中国老年人不同体质指数与抑郁之间的关系研究

目的 了解中国老年人抑郁患病情况,并探讨不同体质指数（body mass index,BMI）与抑郁之间的关系。方法 采用2015年“中国健康与养老追踪调查”（China health and retirement longitudinal study,CHARLS）数据,共纳入全国150个县级单位,450个村级或社区单位60岁及以上老年人10 403例,应用Logistic回归对BMI与抑郁的关系进行研究。结果 中国老年人抑郁发生率为32.7%;控制社会人口学、健康行为方式、日常生活能力等因素后发现,在男性老年人当中,与体重正常组相比,超重组（OR=0.728,95%CI：0.593～0.893）和肥胖组（OR=0.582,95%CI：0.413～0.821）患抑郁的风险较低;在女性老年人中,偏瘦,超重和肥胖与抑郁的关联均无统计学意义（均有P>0.05）。结论 在中国男性老年人中,BMI与抑郁相关,但这种关联不存在于女性中。     

Association between body mass index and all-cause mortality among oldest old Chinese

Objectives

To examine the association between BMI and all-cause mortality in the oldest old (≥80 years).

Design

The study used a prospective cohort study design.

Setting

Chinese Longitudinal Healthy Longevity Survey (CLHLS) between 1998/99 and 2011.

Population

8026 participants aged 80 years and older were followed every two to three years.

Measurements

Body weight and knee height were measured. Height was calculated based on knee height using a validated equation. Deaths were ascertained from family members during follow-up.

Results

The mean BMI was 19.8 (SD 4.5) kg/m². The prevalence of underweight, overweight and obese was 37.5%, 10.2% and 4.4%, respectively. There were 5962 deaths during 29503 person-years of follow-up. Compared with normal weight, underweight was associated with a higher mortality risk (HRs: 1.20 (95%CI 1.13-1.27) but overweight (HR 0.89 (95%CI 0.81-0.99)) were associated with a lower risk. Obesity had a HR 0.91 (95%CI 0.78-1.05) for mortality.

Conclusion

Among oldest old Chinese, underweight is associated with an increased risk of all-cause mortality but overweight is associated with a reduced risk. Interventions to reduce undernutrition should be given priority among the oldest old Chinese.

     

中国成年人体重指数与生命质量的关系研究

目的 探讨中国成年人BMI与生命质量的关系。方法 纳入2010年中国慢性病及其危险因素监测的所有调查对象共83 347名。应用问卷收集调查对象的年龄、性别、相关疾病患病情况等信息。并使用WHO生存质量测定简表（QOL-BREF）测定其生命质量。测量体重和身高,计算BMI。采用秩和检验比较不同BMI分组的人群生命质量的差异;用多元logistic回归模型检验不同性别人群BMI与生命质量的关系。结果 83 347名调查对象中,与体重正常组相比,体重过轻、超重和肥胖组的生理维度得分均较低;超重组的心理和环境维度的得分高于其他3组;社会关系维度的得分以肥胖组最高,体重过轻组得分最低,差异均有统计学意义（P<0.000 1）。体重过轻男性的生理（OR＝1.38,95%CI：1.12～1.70）、心理（OR＝1.29,95%CI：1.08～1.54）、社会关系（OR＝1.26,95%CI：1.08～1.47）和环境（OR＝1.37,95%CI：1.12～1.67）4个维度的生命质量受损的危险度明显增加。超重和肥胖组男性的生理（OR＝0.88,95%CI：0.82～0.94;OR＝0.90,95%CI：0.82～0.98）、心理（OR＝0.88,95%CI：0.83～0.94;OR＝0.83,95%CI：0.77～0.90）、社会关系（OR＝0.89,95% CI：0.84～0.94;OR＝0.78,95% CI：0.71～0.85）和环境（OR＝0.85,95% CI：0.80～0.92;OR＝0.79,95%CI：0.73～0.86）维度的生命质量受损的危险度降低。超重组女性的社会关系（OR＝0.92,95%CI：0.85～0.98）和环境维度（OR＝0.91,95%CI：0.80～0.92）的生命质量受损的危险度显著降低。而肥胖女性社会关系维度的危险度也显著降低（OR＝0.86,95%CI：0.78～0.95）。结论 BMI分组不同的人群各个维度的生命质量不同,男性体重过轻组4个维度的生命质量均较差,男性超重和肥胖组各个维度生命质量均较好,女性超重组的社会关系和环境维度生命质量较好,女性肥胖组社会关系维度生命质量较好。     

