Stenholm Sari, Rantanen Taina, Alanen Erkki, Reunanen Antti, Sainio Päivi, Koskinen Seppo
Department of Health and Functional Capacity, National Public Health Institute, Peltolantie 3, FI-20720 Turku, Finland.
Obesity (Silver Spring). 2007 Apr;15(4):929-38. doi: 10.1038/oby.2007.583.
To study whether walking limitation at old age is determined by obesity history.
In a retrospective longitudinal study based on a representative sample of the Finnish population of 55 years and older (2055 women and 1337 men), maximal walking speed, body mass, and body height were measured in a health examination. Walking limitation was defined as walking speed<1.2 m/s or difficulty in walking 0.5 km. Recalled height at 20 years of age and recalled weight at 20, 30, 40, and 50 years of age were recorded.
Subjects who had been obese at the age of 30, 40, or 50 years had almost a 4-fold higher risk of walking limitation compared to non-obese. Obesity duration increased the age- and gender-adjusted risk of walking limitation among those who had been obese since the age of 50 (odds ratio, 4.33; 95% confidence interval, 2.59 to 7.23, n=114), among the obese since the age of 40 [6.01 (2.55 to 14.14), n=39], and among the obese since the age of 30 [8.97 (3.06 to 26.29), n=14]. The risk remained elevated even among those who had previously been obese but lost weight during their midlife or late adulthood [3.15 (1.63 to 6.11), n=71].
Early onset of obesity and obesity duration increased the risk of walking limitation, and the effect was only partially mediated through current BMI and higher risk of obesity-related diseases. Preventing excess weight gain throughout one's life course is an important goal in order to promote good health and functioning in older age.
研究老年时行走受限是否由肥胖史决定。
在一项基于芬兰55岁及以上有代表性人群样本（2055名女性和1337名男性）的回顾性纵向研究中，在健康检查时测量最大行走速度、体重和身高。行走受限定义为行走速度<1.2米/秒或行走0.5公里困难。记录20岁时回忆的身高以及20、30、40和50岁时回忆的体重。
与非肥胖者相比，在30、40或50岁时肥胖的受试者行走受限风险几乎高4倍。肥胖持续时间增加了50岁起肥胖者（优势比，4.33；95%置信区间，2.59至7.23，n = 114）、40岁起肥胖者[6.01（2.55至14.14），n = 39]以及30岁起肥胖者[8.97（3.06至26.29），n = 14]中经年龄和性别调整后的行走受限风险。即使是那些曾肥胖但在中年或成年后期体重减轻的人，风险仍然升高[3.15（1.63至6.11），n = 71]。
肥胖早发和肥胖持续时间增加了行走受限风险，且该效应仅部分通过当前体重指数和肥胖相关疾病的较高风险介导。为促进老年人的良好健康和功能，在一生中预防体重过度增加是一个重要目标。
