Merchant Reshma Aziz, Kit Michael Wong Wai, Lim Jia Yi, Morley John E
Division of Geriatric Medicine, Department of Medicine, National University Hospital, Singapore, Singapore.
Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.
Endocr Connect. 2021 Aug 5;10(8):909-917. doi: 10.1530/EC-21-0223.
To investigate the association of normal BMI with central obesity (CO), high BMI with CO, high BMI without CO, and normal BMI without CO, with function and cognition in older adults.
Cross-sectional study involving 754 participants ≥ 65 years. Data collected include demographics, cognition, and physical measurements.
Females had a higher prevalence of high BMI with CO and a lower prevalence of high BMI without CO than males (61.0% vs 44.6% and 4.6% vs 15.0%, respectively). Within gender, CO groups, regardless of BMI, had lower mini-mental state examination (MMSE), handgrip strength (HGS), and longer timed-up-and-go (TUG) scores. Overall, the high BMI without CO group had the highest MMSE scores, HGS, and shortest TUG. Amongst males, HGS was significantly lower in the normal BMI with CO group (B -3.28, 95% CI -6.32 to -0.23, P = 0.04). CO, regardless of normal/high BMI, had significantly longer TUG time (B 2.65, 95% CI 0.45 to 4.84, P = 0.02; B 1.07, 95% CI 0.25 to 1.88, P = 0.01, respectively) than normal BMI without CO group. CO was associated with lower MMSE scores in both genders but significant only in males with normal BMI and CO (B -1.60, 95% CI -3.15 to -0.06, P = 0.04).
CO may be a better predictor of obesity and adverse outcomes in older adults. High BMI without CO was associated with better outcomes especially in males but require further validation. Prospective longitudinal studies are needed to ascertain the impact of BMI and/or CO on function, cognition, mortality, and gender differences.
研究正常体重指数（BMI）与中心性肥胖（CO）、高BMI与CO、高BMI无CO以及正常BMI无CO与老年人功能和认知之间的关联。
对754名年龄≥65岁的参与者进行横断面研究。收集的数据包括人口统计学、认知和身体测量指标。
高BMI合并CO的女性患病率高于男性，高BMI无CO的女性患病率低于男性（分别为61.0%对44.6%和4.6%对15.0%）。在性别内部，无论BMI如何，CO组的简易精神状态检查表（MMSE）、握力（HGS）得分较低，计时起立行走测试（TUG）得分较长。总体而言，高BMI无CO组的MMSE得分最高、HGS最高且TUG最短。在男性中，正常BMI合并CO组的HGS显著较低（B -3.28，95%置信区间 -6.32至-0.23，P = 0.04）。无论正常/高BMI如何，CO组的TUG时间均显著长于正常BMI无CO组（分别为B 2.65，95%置信区间0.45至4.84，P = 0.02；B 1.07，95%置信区间0.25至1.88，P = 0.01）。CO在两性中均与较低的MMSE得分相关，但仅在正常BMI合并CO的男性中具有统计学意义（B -1.60，95%置信区间 -3.15至-0.06，P = 0.04）。
CO可能是老年人肥胖和不良结局的更好预测指标。高BMI无CO与更好的结局相关，尤其是在男性中，但需要进一步验证。需要进行前瞻性纵向研究以确定BMI和/或CO对功能、认知、死亡率及性别差异的影响。
