Loss of Weight in Obese Older Adults: A Biomarker of Impending Expansion of Multimorbidity?
Loss of Weight in Obese Older Adults: A Biomarker of Impending Expansion of Multimorbidity?
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DOI：
10.1111/jgs.13608
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发表时间：
2015-09-01
影响因子：
6.3
通讯作者：
Ferrucci, Luigi
中科院分区：
文献类型：
--
作者：
Fabbri, Elisa;Tanaka, Toshiko;Ferrucci, Luigi
目的：为了确定老年人的体重减轻是否可能是即将发生的多重死亡负担的标志，无论最初的体重如何，测试肥胖但不超重的老年人与比正常体重更多的疾病相关的假设，以及随着时间的推移体重减轻的肥胖老年人有最大的多重死亡负担。设计：纵向队列研究背景：社区参与者：基线年龄为60岁及以上的个体平均随访4年（N = 1,025）。基线体重指数（BMI）分为正常体重（< 25.0 kg/m2）、超重（25.0-29.9 kg/m2）和肥胖（>= 30.0 kg/m2）。体重减轻定义为BMI随时间推移每年至少降低0.15 kg/m2。年龄、性别和教育程度是协变量。结果：基线肥胖与高多变量相关，与正常体重（P = 0.005）和超重（P <0.001）相比，多变量纵向增加更大。此外，在随访期间体重减轻的肥胖参与者的多项指标显著高于其他参与者，包括随着时间的推移保持或增加体重的肥胖参与者（P = 0.005）。在非肥胖的参与者中，体重的变化对随着时间的推移而变化的多morphin没有影响。敏感性分析证实，一个特定的疾病并没有驱动的协会和竞争的死亡率并没有偏见association.CONCLUSION：在肥胖的老年人的体重减轻是一个强大的生物标志物即将扩大的multimorphine。减肥的老年肥胖者应该得到周到的医疗照顾。
OBJECTIVES: To determine whether weight loss in older adults may be a marker of impending burden of multimorbidity regardless of initial weight, testing the hypotheses that obesity but not overweight in elderly adults is associated with greater number of diseases than normal weight and that obese older adults who lose weight over time have the greatest burden of multimorbidity.DESIGN: Longitudinal cohort study (Invecchiare in Chianti Study).SETTING: Community.PARTICIPANTS: Individuals aged 60 and older at baseline followed for an average of 4 years (N = 1,025).MEASUREMENTS: Multimorbidity was measured as number of diagnosed diseases. Baseline body mass index (BMI) was categorized as normal weight (< 25.0 kg/m(2)), overweight (25.0-29.9 kg/m(2)), and obese (>= 30.0 kg/m(2)). Loss of weight was defined as decrease over time in BMI of at least 0.15 kg/m(2) per year. Age, sex, and education were covariates.RESULTS: Baseline obesity was cross-sectionally associated with high multimorbidity and greater longitudinal increase of multimorbidity than normal weight (P = .005) and overweight (P < .001). Moreover, obese participants who lost weight over follow-up had a significantly greater increase in multimorbidity than other participants, including obese participants who maintained or gained weight over time (P = .005). In nonobese participants, changes in weight had no effect on changes in multimorbidity over time. Sensitivity analyses confirmed that one specific disease did not drive the association and that competing mortality did not bias the association.CONCLUSION: Loss of weight in obese older persons is a strong biomarker of impending expansion of multimorbidity. Older obese individuals who lose weight should receive thoughtful medical attention.