Department of Epidemiology and Public Health, University College London, UK.
Department of Gerontology, Federal University of Sao Carlos.
J Gerontol A Biol Sci Med Sci. 2019 Jun 18;74(7):1112-1118. doi: 10.1093/gerona/gly182.
There is little epidemiological evidence demonstrating that dynapenic abdominal obese individuals have worse trajectories of disability than those with dynapenia and abdominal obesity alone. Our aim was to investigate whether dynapenic abdominal obesity can result in worse trajectories of activities of daily living (ADL) over 8 years of follow-up.
We used longitudinal data from 3,723 participants free from ADL disability at baseline from the English Longitudinal Study of Ageing. Using measures of handgrip strength (<26 kg for men; <16 kg for women) and waist circumference (>102 cm for men; >88 cm for women), participants were classified into four groups: nondynapenic/nonabdominal obese (reference group), abdominal obese only, dynapenic only, and dynapenic abdominal obese. We used generalized linear mixed models with ADL as the outcome and the four groups according to dynapenia and abdominal obesity status as the main exposure controlled by sociodemographic, behavioral, and clinical characteristics.
The estimated change over time in ADL disability was significantly higher for participants with dynapenic abdominal obesity compared with those with neither condition (+0.018, 95% CI: 0.008 to 0.027). Compared with the results of our main analysis (which took into account the combination of dynapenia and abdominal obesity on the rate of change in ADL), the results of our sensitivity analysis-which examined dynapenia and abdominal obesity only as independent conditions-showed an overestimation of the associations of dynapenia only and of abdominal obesity only on the ADL disability trajectories.
Dynapenic abdominal obesity is an important risk factor for functional decline in older adults.
很少有流行病学证据表明，与单纯 dynapenia 和腹部肥胖相比， dynapenic 腹部肥胖的个体在残疾轨迹方面更差。我们的目的是研究 dynapenic 腹部肥胖是否会导致日常生活活动 (ADL) 轨迹在 8 年的随访中恶化。
我们使用来自英国老龄化纵向研究的 3723 名基线时无 ADL 残疾的参与者的纵向数据。使用握力测量值（男性 <26 公斤；女性 <16 公斤）和腰围（男性 >102 厘米；女性 >88 厘米），参与者分为四组：非 dynapenic/非腹部肥胖（参照组）、仅腹部肥胖、仅 dynapenic 和 dynapenic 腹部肥胖。我们使用广义线性混合模型，将 ADL 作为结果，根据 dynapenia 和腹部肥胖状况将四组作为主要暴露因素进行控制，同时控制社会人口统计学、行为和临床特征。
与既无 dynapenia 也无腹部肥胖的参与者相比，dynapenic 腹部肥胖的参与者 ADL 残疾的估计随时间变化明显更高（+0.018，95%CI：0.008 至 0.027）。与我们的主要分析结果（考虑 dynapenia 和腹部肥胖对 ADL 变化率的组合）相比，我们的敏感性分析结果（仅检查 dynapenia 和腹部肥胖作为独立条件）显示，dynapenia 仅和腹部肥胖仅对 ADL 残疾轨迹的关联存在高估。
dynapenic 腹部肥胖是老年人功能下降的一个重要危险因素。
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