Blaum Caroline S, Xue Qian Li, Michelon Elisabete, Semba Richard D, Fried Linda P
University of Michigan, Medical School, Ann Arbor, Michigan 48109, USA.
J Am Geriatr Soc. 2005 Jun;53(6):927-34. doi: 10.1111/j.1532-5415.2005.53300.x.
To determine whether obesity is associated with the frailty phenotype and, if so, whether comorbid conditions or inflammatory markers explain this association.
Cross-sectional analysis of baseline data from the Women's Health and Aging Studies I (1992) and II (1994), complementary population-based studies.
Twelve contiguous ZIP code areas in Baltimore, Maryland.
Five hundred ninety-nine community-dwelling women aged 70 to 79 with a body mass index (BMI) greater than 18.5 kg/m(2).
The dependent variables were the frailty syndrome, including prefrailty, defined as presence of one or two of five frailty indicators (weakness, slowness, weight loss, low physical activity, exhaustion), and frailty, defined as three or more indicators. Independent variables included BMI, categorized using World Health Organization criteria as normal (18.5 to <25 kg/m(2)), overweight (25 to <30 kg/m(2)), and obese (>/=30 kg/m(2)); chronic diseases; C-reactive protein; and serum carotenoids.
Being overweight was significantly associated with prefrailty, and obesity was associated with prefrailty and frailty. In all frail women, regardless of BMI group, a similar pattern of three defining frailty indicators was found: slowness, weakness, and low activity (with the addition of weight loss in the normal weight group.) In multinomial regression models, obesity was significantly associated with prefrailty (odds ratio (OR)=2.23, 95% confidence interval (CI)=1.29-3.84) and frailty (OR=3.52, 95% CI=1.34-9.13), even when controlling for covariates.
Obesity is associated with the frailty syndrome in older women in cross-sectional data. This association remains significant even when multiple conditions associated with frailty are considered. Prospective studies are needed to confirm this finding.
确定肥胖是否与衰弱表型相关，若相关，共病情况或炎症标志物是否能解释这种关联。
对妇女健康与衰老研究I（1992年）和II（1994年）的基线数据进行横断面分析，这两项研究均为基于人群的补充性研究。
马里兰州巴尔的摩市12个相邻的邮政编码区域。
599名年龄在70至79岁之间、体重指数（BMI）大于18.5kg/m²的社区居住女性。
因变量为衰弱综合征，包括衰弱前期，定义为存在五个衰弱指标（虚弱、行动迟缓、体重减轻、体力活动少、疲惫）中的一至两个，以及衰弱，定义为存在三个或更多指标。自变量包括BMI，根据世界卫生组织标准分为正常（18.5至<25kg/m²）、超重（25至<30kg/m²）和肥胖（≥30kg/m²）；慢性病；C反应蛋白；以及血清类胡萝卜素。
超重与衰弱前期显著相关，肥胖与衰弱前期和衰弱相关。在所有衰弱女性中，无论BMI分组如何，均发现了类似的三个定义衰弱指标的模式：行动迟缓、虚弱和体力活动少（正常体重组还包括体重减轻）。在多项回归模型中，即使控制了协变量，肥胖与衰弱前期（优势比（OR）=2.23，95%置信区间（CI）=1.29 - 3.84）和衰弱（OR=3.52，95%CI=1.34 - 9.13）仍显著相关。
在横断面数据中，肥胖与老年女性的衰弱综合征相关。即使考虑了与衰弱相关的多种情况，这种关联仍然显著。需要进行前瞻性研究来证实这一发现。
