Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Geelong, Victoria, Australia.
Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, Australia.
Obesity (Silver Spring). 2020 Nov;28(11):2232-2241. doi: 10.1002/oby.22984. Epub 2020 Oct 3.
Obesity is commonly defined by BMI rather than adiposity, which may have differential effects on musculoskeletal health. Musculoskeletal outcomes were compared in older adults with normal adiposity and normal BMI (NA-NBMI), those with high adiposity but normal BMI (HA-NBMI), and those with high adiposity and high BMI (HA-HBMI).
In 3,411 70-year-olds, obesity was defined as BMI ≥ 30 kg/m and adiposity as body fat percentage ≥ 25% (men) or ≥ 35% (women) from dual-energy x-ray absorptiometry. Bone parameters were measured by dual-energy x-ray absorptiometry and peripheral quantitative computed tomography. Sarcopenia was defined as low handgrip strength with or without low appendicular lean mass. Falls were self-reported 6 and 12 months later.
Prevalence of NA-NBMI, HA-NBMI, and HA-HBMI was 14.2%, 68.1%, and 17.7%, respectively. Compared with HA-HBMI, HA-NBMI had increased likelihood for sarcopenia (adjusted odds ratio: 3.99; 95% CI: 1.41-11.32) and osteoporosis (2.91; 95% CI: 2.35-3.61) but similar likelihood of falls (P > 0.05). HA-NBMI had lower values for bone geometry parameters, as well as grip strength, than both NA-NBMI and HA-HBMI (all P < 0.05).
High adiposity without high BMI is more common than BMI-defined obesity in older Swedish adults but does not provide similar protection from osteoporosis and sarcopenia.
肥胖通常通过 BMI 定义，而不是体脂率，这可能对肌肉骨骼健康有不同的影响。本研究比较了体脂正常且 BMI 正常（NA-NBMI）、体脂高但 BMI 正常（HA-NBMI）和体脂高且 BMI 高（HA-HBMI）的老年人的肌肉骨骼结局。
在 3411 名 70 岁的老年人中，肥胖定义为 BMI≥30kg/m2，体脂定义为双能 X 射线吸收法测量的体脂肪百分比男性≥25%，女性≥35%。通过双能 X 射线吸收法和外周定量计算机断层扫描测量骨参数。肌少症定义为握力低或低四肢瘦体重伴或不伴握力低。6 个月和 12 个月后报告跌倒情况。
NA-NBMI、HA-NBMI 和 HA-HBMI 的患病率分别为 14.2%、68.1%和 17.7%。与 HA-HBMI 相比，HA-NBMI 发生肌少症的可能性更高（调整后的优势比：3.99；95%置信区间：1.41-11.32）和骨质疏松症（2.91；95%置信区间：2.35-3.61），但跌倒的可能性相似（P>0.05）。与 NA-NBMI 和 HA-HBMI 相比，HA-NBMI 的骨几何参数以及握力值均较低（均 P<0.05）。
在瑞典老年人中，高体脂但 BMI 正常比 BMI 定义的肥胖更为常见，但并不能提供类似的保护，以预防骨质疏松症和肌少症。
