Du Yihang, Zhang Wenjing, Chen Zizhen, Zhu Xueping, Lyu Meng, Wei Yi, Hu Yuanhui
Department of Cardiology, Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China.
Front Med (Lausanne). 2025 May 7;12:1519362. doi: 10.3389/fmed.2025.1519362. eCollection 2025.
To investigate and compare the associations of body mass index (BMI), waist circumference (WC), a body shape index (ABSI), weight-adjusted waist index (WWI), and waist-to-height ratio (WHtR) with activities of daily living (ADL) impairment among the middle-aged and elderly population in China.
In this study, 8,700 participants from 2011 were included in the cross-section analysis. The prospective study used baseline data from 2011 and follow-up data from 2013, 2015, 2018, and 2020, with a total of 5,945 participants included. Binary logistic regression models were employed in the cross-sectional study to calculate odds ratio (OR) with corresponding 95% confidence interval (95% CI). In the prospective study, Cox proportional hazards regression models were utilized to estimate hazard ratio (HR) with 95% CI. Restricted cubic spline curve was used to identify trends, with subgroup analysis performed. Diagnostic performance was quantified through receiver operating characteristic curve analysis, with area under the curve values computed.
In the cross-sectional study, BMI (OR = 0.98, 95% CI: 0.97-1.00) was significantly negatively associated with ADL impairment risk, while ABSI (OR = 1.25, 95% CI: 1.14-1.37), WWI (OR = 1.16, 95% CI: 1.09-1.24) were positively associated with ADL impairment. However, there was no significant association between WC, WHtR and ADL impairment. In the prospective study, WC, WHtR and BMI showed no significant association with ADL impairment, while ABSI (HR = 1.07, 95% CI: 1.01-1.14) and WWI (HR = 1.05, 95% CI: 1.01-1.10) remained positively associated with ADL impairment. Positive linear correlations were observed among ABSI, WWI, and ADL impairment and there was no difference among subgroup variables. The predictive ability of WWI was slightly higher than ABSI, with an AUC value of 0.598.
ABSI and WWI were significantly associated with the risk of ADL impairment among the middle-aged and elderly population in China. ABSI and WWI had the potential to serve as superior obesity indicators for identifying individuals at higher risk for ADL impairment.
探讨并比较体重指数（BMI）、腰围（WC）、体型指数（ABSI）、体重调整腰围指数（WWI）和腰高比（WHtR）与中国中老年人群日常生活活动（ADL）受损之间的关联。
本研究纳入了2011年的8700名参与者进行横断面分析。前瞻性研究使用了2011年的基线数据以及2013年、2015年、2018年和2020年的随访数据，共纳入5945名参与者。横断面研究采用二元逻辑回归模型计算比值比（OR）及相应的95%置信区间（95%CI）。在前瞻性研究中，采用Cox比例风险回归模型估计风险比（HR）及95%CI。使用受限立方样条曲线确定趋势，并进行亚组分析。通过受试者工作特征曲线分析量化诊断性能，计算曲线下面积值。
在横断面研究中，BMI（OR = 0.98，95%CI：0.97 - 1.00）与ADL受损风险呈显著负相关，而ABSI（OR = 1.25，95%CI：1.14 - 1.37）、WWI（OR = 1.16，95%CI：1.09 - 1.24）与ADL受损呈正相关。然而，WC、WHtR与ADL受损之间无显著关联。在前瞻性研究中，WC、WHtR和BMI与ADL受损无显著关联，而ABSI（HR = 1.07，95%CI：1.01 - 1.14）和WWI（HR = 1.05，95%CI：1.01 - 1.10）与ADL受损仍呈正相关。ABSI、WWI与ADL受损之间存在正线性相关性，亚组变量之间无差异。WWI的预测能力略高于ABSI，曲线下面积值为0.598。
ABSI和WWI与中国中老年人群ADL受损风险显著相关。ABSI和WWI有潜力作为识别ADL受损高风险个体的更优肥胖指标。
