Instituto de Nutrição, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, Brazil.
Instituto de Medicina Social, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, Brazil.
PeerJ. 2023 Feb 6;11:e14744. doi: 10.7717/peerj.14744. eCollection 2023.
This study aimed (1) To investigate the association between the Body Mass Index (BMI) and waist circumference (WC) with multimorbidity (MM), and (2) To identify patterns of MM and investigate the relationship between BMI and WC with specific combinations of MM (patterns of MM).
A cross-sectional study was conducted with 2,698 participants of the fourth phase of the Brazilian Longitudinal Study of Adult Health ( Study). MM was defined by the presence of two or more morbidities. MM patterns were identified by exploratory factor analysis based on tetrachoric correlations. Logistic regression models were used to assess associations (odds ratios (OR) with the respective confidence intervals (CI)).
Of the total number of participants, 39.5% were overweight and 30.0% were obese; 89.0% ( = 1,468) of women and 77.0% ( = 952) of men were abdominally obese. Indeed, 60.7% ( = 1,635) was identified with MM. For the category four or more morbidities, OR values of 5.98 (95% CI 4.84-7.13) and 7.48 (95% CI 6.14-8.18) were found for each point of increase in BMI, and 6.74 (95% CI 5.48-7.99) and 8.48 (95% CI 7.64-9.29) for each additional centimeter in the WC, for female and male, respectively. Five patterns of MM were identified: respiratory, osteoarticular, cardiometabolic, gastric, and thyroid diseases (56.4% of the total variance). Positive associations were found between BMI and patterns of cardiometabolic, osteoarticular, thyroid and gastric diseases (higher OR of 1.09 [95% CI 1.04-1.14]) and less pronounced between WC and patterns of cardiometabolic and osteoarticular (higher OR of 1.04 [95% CI 1.03-1.04]).
The results showed that an increase of both BMI and WC was associated with a higher number of morbidities and with patterns of cardiometabolic and osteoarticular diseases.
本研究旨在：（1）探讨体重指数（BMI）和腰围（WC）与多种疾病（MM）之间的关系；（2）识别 MM 的模式，并研究 BMI 和 WC 与 MM 的特定组合（MM 模式）之间的关系。
本横断面研究共纳入 2698 名巴西成人健康纵向研究第四阶段的参与者。MM 定义为两种或两种以上疾病的存在。基于四分相关的探索性因子分析确定 MM 模式。使用逻辑回归模型评估关联（比值比（OR）及其相应置信区间（CI））。
在总参与者中，39.5%超重，30.0%肥胖；89.0%（n=1468）女性和 77.0%（n=952）男性腹部肥胖。事实上，60.7%（n=1635）患有 MM。对于四种或更多种疾病的类别，BMI 每增加一个点，女性和男性的 OR 值分别为 5.98（95%CI 4.84-7.13）和 7.48（95%CI 6.14-8.18），WC 每增加一厘米，女性和男性的 OR 值分别为 6.74（95%CI 5.48-7.99）和 8.48（95%CI 7.64-9.29）。共识别出 5 种 MM 模式：呼吸、骨关节炎、心血管代谢、胃和甲状腺疾病（总方差的 56.4%）。发现 BMI 与心血管代谢、骨关节炎、甲状腺和胃病模式之间存在正相关关系（OR 值为 1.09[95%CI 1.04-1.14]），而 WC 与心血管代谢和骨关节炎模式之间的相关性较弱（OR 值为 1.04[95%CI 1.03-1.04]）。
结果表明，BMI 和 WC 的增加与更多的疾病和心血管代谢及骨关节炎疾病模式有关。
