Department of Endocrinology, Beijing Tongren Hospital, Capital Medical University, Beijing, China.
Beijing Tongren Hospital, Capital Medical University, Beijing, China.
Front Endocrinol (Lausanne). 2024 Jun 21;15:1400204. doi: 10.3389/fendo.2024.1400204. eCollection 2024.
Obesity is a major risk factor for non-communicable diseases (NCDs), which has been the leading cause of death nowadays. The aim of this study is to examine the association between total changes in body mass index (BMI) across adulthood and the risk of obesity-related complex multimorbidity in elderly, characterizing the capacity of BMI waves in predicting major chronic diseases.
In this retrospective study, 15,520 participants were analyzed from the National Health and Nutrition Examination Survey (NHANES) from 1999 and 2018. BMI was categorized as obesity (≥30.0 kg/m²), overweight (25.0-29.9 kg/m²), normal weight (18.5-24.9 kg/m²), and underweight (<18.5 kg/m²). Odds ratios (ORs) with 95% confidence interval (CIs) for the relationship between BMI change patterns and major health outcomes included hypertension, cancer, chronic obstructive pulmonary disease, cardiovascular disease, and diabetes, and population attributable fractions (PAFs) of BMI were evaluated.
In comparison with participants who remained non-obese, those who are stable obese showed the highest risks of developing at least one chronic disease in later life, with odds ratios of 2.76 (95% CI: 2.20 to 3.45) from age 25 years to 10 years before baseline, 2.90 (2.28 to 3.68) from age 25 years to baseline, and 2.49 (2.11 to 2.95) in the 10-year period before baseline. Moving from non-obese to obese weight-change pattern in all periods (from age 25 years to 10 years before baseline: OR = 1.82; 95% CI, 1.57 to 2.11; from age 25 years to baseline: OR = 1.87; 95% CI, 1.59 to 2.19; from 10 years before baseline to baseline: OR = 1.62; 95% CI, 1.26 to 2.08) and moving from obese to non-obese, the 10-year period before baseline (OR = 1.89; 95% CI, 1.39 to 2.57) was associated with increased risk of chronic diseases. Midlife obesity status can explain the 8.6% risk of occurrence of the chronic diseases in elderly.
Maintaining a stable healthy weight and losing weight in early adulthood and midlife are important for better life quality during the aging process. More effective strategies and policies to reduce the prevalence of obesity are needed.
肥胖是多种非传染性疾病（NCDs）的主要危险因素，目前它已成为主要死因。本研究旨在探讨成年后体重指数（BMI）的总体变化与老年人肥胖相关复杂多种疾病的风险之间的关系，并描述 BMI 波在预测主要慢性疾病方面的能力。
在这项回顾性研究中，我们分析了 1999 年至 2018 年期间来自国家健康和营养检查调查（NHANES）的 15520 名参与者的数据。BMI 被归类为肥胖（≥30.0kg/m²）、超重（25.0-29.9kg/m²）、正常体重（18.5-24.9kg/m²）和体重不足（<18.5kg/m²）。采用 95%置信区间（CI）比值比（OR）评估 BMI 变化模式与高血压、癌症、慢性阻塞性肺疾病、心血管疾病和糖尿病等主要健康结果之间的关系，并评估 BMI 的人群归因分数（PAF）。
与保持非肥胖状态的参与者相比，从 25 岁到基线前 10 年、从 25 岁到基线和从基线前 10 年期间，一直处于肥胖状态的参与者发生至少一种慢性疾病的风险最高，比值比分别为 2.76（95%CI：2.20 至 3.45）、2.90（2.28 至 3.68）和 2.49（2.11 至 2.95）。在所有时期（从 25 岁到基线前 10 年：OR=1.82；95%CI，1.57 至 2.11；从 25 岁到基线：OR=1.87；95%CI，1.59 至 2.19；从基线前 10 年到基线：OR=1.62；95%CI，1.26 至 2.08），从非肥胖体重变为肥胖体重的变化模式与慢性疾病风险增加相关，而从肥胖体重变为非肥胖体重的基线前 10 年（OR=1.89；95%CI，1.39 至 2.57）与慢性疾病的发生风险增加相关。中年肥胖状态可以解释老年人中 8.6%的慢性疾病发病风险。
在衰老过程中保持稳定的健康体重和在成年早期和中年减轻体重对于提高生活质量非常重要。需要采取更有效的策略和政策来降低肥胖症的流行率。
