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动力缺乏性腹部肥胖与功能性残疾的发生:来自中国一项中老年人群全国性纵向研究的结果。

Dynapenic abdominal obesity and incident functional disability: Results from a nationwide longitudinal study of middle-aged and older adults in China.

机构信息

Department of Public Health, Huzhou Third Municipal Hospital, The Affiliated Hospital of Huzhou University, Huzhou, Zhejiang, China.

Department of Epidemiology, School of Public Health and Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, Medical College of Soochow University, Suzhou, China.

出版信息

Arch Gerontol Geriatr. 2024 Aug;123:105434. doi: 10.1016/j.archger.2024.105434. Epub 2024 Apr 2.

Abstract

BACKGROUND

There is little epidemiological evidence on the relationship of dynapenic abdominal obesity (DAO) and the development of functional disability, particularly in Asian populations. We aimed to investigate the association of DAO with new-onset functional disability in Chinese adults.

METHODS

A total of 7881 participants aged ≥45 years from China Health and Retirement Longitudinal Study (CHARLS) in 2011 and 2015 were included in the study. Dynapenia and abdominal obesity were respectively defined based on handgrip strength (<28 kg for male and <18 kg for female) and waist circumference (≥ 90 cm for male and ≥85 cm for female). The sample was divided into four groups: non-dynapenic/non-abdominal obesity (ND/NAO), non-dynapenic/abdominal obesity (ND/AO), dynapenic/non-abdominal obesity (D/NAO) and dynapenic/abdominal obesity (D/AO). Functional status was assessed by basic activities of daily living (BADL) or instrumental activities of daily living (IADL). Logistic regression model was used to explore the longitudinal association between dynapenic abdominal obesity and incident functional disability.

RESULTS

After a 4-year follow-up, 1153 (14.6 %) developed BADL disability and 1335 (16.9 %) developed IADL disability. The multivariable-adjusted odds ratios (95 % CIs) for the D/AO versus ND/NAO were 2.21 (1.61-3.03) for BADL disability, and 1.68 (1.23-2.30) for IADL disability. In addition, DAO was associated with an increased risk for functional dependency severity (odds ratio, 2.08 [95 % CI, 1.57-2.75]).

CONCLUSIONS

DAO was significantly associated with greater risk of functional disability among Chinese middle-aged and older adults. Our findings indicated that interventions targeted DAO might be effective in the primary prevention of functional disability.

摘要

背景

关于 dynapenic 腹部肥胖(DAO)与功能障碍发展之间的关系,尤其是在亚洲人群中,很少有流行病学证据。我们旨在研究 DAO 与中国成年人新发功能障碍的关系。

方法

共纳入 2011 年和 2015 年中国健康与退休纵向研究(CHARLS)中 7881 名年龄≥45 岁的参与者。根据握力(男性<28kg,女性<18kg)和腰围(男性≥90cm,女性≥85cm)分别定义 dynapenia 和腹部肥胖。将样本分为四组:非 dynapenic/非腹部肥胖(ND/NAO)、非 dynapenic/腹部肥胖(ND/AO)、dynapenic/非腹部肥胖(D/NAO)和 dynapenic/腹部肥胖(D/AO)。通过基本日常生活活动(BADL)或工具性日常生活活动(IADL)评估功能状态。使用逻辑回归模型探讨 dynapenic 腹部肥胖与新发功能障碍的纵向关系。

结果

随访 4 年后,1153 人(14.6%)发生 BADL 残疾,1335 人(16.9%)发生 IADL 残疾。多变量调整后的比值比(95%CI),D/AO 与 ND/NAO 相比,BADL 残疾为 2.21(1.61-3.03),IADL 残疾为 1.68(1.23-2.30)。此外,DAO 与功能依赖严重程度增加相关(比值比,2.08[95%CI,1.57-2.75])。

结论

DAO 与中国中老年人群功能障碍的风险显著增加相关。我们的研究结果表明,针对 DAO 的干预措施可能对预防功能障碍有效。

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