Department of Rehabilitation Medicine, Shanghai University of Medicine and Health Sciences, Shanghai, People's Republic of China.
Department of Clinical Laboratory Center, Shanghai Jiangwan Hospital, Shanghai, People's Republic of China.
Clin Interv Aging. 2021 Apr 27;16:697-706. doi: 10.2147/CIA.S302167. eCollection 2021.
We examined the association between obesity and physical performance under different metabolic status.
The sample included 1395 Chinese community-dwelling participants (mean age, 71.88 ± 5.87 years; 40.9% men). Being metabolically healthy was defined as having the presence of < 3 of 5 components of metabolic syndrome (MetS); obesity was defined as having a BMI > 28 kg/m. Participants were divided into four groups based on BMI (non-obese/obese) and metabolic health (healthy/unhealthy). Physical performance was measured by grip strength, 4-m walking speed, and the timed up and go test (TUGT).
After multiple adjustments, compared with metabolically healthy non-obese group, the metabolically unhealthy obese group showed lower relative grip strength, lower 4-m walking speed, and higher TUGT ( all < 0.05), and only relative grip strength of the metabolically healthy obese group was significantly lower than that of metabolically healthy non-obese ( < 0.01). Relative grip strength was negatively associated with impaired fasting glucose (β = -0.071), elevated triglycerides (β = -0.062), abdominal obesity (β = -0.230) and general obesity (β = -0.225) ( all < 0.01). Walking speed and TUGT were only associated with general obesity, rather than other metabolic components. The associations of MetS with physical performance were mainly driven by abdominal obesity.
Even in those who are metabolically healthy, obesity (especially general obesity) increases the risk of poor physical performance. Elderly people with general obesity and MetS, whether in combination or alone, have an increased risk of muscle dysfunction, and that combination produces a higher risk of impaired mobility.
我们研究了不同代谢状态下肥胖与身体机能表现的关系。
该样本包括 1395 名中国社区居住的参与者（平均年龄 71.88 ± 5.87 岁，40.9%为男性）。代谢健康定义为代谢综合征（MetS）的 5 个成分中<3 个存在；肥胖定义为 BMI > 28 kg/m。参与者根据 BMI（非肥胖/肥胖）和代谢健康（健康/不健康）分为四组。身体机能表现通过握力、4 米步行速度和计时起立行走测试（TUGT）进行测量。
经过多次调整后，与代谢健康的非肥胖组相比，代谢不健康的肥胖组相对握力较低、4 米步行速度较慢、TUGT 较高（均<0.05），而只有代谢健康的肥胖组的相对握力明显低于代谢健康的非肥胖组（<0.01）。相对握力与空腹血糖受损（β=-0.071）、甘油三酯升高（β=-0.062）、腹型肥胖（β=-0.230）和全身肥胖（β=-0.225）呈负相关（均<0.01）。步行速度和 TUGT 仅与全身肥胖相关，而与其他代谢成分无关。MetS 与身体机能表现的关系主要是由腹型肥胖驱动的。
即使在代谢健康的人群中，肥胖（尤其是全身肥胖）也会增加身体机能表现不佳的风险。有全身肥胖和 MetS 的老年人，无论组合还是单独存在，都有肌肉功能障碍的风险增加，而这种组合会增加行动不便的风险。
