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老年人肥胖、肌肉力量差和静脉血栓栓塞症:INCHIANTI 研究。

Obesity, poor muscle strength, and venous thromboembolism in older persons: the InCHIANTI study.

机构信息

Department of Medicine and Aging, Centre for Aging Sciences (Ce.S.I.), University G. d'Annunzio Foundation, Chieti, Italy.

出版信息

J Gerontol A Biol Sci Med Sci. 2011 Mar;66(3):320-5. doi: 10.1093/gerona/glq207. Epub 2010 Nov 26.

Abstract

BACKGROUND

Both obesity and the decline in muscle strength, which often occur with aging, are accompanied by functional and metabolic changes that may affect the risk of thrombosis. This study evaluated whether obesity and poor muscle strength are associated with venous thromboembolism (VTE).

METHODS

Objectively confirmed VTEs were assessed at baseline and more than a 6-year follow-up in 1,045 participants more than or equal to 60 years enrolled in the InCHIANTI study.

RESULTS

At baseline, 97 participants had a positive history of VTE. Obese participants were almost twice more likely (odds ratio 1.76; 95% confidence interval 1.03-3.01) and obese with poor muscle strength were threefold more likely (odds ratio 2.99; 95% confidence interval 1.56-5.73) to have VTE compared with lean participants with normal strength. Fifty-five VTEs occurred during follow-up. History of VTE, obesity, and/or poor strength independently predicted new VTE events. In participants with previous VTE, the odds ratio (95% confidence interval) for thrombosis was 6.64 (1.92-22.95) with poor strength, 9.69 (3.13-30.01) in the obese, and 14.57 (5.16-41.15) in the obese with poor strength as compared with lean participants with normal strength.

CONCLUSION

Obesity with or without poor muscle strength is a risk factor for VTE among older persons and significantly amplifies the risk of recurrent thrombosis.

摘要

背景

肥胖和肌肉力量下降,常随着年龄增长而发生,两者都伴随着可能影响血栓形成风险的功能和代谢变化。本研究评估了肥胖和肌肉力量差是否与静脉血栓栓塞(VTE)有关。

方法

在 INCHIANTI 研究中,对 1045 名年龄在 60 岁及以上、客观证实的 VTE 在基线和超过 6 年的随访中进行评估。

结果

基线时有 97 名参与者有 VTE 的阳性病史。肥胖参与者发生 VTE 的可能性几乎是正常体重参与者的两倍(优势比 1.76;95%置信区间 1.03-3.01),肥胖且肌肉力量差的参与者发生 VTE 的可能性是正常体重且肌肉力量正常的参与者的三倍(优势比 2.99;95%置信区间 1.56-5.73)。在随访期间,有 55 例发生 VTE。VTE 病史、肥胖和/或肌肉力量差独立预测新的 VTE 事件。在有 VTE 病史的参与者中,与正常体重且肌肉力量正常的参与者相比,血栓形成的比值比(95%置信区间)为 6.64(1.92-22.95),肥胖的比值比为 9.69(3.13-30.01),肥胖且肌肉力量差的比值比为 14.57(5.16-41.15)。

结论

肥胖伴有或不伴有肌肉力量差是老年人 VTE 的危险因素,显著增加了复发性血栓形成的风险。

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