Medical School, Nanjing University, Nanjing 210093, PR China.
Pediatric Outpatient Clinic, Changzheng People's Hospital of Shangqiu City, Shangqiu 476000, PR China.
Age Ageing. 2021 Jun 28;50(4):1118-1128. doi: 10.1093/ageing/afab039.
Obese older people are more likely to be frail than those with a normal body mass index (BMI), but the results of individual studies have been inconsistent. We conducted a systematic review and meta-analysis to clarify the association between obesity and the risk of frailty, and whether there was a relationship between BMI and frailty, in community-dwelling older adults aged ≥60 years. Eight databases (PubMed/MEDLINE, EMBASE, EBSCO, CINAHL, Scopus, Cochrane Library and Web of Science) were systematically searched from inception to August 2020. Relative risks for incident frailty were pooled using a random-effects model. We found a positive association between abdominal obesity and frailty [relative risk (RR) = 1.57, 95% confidence interval (CI) 1.29-1.91, I2 = 48.1%, P = 0.086, six observational studies, 18,764 subjects]. People in the higher category of waist circumference had a pooled 57% higher risk of frailty than those with a normal waist circumference. In addition, a total of 12 observational studies comprising 37,985 older people were included in the meta-analysis on the relationship between BMI and the risk for frailty. Taking the normal BMI as the reference group, the pooled RR of frailty risk ranged from 1.45 (95% CI 1.10-1.90, I2 = 83.3%; P < 0.01) for the underweight group, to 0.93 (95% CI 0.85-1.02, I2 = 34.6%; P = 0.114) for the overweight group and to 1.40 (95% CI 1.17-1.67, I2 = 86.1%; P < 0.01) for the obese group. We have shown that obesity or underweight is associated with an increased risk of frailty in community-dwelling older adults.
肥胖的老年人比体重指数（BMI）正常的老年人更容易出现虚弱，但个别研究的结果并不一致。我们进行了一项系统评价和荟萃分析，以明确肥胖与虚弱风险之间的关系，以及 BMI 与虚弱之间是否存在关系，研究对象为年龄≥60 岁的社区居住老年人。从开始到 2020 年 8 月，我们系统地检索了 8 个数据库（PubMed/MEDLINE、EMBASE、EBSCO、CINAHL、Scopus、Cochrane 图书馆和 Web of Science）。使用随机效应模型汇总了虚弱的发生率的相对风险。我们发现腹部肥胖与虚弱之间存在正相关[相对风险（RR）=1.57，95%置信区间（CI）1.29-1.91，I2=48.1%，P=0.086，六项观察性研究，18764 名受试者]。腰围较高的人群发生虚弱的风险比腰围正常的人群高 57%。此外，我们还对 BMI 与虚弱风险之间的关系进行了荟萃分析，共纳入了 12 项观察性研究，涉及 37985 名老年人。以正常 BMI 为参照组，虚弱风险的汇总 RR 范围从体重不足组的 1.45（95%CI 1.10-1.90，I2=83.3%；P<0.01）到超重组的 0.93（95%CI 0.85-1.02，I2=34.6%；P=0.114）再到肥胖组的 1.40（95%CI 1.17-1.67，I2=86.1%；P<0.01）。我们的研究表明，肥胖或体重不足与社区居住的老年人虚弱风险增加有关。
