中国老年人群体体重指数与新发糖尿病的关系：一项队列研究。
The Relationship between Body Mass Index and Incident Diabetes Mellitus in Chinese Aged Population: A Cohort Study.
机构信息
Department of Clinical Nutrition, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200127, China.
出版信息
J Diabetes Res. 2021 Aug 24;2021:5581349. doi: 10.1155/2021/5581349. eCollection 2021.
OBJECTIVES
Previous studies reported that overweight older adults had a lower mortality after cardiovascular diseases attack, indicating being thinner might not always be better. However, there is an ongoing debate about what is the optimal range of body mass index (BMI) for the aged population. We aimed to evaluate the value of BMI for the prediction of incident diabetes mellitus (DM) in the Chinese elderly population.
METHODS
A total number of 6,911 Chinese elderly people (4,110 men and 2,801 women, aged 71 ± 6.0 years) were included in this cohort study. BMI was measured at baseline (Jan 1, 2014, to Dec 31, 2014). All the participants were further classified into six groups: <18.5 kg/m, 18.5 to <22.5 kg/m, 22.5 to <25.0 kg/m, 25.0 to <27.5 kg/m, 27.5 to <30.0 kg/m, and ≥30.0 kg/m. Fasting blood glucose (FBG) and glycated hemoglobin A1c (HbA1c) were annually measured during follow-up (Jan 1, 2015-May 31, 2019). DM was confirmed if either FBG ≥ 7.0 mmol/L or HbA1c ≥ 6.5%. We used the Cox proportional hazard regression model to evaluate the association between BMI and the prediction of incident DM.
RESULTS
Comparing individuals with a BMI range of 18.5 to <22.5 kg/m (reference), the hazard ratio for incident DM was 2.13 (95% CI: 1.542.95), 2.14 (95% CI: 1.533.00), 3.17 (95% CI: 2.194.59), 3.15 (95% CI: 1.945.09), and 3.14 (95% CI: 1.94~5.09) for the group with a BMI range of 22.5 to <25.0 kg/m, 25.0 to <27.5 kg/m, 27.5 to <30.0 kg/m, and ≥30.0 kg/m after adjusting for baseline age, sex, blood pressure, lipid profiles, and eGFR ( trend < 0.001), after adjusting for the abovementioned confounders. The association tended to be closer in men and young participants, compared with their counterparts.
CONCLUSIONS
High BMI was associated with a high risk of developing DM in the Chinese aged population. Thus, it is optimal for the aged population to maintain their body weight within a reasonable range to prevent chronic diseases.
目的
先前的研究报告称，心血管疾病发作后超重的老年患者死亡率较低，这表明更瘦并不总是更好。然而，对于老年人的最佳体重指数（BMI）范围仍存在争议。我们旨在评估 BMI 对中国老年人群中糖尿病（DM）发病的预测价值。
方法
本队列研究共纳入 6911 名中国老年人（4110 名男性和 2801 名女性，年龄 71±6.0 岁）。BMI 于基线（2014 年 1 月 1 日至 2014 年 12 月 31 日）进行测量。所有参与者进一步分为六组：<18.5kg/m，18.5 至<22.5kg/m，22.5 至<25.0kg/m，25.0 至<27.5kg/m，27.5 至<30.0kg/m，和≥30.0kg/m。在随访期间（2015 年 1 月 1 日至 2019 年 5 月 31 日），每年测量空腹血糖（FBG）和糖化血红蛋白 A1c（HbA1c）。如果 FBG≥7.0mmol/L 或 HbA1c≥6.5%，则确诊为 DM。我们使用 Cox 比例风险回归模型评估 BMI 与 DM 发病预测之间的关系。
结果
与 BMI 范围为 18.5 至<22.5kg/m（参考）的个体相比，BMI 范围为 22.5 至<25.0kg/m、25.0 至<27.5kg/m、27.5 至<30.0kg/m 和≥30.0kg/m 的组发生 DM 的风险比分别为 2.13（95%CI：1.542.95）、2.14（95%CI：1.533.00）、3.17（95%CI：2.194.59）、3.15（95%CI：1.945.09）和 3.14（95%CI：1.94~5.09），校正基线年龄、性别、血压、血脂谱和 eGFR 后（趋势<0.001），在校正上述混杂因素后。与对照组相比，男性和年轻参与者的关联更为密切。
结论
高 BMI 与中国老年人群发生 DM 的风险增加相关。因此，老年人保持体重在合理范围内以预防慢性病是最佳选择。
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