Body mass index in midlife and dementia: Systematic review and meta-regression analysis of 589,649 men and women followed in longitudinal studies.
Body mass index in midlife and dementia: Systematic review and meta-regression analysis of 589,649 men and women followed in longitudinal studies.
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DOI：
10.1016/j.dadm.2017.05.007
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发表时间：
2017
期刊：
影响因子：
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通讯作者：
Egan K
中科院分区：
文献类型：
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作者：
Albanese E;Launer LJ;Egger M;Prince MJ;Giannakopoulos P;Wolters FJ;Egan K
我们对中年体重指数（BMI）与痴呆之间相关性的流行病学证据进行了荟萃分析。我们检索了标准数据库，以确定关于中年体重不足、超重和肥胖的痴呆风险的前瞻性、基于人群的研究。我们进行了随机效应荟萃分析和校正相对风险（RR）估计的荟萃回归，并正式探讨了研究间异质性。我们纳入了19项研究，涉及589，649名参与者（2040例痴呆病例），随访时间长达42年。中年（年龄35 - 65岁）肥胖（BMI ≥ 30）（RR，1.33; 95%可信区间[CI]，1.08-1.63），但不超重（25 < BMI < 30）（RR，1.07; 95% CI，0.96-1.20），与老年痴呆相关。与中年体重不足的相关性（RR，1.39; 95% CI，1.13-1.70）可能是由剩余混杂（荟萃回归的P = 0.004）、选择（P = 0.046）和信息偏倚（P = 0.007）驱动的。中年肥胖会增加患痴呆症的风险。体重不足和痴呆症之间的联系仍然存在争议。
We conducted a meta-analysis of the conflicting epidemiologic evidence on the association between midlife body mass index (BMI) and dementia. We searched standard databases to identify prospective, population-based studies of dementia risk by midlife underweight, overweight, and obesity. We performed random-effects meta-analyses and meta-regressions of adjusted relative risk (RR) estimates and formally explored between-study heterogeneity. We included 19 studies on 589,649 participants (2040 incident dementia cases) followed up for up to 42 years. Midlife (age 35 to 65 years) obesity (BMI ≥ 30) (RR, 1.33; 95% confidence interval [CI], 1.08–1.63), but not overweight (25 < BMI < 30) (RR, 1.07; 95% CI, 0.96–1.20), was associated with dementia in late life. The association with midlife underweight (RR, 1.39; 95% CI, 1.13–1.70) was potentially driven by residual confounding (P from meta-regression = .004), selection (P = .046), and information bias (P = .007). Obesity in midlife increases the risk of dementia. The association between underweight and dementia remains controversial.