老年人肥胖与虚弱的关联：NHANES 1999-2004。
Association of Obesity and Frailty in Older Adults: NHANES 1999-2004.
机构信息
Rebecca Crow, DO, Section of General Internal Medicine, Dartmouth-Hitchcock Medical Center, 1 Medical Center Drive, Lebanon, NH 03756, Telephone: (603) 653-9500, Facsimile: (603) 650-0915, E-mail:
出版信息
J Nutr Health Aging. 2019;23(2):138-144. doi: 10.1007/s12603-018-1138-x.
OBJECTIVES
Body composition changes with aging can increase rates of obesity, frailty and impact function. Measuring adiposity using body fat (%BF) or central adiposity using waist circumference (WC) have greater diagnostic accuracy than traditional measures such as body mass index (BMI).
DESIGN
This is an observational study.
SETTING
This study focused on older community-dwelling participants.
PARTICIPANTS
We identified individuals age ≥ 60 years old using the 1999-2004 cross-sectional National Health and Nutrition Survey (NHANES).
INTERVENTION
The primary analysis evaluated the association between frailty and %BF or WC. Frailty was the primary predictor (robust=referent) and %BF and WC were considered continuous outcomes. Multiple imputation analyses accounted for missing characteristics.
MEASUREMENT
Dual energy x-ray absorptiometry was used to assess %BF and WC was objectively measured. Frailty was defined using an adapted version of Fried's criteria that was self-reported: (low BMI<18.5kg/m2; slow walking speed [<0.8m/s]; weakness [unable to lift 10lbs]; exhaustion [difficulty walking between rooms on same floor] and low physical activity [compared to others]). Robust, pre-frail and frail persons met zero, 1 or 2, and ≥3 criteria, respectively.
RESULTS
Of the 4,984 participants, the mean age was 71.1±0.2 (SE) years and 56.5% were females. We classified 2,246 (50.4%), 2,195 (40.3%), and 541 (9.2%) individuals as robust, pre-frail and frail, respectively. Percent BF was 35.9±0.13, 38.3±0.20 and 40.0±0.46 in the robust, pre-frail and frail individuals, respectively. WC was 99.5±0.32 in the robust, 100.1±0.43 in pre-frail, 104.7±1.17 in frail individuals. Compared to robust individuals, only frail individuals had greater %BF on average (β=0.97±0.43,p=0.03); however, pre-frail and frail individuals had 2.18 and 4.80 greater WC, respectively (β=2.18±0.64,p=0.002, and β=4.80±1.1,p<0.001).
CONCLUSION
Our results demonstrate that in older adults, frailty and pre-frailty are associated with a greater likelihood of high WC (as dichotomized) and a greater average WC (continuous).
目的
随着年龄的增长，身体成分的变化会增加肥胖、虚弱和功能障碍的发生率。使用体脂肪（%BF）或腰围（WC）等中心肥胖来衡量肥胖的诊断准确性优于体重指数（BMI）等传统指标。
设计
这是一项观察性研究。
地点
本研究侧重于年龄较大的社区居住参与者。
参与者
我们使用 1999-2004 年全国健康和营养调查（NHANES）的数据，确定了年龄≥60 岁的个体。
干预措施
主要分析评估了虚弱与%BF或 WC 的关系。虚弱是主要预测因素（强壮=参考），%BF 和 WC 被视为连续结果。多重插补分析考虑了缺失特征。
测量
双能 X 射线吸收法用于评估%BF，WC 则通过客观测量。虚弱是根据 Fried 标准的一个适应性版本来定义的，该标准是自我报告的：（低 BMI<18.5kg/m2；步行速度较慢 [<0.8m/s]；虚弱[无法举起 10 磅重物]；疲惫[难以在同一楼层的房间之间行走]和低体力活动[与他人相比]）。强壮、虚弱前期和虚弱的人分别符合零、一或二项和≥三项标准。
结果
在 4984 名参与者中，平均年龄为 71.1±0.2（SE）岁，56.5%为女性。我们将 2246（50.4%）、2195（40.3%）和 541（9.2%）名个体分别归类为强壮、虚弱前期和虚弱。在强壮、虚弱前期和虚弱的个体中，%BF 分别为 35.9±0.13、38.3±0.20 和 40.0±0.46。在强壮的个体中 WC 为 99.5±0.32，在虚弱前期的个体中为 100.1±0.43，在虚弱的个体中为 104.7±1.17。与强壮的个体相比，只有虚弱的个体平均%BF 更高（β=0.97±0.43，p=0.03）；然而，虚弱前期和虚弱的个体 WC 分别高出 2.18 和 4.80（β=2.18±0.64，p=0.002，β=4.80±1.1，p<0.001）。
结论
我们的结果表明，在老年人中，虚弱和虚弱前期与较高 WC（二分法）和较高平均 WC（连续）的可能性增加相关。
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