Normal Weight with Central Obesity, Physical Activity, and Functional Decline: Data from the Osteoarthritis Initiative.
Normal Weight with Central Obesity, Physical Activity, and Functional Decline: Data from the Osteoarthritis Initiative.
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DOI：
10.1111/jgs.13542
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发表时间：
2015-08
影响因子：
6.3
通讯作者：
Bartels SJ
中科院分区：
文献类型：
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作者：
Batsis JA;Zbehlik AJ;Scherer EA;Barre LK;Bartels SJ
确定正常体重指数（BMI）和中心性肥胖（正常体重和中心性肥胖（NWCO））结合对身体活动和功能的风险。纵向骨关节炎倡议研究。基于社区。根据BMI（正常18.5 ~ 24.9 kg/m2，超重25.0 ~ 29.9 kg/m2，肥胖≥30.0 kg/m2）对60岁及以上有骨关节炎风险的成人（N= 2210，平均年龄68岁，67.1 ~ 69.0）进行分组。高腰围（WC）被定义为女性大于88厘米，男性大于102厘米。受试者按WC再分类（五类）。BMI正常且WC较大的受试者被认为患有NWCO （n=280, 12.7%）。对医学结局研究12项短表调查（PCS）、老年人身体活动量表（PASE）和晚年功能与残疾指数（LL-FDI）的6年变化进行了检测。评估6年BMI和WC之间的关系（参考正常BMI，正常WC）。按年龄（60-69岁；≥70岁）进行分层分析。物理成分得分、PASE和LL-FDI随时间下降。NWCO组与BMI和WC正常组6年平均PASE评分差异（117.7 vs 141.5），但从基线到6年的变化率无显著差异（p= 0.35）。在调整后的模型中，与BMI和WC正常的患者相比，NWCO患者的PCS随时间的下降幅度更大，尤其是70岁及以上的患者（时间相互作用β= -0.37, 95%置信区间= -0.68 ~ -0.06）。有骨关节炎风险的老年人的NWCO可能是功能和身体活动下降的一个危险因素，特别是在70岁及以上的老年人中，这表明针对那些本来被标记为低风险的NWCO患者的价值。
To identify the risks of the combination of normal body mass index (BMI) and central obesity (normal weight and central obesity (NWCO)) on physical activity and function. Longitudinal Osteoarthritis Initiative Study. Community based. Adults aged 60 and older at risk of osteoarthritis (N= 2,210; mean age 68, range 67.1–69.0) were grouped according to BMI (normal 18.5–24.9 kg/m2, overweight 25.0–29.9 kg/m2, obese ≥30.0 kg/m2). High waist circumference (WC) was defined as greater than 88 cm for women and greater than 102 cm for men. Subjects were subcategorized according to WC (five categories). Subjects with normal BMI and a large WC were considered to have NWCO (n=280, 12.7%). Six-year changes in the Physical Component Summary of the Medical Outcomes Study 12-item Short Form Survey (PCS), Physical Activity Scale for the Elderly (PASE), and Late-Life Function and Disability Index (LL-FDI) were examined. The association between BMI and WC over 6 years was assessed (reference normal BMI, normal WC). Stratified analyses were performed according to age (60–69; ≥70). Physical component scores, PASE, and LL-FDI declined with time. Mean PASE scores at 6 years differed between the NWCO group and the group with normal BMI and WC (117.7 vs 141.5), but rate of change from baseline to 6 years was not significantly different (p=.35). In adjusted models, those with NWCO had greater decline in PCS over time, particularly those aged 70 and older than those with normal BMI and WC (time interaction β=–0.37, 95% confidence interval=–0.68 to –0.06). NWCO in older adults at risk of osteoarthritis may be a risk factor for declining function and physical activity, particularly in those aged 70 and older, suggesting the value of targeting those with NWCO who would otherwise be labeled as low risk.