David C N, Mello R B, Bruscato N M, Moriguchi E H
Renato Bandeira de Mello, Hospital de Clínicas de Porto Alegre, 2350, Ramiro Barcelos st., Division of Internal Medicine; room 700, Porto Alegre, Rio Grande do Sul 90035903, Brazil,
J Nutr Health Aging. 2017;21(5):597-603. doi: 10.1007/s12603-016-0812-0.
To evaluate the association between overweight and abdominal obesity with all-cause and cardiovascular mortality in the elderly aged 80 and over.
A prospective cohort study.
A population-based study of community-dwelling very elderly adults in a city in southern Brazil.
236 very elderly adults, number that represents 85% of the population aged 80 and over living in the city in the period (mean age 83.4 ± 3.2).
Overweight and abdominal obesity were assessed using recommended cut-off points for body mass index (BMI), waist circumference (WC), waist-hip ratio (WHR) and waist-height ratio (WHtR). The association between these anthropometric measurements and all-cause and cardiovascular mortality were independently estimated by Cox proportional hazards model. Kaplan-Meier was used to assess survival time.
Increased WC (>80cm F and >94cm M) and WHtR (>0.53 F and >0.52 M) were associated with lower all-cause mortality, but only WHtR remained associated even after controlling for residual confounding (HR 0.55 CI95% 0.36-0.84; p<0.001). Additionally increased WC was independently associated with lower mortality from cardiovascular diseases (HR 0.57 CI95% 0.34-0.95; p<0.030). BMI and WHR did not show significant independent association with mortality in the main analysis.
Greater abdominal fat accumulation, as estimated by WC and WHtR, presented an association with lower allcause and cardiovascular mortality in the elderly aged 80 and over, but not by BMI and WHR.
评估80岁及以上老年人超重和腹型肥胖与全因死亡率及心血管疾病死亡率之间的关联。
前瞻性队列研究。
对巴西南部一个城市中居住在社区的高龄老年人进行的基于人群的研究。
236名高龄老年人,这一数字占该时期居住在该市的80岁及以上人口的85%(平均年龄83.4±3.2岁)。
采用推荐的体重指数(BMI)、腰围(WC)、腰臀比(WHR)和腰高比(WHtR)切点来评估超重和腹型肥胖。通过Cox比例风险模型独立估计这些人体测量指标与全因死亡率及心血管疾病死亡率之间的关联。采用Kaplan-Meier法评估生存时间。
WC增加(女性>80cm,男性>94cm)和WHtR增加(女性>0.53,男性>0.52)与较低的全因死亡率相关,但即使在控制残余混杂因素后,只有WHtR仍具有相关性(风险比0.55,95%置信区间0.36 - 0.84;p<0.001)。此外,WC增加与较低的心血管疾病死亡率独立相关(风险比0.57,95%置信区间0.34 - 0.95;p<0.030)。在主要分析中,BMI和WHR与死亡率未显示出显著的独立关联。
通过WC和WHtR估计,更大的腹部脂肪堆积与80岁及以上老年人较低的全因死亡率和心血管疾病死亡率相关,但与BMI和WHR无关。