Université Paris 13, Equipe de Recherche en Epidémiologie Nutritionnelle (EREN), Centre d'Epidémiologie et Statistiques Sorbonne Paris Cité, INSERM (U1153), INRA (U1125), CNAM, COMUE Sorbonne Paris Cité, Bobigny, France.
Département de Santé Publique, Hôpital Avicenne, Bobigny, France.
Obesity (Silver Spring). 2017 Jul;25(7):1254-1262. doi: 10.1002/oby.21853. Epub 2017 May 11.
To assess the association between midlife body mass index (BMI) and healthy aging (HA) in the French SU.VI.MAX cohort.
HA was assessed in 2007 to 2009 among 2,733 individuals, aged 45 to 60 years and free of diabetes, cardiovascular disease and cancer at baseline (1994-1995). HA was defined as not developing any major chronic disease, good physical and cognitive functioning, no limitations in instrumental activities of daily living, no depressive symptoms, no health-related limitations in social life, good overall self-perceived health, and no function-limiting pain. Associations between anthropometric indicators (measured in 1995-1996) and HA were assessed using robust-error-variance Poisson regression.
After adjustment for potential confounders, BMI (continuous) was negatively associated with HA: relative risk (RR) = 0.97 (95% confidence interval = 0.96-0.99). Moreover, the detrimental role of obesity (RR = 0.67 [0.51-0.88]) was substantially stronger than that of overweight (RR = 0.91 [0.81-1.01]). Furthermore, while metabolically healthy individuals with overweight had a similar HA probability as metabolically healthy individuals with normal weight, metabolically unhealthy overweight individuals had a substantially lowered HA probability.
This study provides novel evidence that an elevated BMI at midlife may jeopardize the preservation of health during aging. Our results also highlight the importance of maintaining a healthy metabolic profile during midlife.
评估法国 SU.VI.MAX 队列中年期体重指数(BMI)与健康老龄化(HA)之间的关联。
在基线(1994-1995 年)时无糖尿病、心血管疾病和癌症的 2733 名年龄在 45 至 60 岁的个体于 2007 年至 2009 年期间评估 HA。HA 定义为不发生任何重大慢性疾病、身体和认知功能良好、日常生活活动无工具性限制、无抑郁症状、社会生活中无健康相关限制、总体自我感知健康良好且无功能受限的疼痛。使用稳健误差方差泊松回归评估 1995-1996 年测量的人体测量指标(体重指数、腰围和臀围)与 HA 之间的关联。
在调整潜在混杂因素后,BMI(连续变量)与 HA 呈负相关:相对风险(RR)=0.97(95%置信区间为 0.96-0.99)。此外,肥胖(RR=0.67 [0.51-0.88])的不利作用明显强于超重(RR=0.91 [0.81-1.01])。此外,尽管超重的代谢健康个体与正常体重的代谢健康个体具有相似的 HA 可能性,但代谢不健康的超重个体的 HA 可能性明显降低。
本研究提供了新的证据,表明中年期升高的 BMI 可能危及衰老期间的健康维持。我们的结果还强调了在中年期保持健康代谢特征的重要性。