School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, China.
Key Laboratory for Disease Prevention and Control and Health Promotion of Shaanxi Province, Xi'an, China.
Diabetes Obes Metab. 2024 Jul;26(7):2890-2904. doi: 10.1111/dom.15610. Epub 2024 Apr 30.
This study investigated the depot- and sex-specific associations of adiposity indicators with incident multimorbidity and comorbidity pairs.
We selected 382 678 adults without multimorbidity (≥2 chronic diseases) at baseline from the UK Biobank. General obesity, abdominal obesity and body fat percentage indices were measured.
Cox proportional hazard regression analyses of general obesity indices revealed that for every one-unit increase in body mass index, the risk of incident multimorbidity increased by 5.2% (95% confidence interval 5.0%-5.4%). A dose-response relationship was observed between general obesity degrees and incident multimorbidity. The analysis of abdominal obesity indices showed that for every 0.1 increment in waist-to-height ratio and waist-to-hip ratio, the risk of incident multimorbidity increased by 42.0% (37.9%-46.2%) and 27.9% (25.7%-30.0%), respectively. Central obesity, as defined by waist circumference, contributed to a 23.2% increased risk of incident multimorbidity. Hip circumference and hip-to-height ratio had protective effects on multimorbidity onset. Consistent findings were observed for males and females. Body fat percentage elevated 3% (0.2%-5.9%) and 5.3% (1.1%-9.7%) risks of incident multimorbidity in all adults and females, respectively. Arm fat percentages elevated 5.3% (0.8%-9.9%) and 19.4% (11.0%-28.5%) risks of incident multimorbidity in all adults and males, respectively. The general obesity indices, waist circumference, waist-to-height ratio, waist-to-hip ratio and central obesity increased the onset of comorbidity pairs, whereas hip circumference and hip-to-height ratio decreased the onset of comorbidity pairs. These adiposity indicators mainly affect diabetes mellitus-related comorbidity onset in males and hypertensive-related comorbidity onset in females.
Adiposity indicators are predictors of multimorbidity and comorbidity pairs and represent a promising approach for intervention.
本研究旨在探讨肥胖指标与多发病和共病对的发生在特定部位和性别的相关性。
我们从英国生物库中选择了 382678 名基线时无多发病（≥2 种慢性疾病）的成年人。测量了一般肥胖、腹部肥胖和体脂百分比指数。
采用 Cox 比例风险回归分析一般肥胖指数，发现体重指数每增加一个单位，多发病的发病风险增加 5.2%（95%置信区间 5.0%-5.4%）。一般肥胖程度与多发病的发生呈剂量反应关系。腹部肥胖指数分析显示，腰围身高比和腰围臀围比每增加 0.1，多发病的发病风险分别增加 42.0%（37.9%-46.2%）和 27.9%（25.7%-30.0%）。腰围定义的中心性肥胖导致多发病发病风险增加 23.2%。臀围和臀高比对多发病发病有保护作用。男性和女性均观察到一致的结果。体脂百分比升高 3%（0.2%-5.9%）和 5.3%（1.1%-9.7%）会增加所有成年人和女性多发病的发病风险。臂脂百分比升高 5.3%（0.8%-9.9%）和 19.4%（11.0%-28.5%）会增加所有成年人和男性多发病的发病风险。一般肥胖指数、腰围、腰围身高比、腰围臀围比和中心性肥胖增加了共病对的发病，而臀围和臀高比降低了共病对的发病。这些肥胖指标主要影响男性的糖尿病相关共病发病和女性的高血压相关共病发病。
肥胖指标是多发病和共病对的预测指标，代表了一种有前途的干预方法。
