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相对脂肪量和体质指数对社区居住老年人心血管健康的预测价值:长寿体检(Lookup)7 的结果。

Predictive values of relative fat mass and body mass index on cardiovascular health in community-dwelling older adults: Results from the Longevity Check-up (Lookup) 7.

机构信息

Department of Geriatrics, Orthopedics and Rheumatology, Università Cattolica del Sacro Cuore, L.go F. Vito 1, 00168 Rome, Italy.

Department of Geriatrics, Orthopedics and Rheumatology, Università Cattolica del Sacro Cuore, L.go F. Vito 1, 00168 Rome, Italy; Fondazione Policlinico Universitario "Agostino Gemelli" IRCCS, L.go A. Gemelli 8, 00168 Rome, Italy.

出版信息

Maturitas. 2024 Jul;185:108011. doi: 10.1016/j.maturitas.2024.108011. Epub 2024 May 1.

Abstract

OBJECTIVES

To assess the predictive value of relative fat mass compared to body mass index for hypertension, diabetes, hyperlipidemia, and heightened cardiovascular risk in a cohort of community-dwelling older adults from the Longevity Check-up 7+ cohort.

STUDY DESIGN

Retrospective cross-sectional study.

MAIN OUTCOME MEASURES

Hyperlipidemia was defined as total cholesterol ≥200 mg/dL or ongoing lipid-lowering treatment. Diabetes was defined either as self-reported diagnosis or fasting blood glucose >126 mg/dL or a random blood glucose >200 mg/dL. Hypertension was defined as blood pressure ≥ 140/90 mmHg or requiring daily antihypertensive medications. Heightened cardiovascular risk was operationalized as having at least two of these conditions.

RESULTS

Analyses were conducted in 1990 participants (mean age 73.2 ± 6.0 years; 54.1 % women). Higher proportions of men than women had hypertension and diabetes, while hyperlipidemia was more prevalent in women. Receiver operating curve analysis indicated relative fat mass was a better predictor of hypertension in women and diabetes in both sexes. Body mass index performed better in predicting hyperlipidemia in women. Relative fat mass thresholds of ≥27 % for men and ≥40 % for women were identified as optimal indicators of heightened cardiovascular risk and so were used to defined high adiposity. Moderate correlations were found between high adiposity or body mass index ≥25 kg/m and the presence of hypertension, hyperlipidemia and heightened cardiovascular risk, while a strong correlation was found with diabetes. Logistic regression analysis highlighted significant associations between high adiposity and increased odds of hypertension, diabetes, and heightened cardiovascular risk.

CONCLUSIONS

Proposed cut-offs for relative fat mass were more reliable indices than the usual cut-offs for body mass index for identifying individuals at heightened cardiovascular risk. Our findings support the role of anthropometric measures in evaluating body composition and the associated metabolic and cardiovascular conditions in older adults.

摘要

目的

在长寿检查 7+队列中,评估相对脂肪量相对于体重指数对高血压、糖尿病、高血脂和心血管风险升高的预测价值。

研究设计

回顾性横断面研究。

主要观察指标

高血脂定义为总胆固醇≥200mg/dL 或正在进行降脂治疗。糖尿病定义为自我报告的诊断或空腹血糖>126mg/dL 或随机血糖>200mg/dL。高血压定义为血压≥140/90mmHg 或需要每日降压药物。心血管风险升高定义为至少有两种上述情况。

结果

在 1990 名参与者(平均年龄 73.2±6.0 岁;54.1%为女性)中进行了分析。男性中高血压和糖尿病的比例高于女性,而女性中高血脂更为常见。接受者操作特征曲线分析表明,相对脂肪量是女性高血压和两性糖尿病的更好预测指标。体重指数在预测女性高血脂方面表现更好。确定男性相对脂肪量≥27%和女性相对脂肪量≥40%为心血管风险升高的最佳指标,并将其用于定义高肥胖症。高肥胖症或体重指数≥25kg/m2与高血压、高血脂和心血管风险升高之间存在中度相关性,而与糖尿病之间存在强相关性。逻辑回归分析强调了高肥胖症与高血压、糖尿病和心血管风险升高之间存在显著相关性。

结论

与体重指数的常用切点相比,提出的相对脂肪量切点是识别心血管风险升高个体的更可靠指标。我们的研究结果支持了人体测量学指标在评估老年人身体成分以及相关代谢和心血管状况中的作用。

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