Association of body mass index and weight change with all-cause mortality in the elderly

The authors explored the relation of body mass index (BMI; weight (kg)/height (m)(2)) and weight change to all-cause mortality in the elderly, using data from a large, population-based California cohort study, the Leisure World Cohort Study. They estimated relative risks of mortality associated with self-reported BMI at study entry, BMI at age 21 years, and weight change between age 21 and study entry. Participants were categorized as underweight (BMI <18.5), normal weight (BMI 18.5-24.9), overweight (BMI 25-29.9), or obese (BMI >or=30). Of 13,451 participants aged 73 years (on average) at study entry (1981-1985), 11,203 died during 23 years of follow-up (1981-2004). Relative to normal weight, being underweight (relative risk (RR) = 1.51, 95% confidence interval (CI): 1.38, 1.65) or obese (RR = 1.25, 95% CI: 1.13, 1.38) at study entry was associated with increased mortality. People who were either overweight or obese at age 21 also had increased mortality (RR = 1.17, 95% CI: 1.09, 1.25). Participants who lost weight between age 21 and study entry had increased mortality regardless of their BMI category at age 21. Obesity was significantly associated with increased mortality only among persons under age 75 years and among never or past smokers. This study highlights the influence on older-age mortality risk of being overweight or obese in young adulthood and underweight or obese in later life.     

体重指数与儿童青少年体能指数关联性研究

目的 探讨体重指数(BMI)与儿童青少年体能指数(PFI)之间的关联.方法 以安徽省参加2010年全国学生体质健康调查的7～18岁汉族学生共8941人为研究对象.按性别、年龄分层后,将研究对象依据BMI百分位数分为5组:很低(BMI＜P₅)、较低(P₅≤BMI＜P₁₅)、正常(P₁₅≤BMI＜ P₈₅)、较高(P₈₅≤BMI＜P₉₅)、很高(BMI≥P₉₅).对各体能测试成绩进行标准化,将其Z分相加算出PFI.用方差分析比较不同BMI组PFI的差异.用线性回归模型分析不同性别不同学龄段学生BMI与PFI的关联.结果 8941名学生中BMI很低、较低、正常、较高、很高组的PF1分别为-1.77、-0.91、0.32、-0.17、-0.54,呈倒“U”形分布;BMI正常组的PFI显著高于其他各组(P值均＜0.05).回归分析显示PFI与BMI呈正相关,与BMI²呈负相关,表明PFI是BMI的二次函数,随着BMI的增高PFI呈现先上升后下降的抛物线变化趋势.结论 BMI与儿童青少年PFI呈现抛物线变化趋势.     

体重指数与儿童青少年体能指数关联性研究

目的 探讨体重指数(BMI)与儿童青少年体能指数(PFI)之间的关联.方法 以安徽省参加2010年全国学生体质健康调查的7～18岁汉族学生共8941人为研究对象.按性别、年龄分层后,将研究对象依据BMI百分位数分为5组:很低(BMI＜P5)、较低(P5≤BMI＜P15)、正常(P15≤BMI＜ P85)、较高(P85≤BMI＜P95)、很高(BMI≥P95).对各体能测试成绩进行标准化,将其Z分相加算出PFI.用方差分析比较不同BMI组PFI的差异.用线性回归模型分析不同性别不同学龄段学生BMI与PFI的关联.结果 8941名学生中BMI很低、较低、正常、较高、很高组的PF1分别为-1.77、-0.91、0.32、-0.17、-0.54,呈倒“U”形分布;BMI正常组的PFI显著高于其他各组(P值均＜0.05).回归分析显示PFI与BMI呈正相关,与BMI2呈负相关,表明PFI是BMI的二次函数,随着BMI的增高PFI呈现先上升后下降的抛物线变化趋势.结论 BMI与儿童青少年PFI呈现抛物线变化趋势.     

