Bijani Ali, Cumming Robert G, Hosseini Seyed-Reza, Yazdanpour Masoumeh, Rahimi Mahdis, Sahebian Abbas, Ghadimi Reza
1Social Determinants of Health Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran.
2School of Public Health, University of Sydney, Sydney, Australia.
J Diabetes Metab Disord. 2018 Apr 11;17(1):45-51. doi: 10.1007/s40200-018-0337-7. eCollection 2018 Jun.
Overweight and obesity are among the important challenges in health issues and survival of elderly people. The current study aimed to evaluate the survival rate of elderly patients with diabetes, and its influencing factors, on the basis of body mass index (BMI).
The design of the current study was based on the Amirkola Health and Aging Project (AHAP) cohort. The 5-year survival rate of elderly people with diabetes and the factors that influence the mortality rate by Cox regression model were analyzed.
Out of 1616 elderly people who were evaluated in the current study, 501 (31%) had diabetes. The results showed that diabetes significantly increased the mortality rate (adjusted hazard ratio [HR] = 2.10; 95% confidence interval [CI]: 1.57-2.81; < 0.001). Furthermore, overweight (HR = 0.41; 95%CI: 0.24-0.75; = 0.002), obesity (HR = 0.30; 95% CI: 0.41-0.63; P = 0.002), history of diabetes (HR = 0.56; 95%CI: 0.34-0.93; = 0.024), moderate and high physical activity level (HR = 0.36; 95%CI: 0.13-0.99; = 0.049) decreased the risk of mortality and central obesity (HR = 1.76; 95% CI: 1.01-3.11; P = 0.049), fasting blood sugar ≥200 (HR = 2.46; 95% CI: 1.46-4.15; < 0.001), brain stroke, and neurological diseases (HR = 3.12; 95% CI: 1.78-5.49; P < 0.001) increased the risk of mortality.
Although overweight and obesity significantly improved the risk of mortality in elderly patients with diabetes, central obesity is still considered as an important risk factor.
超重和肥胖是老年人健康问题及生存面临的重要挑战。本研究旨在基于体重指数（BMI）评估老年糖尿病患者的生存率及其影响因素。
本研究设计基于阿米尔科拉健康与老龄化项目（AHAP）队列。分析了老年糖尿病患者的5年生存率以及通过Cox回归模型影响死亡率的因素。
在本研究评估的1616名老年人中，501人（31%）患有糖尿病。结果显示，糖尿病显著增加死亡率（调整后风险比[HR]=2.10；95%置信区间[CI]：1.57 - 2.81；P<0.001）。此外，超重（HR=0.41；95%CI：0.24 - 0.75；P=0.002）、肥胖（HR=0.30；95%CI：0.41 - 0.63；P=0.002）、糖尿病病史（HR=0.56；95%CI：0.34 - 0.93；P=0.024）、中度和高强度身体活动水平（HR=0.36；95%CI：0.13 - 0.99；P=0.049）降低死亡风险，而中心性肥胖（HR=1.76；95%CI：1.01 - 3.11；P=0.049）、空腹血糖≥200（HR=2.46；95%CI：1.46 - 4.15；P<0.001）、脑卒中和神经疾病（HR=3.12；95%CI：1.78 - 5.49；P<0.001）增加死亡风险。
尽管超重和肥胖显著改善了老年糖尿病患者的死亡风险，但中心性肥胖仍被视为重要的风险因素。
