Lind Lars, Elmståhl Sölve, Ärnlöv Johan
1 Department of Medical Sciences, Uppsala University, Uppsala University Hospital , Uppsala, Sweden .
2 Department of Health Sciences, Division of Geriatric Medicine, Lund University, Malmö University Hospital , Malmö, Sweden .
Metab Syndr Relat Disord. 2017 Apr;15(3):112-117. doi: 10.1089/met.2016.0121. Epub 2017 Feb 16.
Higher body weight is a well-known determinant of the metabolic syndrome (MetS) and its components. It is however less well studied how the change in weight from age 20 years to middle age or old age affects MetS development.
In the community-based EpiHealth (n = 19,000, age range 45 to 75 years, 56% females) and PIVUS (n = 1000, all aged 70 years, 50% females) studies, the participants were asked about their body weight at age 20 years. Data were collected to determine MetS prevalence (NCEP ATP III criteria).
In EpiHealth, the probability of having MetS increased fairly linearly with increasing weight from age 20 in the obese [odds ratios (OR) 1.04 per kg change in weight, 95% confidence interval (CI) 1.03-1.05, P < 0.0001], as well as in the overweight (OR 1.15, 95% CI 1.14-1.17, P < 0.0001) and normal-weight (OR 1.18, 95% CI 1.14-1.21, P < 0.0001), subjects after adjustment for age, sex, body mass index (BMI) at age 20, alcohol intake, smoking, education, and exercise habits. Also in the PIVUS study, the change in weight over 50 years was related to prevalent MetS (OR 1.08 per kg change in weight, 95% CI 1.06-1.10, P < 0.0001). In both studies, self-reported BMI at age 20 was related to prevalent MetS.
Self-reported weight gain from age 20 was strongly and independently associated with prevalent MetS both in middle age or old age. Interestingly, this relationship was not restricted only to obese subjects. Our data provide additional support for the importance of maintaining a stable weight throughout life.
较高的体重是代谢综合征（MetS）及其组成成分的一个众所周知的决定因素。然而，从20岁到中年或老年体重的变化如何影响MetS的发展，这方面的研究较少。
在基于社区的EpiHealth研究（n = 19000，年龄范围45至75岁，女性占56%）和PIVUS研究（n = 1000，均为70岁，女性占50%）中，询问参与者20岁时的体重。收集数据以确定MetS患病率（采用美国国家胆固醇教育计划成人治疗组第三次报告标准）。
在EpiHealth研究中，在调整年龄、性别、20岁时的体重指数（BMI）、酒精摄入量、吸烟情况、教育程度和运动习惯后，肥胖者（体重每增加1千克的比值比（OR）为1.04，95%置信区间（CI）为1.03 - 1.05，P < 0.0001）、超重者（OR为1.15，95% CI为1.14 - 1.17，P < 0.0001）和正常体重者（OR为1.18，95% CI为1.14 - 1.21，P < 0.0001）中，患MetS的概率随20岁后体重增加呈近似线性上升。在PIVUS研究中，50年间体重的变化也与MetS患病率相关（体重每增加1千克的OR为1.08，95% CI为1.06 - 1.10，P < 0.0001）。在两项研究中，自我报告的20岁时BMI均与MetS患病率相关。
自我报告的从20岁起的体重增加与中年或老年时的MetS患病率密切且独立相关。有趣的是，这种关系不仅限于肥胖者。我们的数据为终生保持体重稳定的重要性提供了更多支持。
