Lisa Dowling, University of Sheffield Medical School, Beech Hill Road, S10 2RX, UK,
J Frailty Aging. 2023;12(1):37-42. doi: 10.14283/jfa.2022.18.
Obesity and low muscle strength (dynapenia) are independently associated with greater falls risk. It remains unclear whether dynapenia and obesity have an additive effect on falls risk, greater than either phenotype alone.
To determine whether a combination of abdominal obesity with dynapenia, dynapenic abdominal obesity (DAO), confers a greater risk of falls than either obesity or dynapenia alone in both men and women.
An observational cohort study was conducted.
Data from English adults (n=4239, 60-87 years) who took part in the English Longitudinal Study of Ageing were included.
Dynapenia, was defined as hand-grip strength <20kg (female), <30kg (male). Abdominal obesity was defined as waist circumference >88cm (female), >102cm (male). Data on falls and fall-related injuries over a 2-year follow-up were collected. Multiple logistic regression analyses were performed adjusting for age and sex, with results expressed as odds ratios (OR) and areas under the receiver operating characteristic curve (AUC).
Falls occurred in 1049 participants, with 284 reporting a related injury during follow-up. DAO was associated with greater OR of falls in men (OR 2.1, 95% Confidence Intervals (CI) 1.3-3.2). Dynapenia rather than obesity was associated with falls in women, with greatest OR observed in those with low hand-grip strength (OR 1.4, 95% CI 1.1-1.7). Individual discrimination was low for measures of obesity or dynapenia either alone or in combination (AUC 0.51-0.58). There was no relationship between fall-related injuries and obesity or dynapenia.
Our findings suggest a synergistic effect of obesity with dynapenia on falls risk in men but not women.
肥胖和低肌肉力量（肌肉衰减症）与更高的跌倒风险独立相关。目前尚不清楚肌肉衰减症和肥胖是否对跌倒风险有累加效应，超过任何单一表型的影响。
确定腹部肥胖与肌肉衰减症的组合（肌肉衰减症性腹型肥胖，DAO）是否比肥胖或肌肉衰减症单独对男女的跌倒风险产生更大的影响。
进行了一项观察性队列研究。
纳入了参加英国老龄化纵向研究的英国成年人（n=4239，年龄 60-87 岁）的数据。
肌肉衰减症定义为握力<20kg（女性），<30kg（男性）。腹部肥胖定义为腰围>88cm（女性），>102cm（男性）。收集了 2 年随访期间的跌倒和跌倒相关伤害数据。使用多变量逻辑回归分析，调整年龄和性别后，结果表示为比值比（OR）和受试者工作特征曲线下面积（AUC）。
1049 名参与者发生跌倒，284 名参与者在随访期间报告相关伤害。DAO 与男性跌倒的 OR 增加相关（OR 2.1，95%置信区间（CI）1.3-3.2）。在女性中，肌肉衰减症而不是肥胖与跌倒相关，握力较低的女性观察到最大的 OR（OR 1.4，95%CI 1.1-1.7）。单独使用或组合使用肥胖或肌肉衰减症的指标，个体判别能力均较低（AUC 0.51-0.58）。肥胖或肌肉衰减症与跌倒相关伤害之间没有关系。
我们的研究结果表明，肥胖与男性肌肉衰减症对跌倒风险有协同作用，但在女性中则没有。
