Dept of Epidemiology and Biostatistics, University of South Carolina, Columbia, SC, USA.
J Phys Act Health. 2011 Jan;8(1):18-26. doi: 10.1123/jpah.8.1.18.
This study examined the associations of body mass index (BMI), waist circumference (WC), and cardiorespiratory fitness (CRF) with incident functional limitation (IFL) in adults.
Patients (n = 2400), 30+ years [mean age, 45.2 (SD, 8.3); 12% women], completed a baseline health examination during 1979 to 1995. CRF was quantified by age-and sex-specific thirds for maximal treadmill exercise test duration. Adiposity was assessed by BMI and WC (grouped for analysis according to clinical guidelines). Incident IFL was identified from mail-back surveys during 1995, 1999, and 2004.
After adjusting for potential confounders and either BMI or WC, CRF was inversely related to IFL (P trend < .001). The association between BMI and IFL was significant after adjusting for all confounders (P trend = .002), but not after additional adjustment for CRF (P trend = .23). After controlling for all confounders and CRF, high WC was associated with greater odds of IFL in those aged 30 to 49; normal WC was associated with greater odds of IFL in those aged 50+.
CRF was a significant predictor of IFL in middle aged and older adults, independent of overall or abdominal adiposity. Clinicians should consider the importance of preserving functional capacity by recommending regular physical activity for normal-weight and overweight individuals.
本研究探讨了身体质量指数（BMI）、腰围（WC）和心肺适能（CRF）与成年人新发功能障碍（IFL）的相关性。
患者（n=2400），年龄 30 岁以上[平均年龄，45.2（SD，8.3）；12%为女性]，于 1979 年至 1995 年期间完成基线健康检查。CRF 通过最大跑步机运动试验持续时间的年龄和性别特定三分位数进行量化。肥胖通过 BMI 和 WC（根据临床指南进行分组分析）进行评估。新发 IFL 通过 1995 年、1999 年和 2004 年的邮件回复调查确定。
在调整了潜在混杂因素以及 BMI 或 WC 后，CRF 与 IFL 呈负相关（P 趋势<.001）。在调整了所有混杂因素后，BMI 与 IFL 之间的关联具有统计学意义（P 趋势=.002），但在进一步调整 CRF 后则不具有统计学意义（P 趋势=.23）。在控制了所有混杂因素和 CRF 后，在 30 至 49 岁的人群中，高 WC 与 IFL 的发病风险增加相关；在 50 岁及以上的人群中，正常 WC 与 IFL 的发病风险增加相关。
CRF 是中老年人 IFL 的重要预测指标，与整体或腹部肥胖无关。临床医生应通过建议定期进行体育活动来保持正常体重和超重人群的功能能力，从而重视这一点。
