超重/肥胖和代谢综合征对日本中老年成年人虚弱的影响。

Effect of overweight/obesity and metabolic syndrome on frailty in middle-aged and older Japanese adults.

作者信息

Nishida Yuki, Yamada Yosuke, Sasaki Satoshi, Kanda Eiichiro, Kanno Yoshihiko, Anzai Tatsuhiko, Takahashi Kunihiko, Yamauchi Keita, Katsukawa Fuminori

机构信息

Department of Biostatistics M&D Data Science Center Tokyo Medical and Dental University Tokyo Japan.

Graduate School of Health Management Keio University Fujisawa Kanagawa Japan.

出版信息

Obes Sci Pract. 2023 Sep 27;10(1):e714. doi: 10.1002/osp4.714. eCollection 2024 Feb.

DOI:10.1002/osp4.714

PMID:38264004

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10804331/

Abstract

BACKGROUND

The potential for developing frailty exists in middle-aged and older adults. While obesity and metabolic syndrome (MetS) increase the risk of frailty in older adults, this relationship remains unclear in middle-aged adults, who are prone to developing lifestyle-related diseases.

OBJECTIVE

To examine the effect of overweight/obesity and MetS on frailty development in middle-aged and older Japanese adults using real-world data.

METHODS

This nationwide cohort study used exhaustive health insurance claims data of 3,958,708 Japanese people from 2015 to 2019 provided by the Japan Health Insurance Association. Participants aged ≥35 and < 70 years who received health checkups in 2015 were included. Multivariate logistic regression was used to assess the effect of body mass index (BMI) and MetS or MetS components (i.e., diabetes, hypertension, and dyslipidemia) in 2015 on frailty risk assessed using the hospital frailty risk score in 2019. Additionally, a subgroup analysis was performed to examine the interaction effects of MetS components and 4-year weight change (%) on frailty risk among participants who were overweight and obese (BMI ≥25 kg/m).

RESULTS

In 2019, 7204 (0.2%) and 253,671 (6.4%) participants were at high and intermediate frailty risks, respectively. Obesity and MetS were independently associated with intermediate/high frailty risk (odds ratio (OR) 1.36, < 0.05; OR 1.23, < 0.05, respectively) and high frailty risk (OR 1.80, < 0.05; OR 1.37, < 0.05, respectively) in all participants. Although all MetS components were frailty risk factors, these effects diminished with age in both sexes. Subgroup analysis of patients with diabetes revealed that 5%-10% weight loss was associated with reduced frailty risk in both sexes.

CONCLUSIONS

Obesity, MetS, and MetS components were independent frailty risk factors in middle-aged and older Japanese adults. Weight loss of up to 10% over 4 years prevented frailty in patients with diabetes who were overweight and obese.

摘要

背景

中年及老年人群存在发生衰弱的可能性。虽然肥胖和代谢综合征（MetS）会增加老年人衰弱的风险，但在易患生活方式相关疾病的中年人群中，这种关系尚不清楚。

目的

利用真实世界数据，研究超重/肥胖和MetS对日本中年及老年人群衰弱发生的影响。

方法

这项全国性队列研究使用了日本健康保险协会提供的2015年至2019年3958708名日本人详尽的医疗保险理赔数据。纳入2015年接受健康检查、年龄≥35岁且<70岁的参与者。采用多因素逻辑回归分析评估2015年体重指数（BMI）和MetS或MetS各组分（即糖尿病、高血压和血脂异常）对2019年使用医院衰弱风险评分评估的衰弱风险的影响。此外，对超重和肥胖（BMI≥25kg/m²）参与者进行亚组分析，以研究MetS各组分与4年体重变化（%）对衰弱风险的交互作用。

结果

2019年，分别有7204名（0.2%）和253671名（6.4%）参与者处于高衰弱风险和中衰弱风险。在所有参与者中，肥胖和MetS分别与中/高衰弱风险（比值比（OR）分别为1.36，P<0.05；OR为1.23，P<0.05）和高衰弱风险（OR分别为1.80，P<0.05；OR为1.37，P<0.05）独立相关。虽然所有MetS组分均为衰弱风险因素，但在两性中，这些影响均随年龄增长而减弱。糖尿病患者的亚组分析显示，体重减轻5%-10%与两性衰弱风险降低相关。