
利用2000年至2002年收集的数据对体重指数（BMI）和健康状况进行横断面分析。根据BMI切点将参与者分为正常体重、超重、肥胖I级或肥胖II/III级。健康状况包括7种严重疾病、2种与心血管疾病风险相关的状况、23种疾病状况和11种健康问题。使用逻辑回归模型的比值比（OR）来检验四个BMI类别与每种健康状况之间的关联。分析按性别分层，并对年龄、教育程度、种族/族裔和吸烟状况进行了调整。
在女性中，34%超重，16%属于肥胖I级，10%属于肥胖II/III级。在男性中，49%超重，18%属于肥胖I级，6%属于肥胖II/III级。总体而言，女性所检查的41种状况中有37种、男性所检查的41种状况中有29种与BMI水平升高相关（所有模型的趋势p<0.05）。对于女性和男性，将肥胖II/III级与正常体重进行比较时，最高的OR分别是糖尿病（OR=12.5和8.3）、膝关节置换（OR=11.7和6.1）以及高血压（OR=5.4和5.6）。肥胖还增加了几种罕见疾病的患病几率，如胰腺炎（OR=1.9和1.5）以及健康问题的几率，如慢性疲劳（OR=3.7和3.5）和失眠（OR=3.5和3.1）。
多种疾病和健康问题都与肥胖有关。临床医生在就减肥问题向患者提供咨询时，应意识到超重或肥胖可能影响患者健康的多种方式。
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