Cardiorespiratory fitness and adiposity as mortality predictors in older adults
Cardiorespiratory fitness and adiposity as mortality predictors in older adults
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DOI：
10.1001/jama.298.21.2507
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发表时间：
2007-12-05
影响因子：
120.7
通讯作者：
Blair, Steven N.
中科院分区：
文献类型：
--
作者：
Sui, Xuemei;LaMonte, Michael J.;Blair, Steven N.
背景：尽管体力活动和有氧能力水平随着年龄的增长而下降，肥胖症的患病率随着年龄的增长而增加，但在老年人中体能、肥胖和死亡率之间的独立和联合联系还没有得到充分的研究。目的确定心肺健康、肥胖和老年人死亡率之间的关系。设计、设置和患者队列2603名60岁或以上的成年人(平均年龄64.4[SD，4.8]岁；19.8%的女性)参加了1979-2001年间完成基线健康检查的健美操中心纵向研究。健康状况通过最大运动试验进行评估，肥胖症通过身体质量指数(BMI)、腰围和体脂百分比进行评估。低适合度被定义为最大跑步机运动试验持续时间的性别分布的最低五分之一。根据临床指南将体重指数、腰围和体脂百分比的分布分组进行分析。主要结果衡量截至2003年12月31日的全因死亡率。结果平均随访12年，31236人年，死亡450人。在体重指数为18.524.9、25.0-29.9、30.0-34.9和35.0的BMI组中，经年龄、性别和检查年份调整后的每1000人年死亡率分别为13.9、13.3、18.3和31.8(趋势P=0.01)；正常腰围和高腰围的死亡率分别为13.3和18.2(女性为88厘米；男性为102厘米)(P=。004)；正常和高脂肪百分比的13.7和14.6(女性=30%；男性=25%)(P=。51)；适合度增量五分之一分别为32.6、16.6、12.8、12.3和8.1(P
Context Although levels of physical activity and aerobic capacity decline with age and the prevalence of obesity tends to increase with age, the independent and joint associations among fitness, adiposity, and mortality in older adults have not been adequately examined.Objective To determine the association among cardiorespiratory fitness ("fitness"), adiposity, and mortality in older adults.Design, Setting, and Patients Cohort of 2603 adults aged 60 years or older ( mean age, 64.4 [SD, 4.8] years; 19.8% women) enrolled in the Aerobics Center Longitudinal Study who completed a baseline health examination during 1979-2001. Fitness was assessed by a maximal exercise test, and adiposity was assessed by body mass index (BMI), waist circumference, and percent body fat. Low fitness was defined as the lowest fifth of the sex-specific distribution of maximal treadmill exercise test duration. The distributions of BMI, waist circumference, and percent body fat were grouped for analysis according to clinical guidelines.Main Outcome Measure All-cause mortality through December 31, 2003.Results There were 450 deaths during a mean follow-up of 12 years and 31 236 person-years of exposure. Death rates per 1000 person-years, adjusted for age, sex, and examination year were 13.9, 13.3, 18.3, and 31.8 across BMI groups of 18.524.9, 25.0-29.9, 30.0-34.9, and >= 35.0, respectively (P=.01 for trend); 13.3 and 18.2 for normal and high waist circumference (>= 88 cm in women; >= 102 cm in men) (P=. 004); 13.7 and 14.6 for normal and high percent body fat (>= 30% in women; >= 25% in men) ( P=. 51); and 32.6, 16.6, 12.8, 12.3, and 8.1 across incremental fifths of fitness ( P