肥胖与 65 岁及以上加拿大社区居住者自我报告的跌倒和损伤的性别特异性关联。
Sex-specific association between obesity and self-reported falls and injuries among community-dwelling Canadians aged 65 years and older.
机构信息
School of Kinesiology and Leisure, Université de Moncton, Moncton, NB, Canada.
Institut National Santé Publique Québec, Québec, QC, Canada.
出版信息
Osteoporos Int. 2017 Feb;28(2):483-494. doi: 10.1007/s00198-016-3745-x. Epub 2016 Aug 25.
UNLABELLED
This study investigated the relationship between body mass index (BMI) and falls among community-dwelling elderly. Results indicate that obesity is associated with increased falls and there appears to be a sex-specific difference with obese men at higher risk of falling. Obesity is identified as a risk factor for falls in men.
INTRODUCTION
The prevalence of falls, fall-related injuries, and obesity has increased over the last decade. The objectives of this study were to investigate sex-specific association and dose-response relationship between BMI and falls (and related injuries) among community-dwelling elderly.
METHODS
Our study sample consisted of 15,860 adults aged 65 years or older (6399 men and 9461 women) from the 2008-2009 Canadian Community Health Survey-Healthy Aging (CCHS-HA). Falls, fall-related injuries, and BMI measures were self-reported. For both sex, dose-response curves presenting the relationship between BMI, falls, and fall-related injuries were first examined. Thereafter, multivariate logistic regression analyses were also performed to investigate these relationships after adjustment for potentially confounding variables.
RESULTS
Of women, 21.7 % reported a fall and 16.9 % of men. The dose-response relationship between BMI and prevalence of falls showed that underweight and obese individuals reported falling more than normal and overweight individuals; this being more apparent in men than women. Finally, the dose relationship between BMI and prevalence of fall-related injuries showed that only obese men seem more likely to have sustained a fall-related injury. Results from the multivariate analysis showed that obesity in men was significantly associated with higher odds of falling odds ratio (OR) 1.33 (1.04-1.70) and was not significantly associated with higher odds of fall-related injuries OR 1.10 (0.66-1.84) over a 12-month period compared to normal weight men. For women, obesity was not significantly associated with higher fall prevalence OR 0.99 (0.79-1.25) and fall-related injuries OR 0.71 (0.51-1.00).
CONCLUSION
Obesity is associated with self-reported falls, and there appears to be a sex-specific difference in elderly persons.
本研究调查了社区居住的老年人中体重指数（BMI）与跌倒之间的关系。结果表明，肥胖与跌倒增加有关，而且似乎存在性别特异性差异，肥胖男性跌倒的风险更高。肥胖被确定为男性跌倒的一个风险因素。
引言
在过去十年中，跌倒、与跌倒相关的伤害和肥胖的患病率有所增加。本研究的目的是调查社区居住的老年人中 BMI 与跌倒（和相关伤害）之间的特定性别关联和剂量反应关系。
方法
我们的研究样本包括 2008-2009 年加拿大社区健康调查-健康老龄化（CCHS-HA）中 15860 名 65 岁或以上的成年人（6399 名男性和 9461 名女性）。跌倒、与跌倒相关的伤害和 BMI 测量均为自我报告。对于两性，首先检查 BMI、跌倒和与跌倒相关的伤害之间的关系呈现剂量反应曲线。此后，还进行了多变量逻辑回归分析，以调查在调整潜在混杂变量后这些关系。
结果
在女性中，21.7%报告跌倒，16.9%的男性报告跌倒。BMI 与跌倒发生率之间的剂量反应关系表明，体重过轻和肥胖者比体重正常和超重者更有可能跌倒；这种情况在男性中比女性中更为明显。最后，BMI 与与跌倒相关的伤害发生率之间的剂量关系表明，只有肥胖男性似乎更有可能发生与跌倒相关的伤害。多变量分析的结果表明，与体重正常的男性相比，男性肥胖与更高的跌倒风险显著相关（优势比[OR]1.33，1.04-1.70），与 12 个月内与跌倒相关的伤害风险无显著相关（OR 1.10，0.66-1.84）。对于女性，肥胖与更高的跌倒发生率（OR 0.99，0.79-1.25）和与跌倒相关的伤害（OR 0.71，0.51-1.00）无关。
结论
肥胖与自我报告的跌倒有关，而且在老年人中似乎存在性别特异性差异。
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