Rhynehart Amanda, Dunlevy Colin, Hayes Katie, O'Connell Jean, O'Shea Donal, O'Malley Emer
Weight Management Service, St Columcille's Hospital, Dublin, Ireland.
Obesity Research Group, St Vincent's University Hospital, Dublin, Ireland.
Front Rehabil Sci. 2021 Sep 16;2:716392. doi: 10.3389/fresc.2021.716392. eCollection 2021.
Frailty, falls and metabolic syndrome are known to be associated with poorer physical function. This study builds on available research by further investigating the relationship between physical function measures, including those comprising frailty, with metabolic syndrome (MetS) and falls, in the context of complex obesity. Participants were recruited from the national Level 3 weight management service in Ireland. A retrospective audit of data gathered at initial assessment was performed. Data included past medical history, blood tests, blood pressure measurement, anthropometrics, falls history, self-reported physical activity levels (PALs) and physical function measures, including hand grip strength (HGS), "timed up and go" (TUG), functional reach (FR), sit to stand (STS) and gait speed. A modified version of the Fried Frailty Index was employed. Of the 713 participants, 65.1% ( = 464) were female and 34.9% ( = 249) were male with a mean age of 44.2 (±11.7) years and body mass index (BMI) of 50.6 kg/m (±8.2). Frailty was identified in 3.4% ( = 24), falls in 28.8% ( = 205) and MetS in 55.1% ( = 393). Frailty was associated with older age (53.8 ± 14.3 vs. 43.9 ± 11.5 years), poorer PALs (27.29 ± 46.3 vs. 101.1 ± 147.4 min/wk), reduced grip strength (17.7 ± 4.6 vs. 34.2 ± 11.0 Kg) longer STS (21.7 ± 6.6 vs. 13.7 ± 5.7 s), shorter functional reach (29.7 ± 7.9 vs. 37.9 ± 8.2 cm) and slower gait speed (0.6 ± 0.2 vs. 1.1 ± 0.5 m/s). Those reporting a falls history had a reduced FR (35.8 ± 8.9 vs. 38.3 ± 7.8 cm) and slower STS (15.4 ± 8.0 vs. 13.3 ± 4.7 s). Participants with MetS had lower PALs (83.2 ± 128.2 vs. 119.2 ± 157.6) and gait speed (1.1 ± 0.3 vs. 1.2 ± 0.7 m/s). There was no difference in BMI between fallers and non-fallers (51.34 ± 8.44 vs. 50.33 ± 8.13 Kg/m, = 0.138), nor between those with or without MetS. Significant associations were found between BMI and all physical function measures except the TUAG. The associations between frailty, falls and MetS and their combined impact on physical function in people living with obesity demonstrates the need for appropriate screening. Utilising grip strength and gait speed to identify frailty in those with obesity and metabolic syndrome could help target therapies aimed at improving strength, physical function and ultimately quality of life.
众所周知，身体虚弱、跌倒和代谢综合征与较差的身体功能相关。本研究在现有研究的基础上，进一步探讨了在复杂肥胖背景下，包括那些构成身体虚弱的指标在内的身体功能指标与代谢综合征（MetS）和跌倒之间的关系。参与者从爱尔兰国家三级体重管理服务机构招募。对初始评估时收集的数据进行了回顾性审计。数据包括既往病史、血液检查、血压测量、人体测量学、跌倒史、自我报告的身体活动水平（PALs）以及身体功能指标，包括握力（HGS）、“起身行走计时”（TUG）、功能性伸展（FR）、坐立试验（STS）和步速。采用了Fried身体虚弱指数的修改版。713名参与者中，65.1%（n = 464）为女性，34.9%（n = 249）为男性，平均年龄为44.2（±11.7）岁，体重指数（BMI）为50.6 kg/m²（±8.2）。发现3.4%（n = 24）的人身体虚弱，28.8%（n = 205）的人有跌倒史，55.1%（n = 393）的人患有代谢综合征。身体虚弱与年龄较大（53.8 ± 14.3岁 vs. 43.9 ± 11.5岁）、身体活动水平较差（27.29 ± 46.3 vs. 101.1 ± 147.4分钟/周）、握力降低（17.