成人腰围、体重指数与高三酰甘油血症的关系

目的探讨体重指数（BMI）、腰围（WC）与三酰甘油水平之间的关系,并用受试者工作特征（ROC）凹线评价BMI和WC对诊断高三酰甘油血症的价值。方法以2008年7至9月在我院进行常规体检的1093人（男性707人、女性386人）为研究对象,检测身高、体重、腰围和血三酰甘油水平。比较三酰甘油正常组与异常组BMI和WC的差异。建立BMI和WC的ROC曲线,获得曲线下面积及曲线上各界值点的灵敏度和特异度。结果男女性三酰甘油异常率分别为33．5％和8．3％。三酰甘油异常者的BMI和WC明显大于三酰甘油正常者（P〈0．01）。以BMI诊断高三酰甘油血症的ROC曲线下面积：男性为0．728±0．041、女性为0．708±0．021,最佳界值点：男性为24．5、女性为22．5;以WC诊断高三酰甘油血症的ROC曲线下面积：男性为0．790±0．042,女性为0．714±0．020,最佳界值点：男性为86cm,女性为77cm。结论BMI和WC与三酰甘油水平均相关。BMI和WC是预测高三酰甘油血症较为理想的指标。     

Associations between body mass index and health-related quality of life among Australian adults

Objectives  

To assess the relationship between body mass index (BMI) and health-related quality of life (HQoL), as measured by the Short Form Health Survey (SF-36) within a sample with broad population coverage.     

北京市中老年人体质指数与死亡的关系

目的：探讨北京市中老年人体质指数（BMI）与死亡的关系，方法：采用前瞻队列研究方法，于1991年对北京市40岁以上的自然人群共6209人进行基线危险因素调查后，并随访至1999年12月，对在随访期间发生的所有死亡病例按ICD－9编码进行登记，并在个体水平对BMI与总死亡及几种主要死因的关系进行分析。结果：近10年北京市中老年人前5位主要死因依次为心脑血管疾病，肺心病，消化道肿瘤，不明原因突然死亡，肺癌，其死亡构成比分别为33．3％，13．8％，11．2％，7．4％，5．6％，人群总死亡率及不吸烟者总死亡率均以BMI值23．6－26．2组最小，以此BMI组为参照，BMI＜21．2组上述二组人群总死亡的RR值分别为1．7和1．9，在BMI≥26．2组以上二组人群总死亡的RR值分别为1．3和1．5，BMI与心血管病死亡呈正关联，BMI≥26.2组较BMI＜21．2组心血管病死亡的RR值为1．2，BMI与肺心病，消化道肿瘤，肺癌，肺炎及不明原因突然死亡分别均呈U型关系，均以BMI值23．6－26．2组死亡率最低，与此BMI组相比，BMI＜21．2组因上述5种疾病死亡的RR值分别为14．8，1．1，5．6，2．4和2．6，BMI≥26．2组因上述5种疾病死亡的RR值分别为3．0，1．9，3．7，2．2和1．5，各BMI组均以心血管病死亡构成比最大（28．0％－54．8％），结论：北京市中老年人体质指数与总死亡呈U型关系；心脑血管疾病仍是目前影响人们健康的最主要疾病，其死亡危险性随BMI的增加而增加。     

Effects of low body mass index and smoking on all-cause mortality among middle-aged and elderly Japanese

To investigate effects of low body mass index (BMI) and smoking on all-cause mortality among middle-aged and elderly Japanese, we conducted a community-based prospective study. A mail survey was conducted in 1987-1990 in four towns, western Japan. A cohort of 7,301 Japanese men and 8,825 Japanese women was followed up from the date of the mail survey to 1995 in three of the towns and 1998 in the fourth town. We investigated the effect of BMI and smoking on all-cause mortality by using Cox's proportional hazards model. The relationship between BMI and all-cause mortality was a reverse J-shape with minimal mortality in 24 < or = BMI < 26 in men and a U-shape with minimal mortality in 22 < or = BMI < 24 in women, after adjusting for age and smoking. The lowest BMI category (BM < 20) had the highest all-cause mortality in men and also in women. Taking only never-smokers, the highest risk for all-cause mortality was observed in the lowest BMI category for men and for women. This does not seem to be explained by smoking and pre-existing diseases. More attention should be paid to persons with low BMI.     

北京市中老年人体质指数与死亡的相关关系

目的探讨北京市中老年人体质指数(BMI)与死亡的相关关系.方法采用前瞻对列研究方法,于1991年对北京市40岁以上的自然人群共6 209人进行基线危险因素调查后,并随访至1999年12月.对在随访期间发生的所有死亡病例按ICD-9编码进行登记,并在个体水平对BMI与总死亡及几种主要死因进行相关分析.结果近10年北京市中老年人前5位主要死因依次为心脑血管疾病、肺心病、消化道肿瘤、不明原因突然死亡、肺癌,其死亡构成比分别为33.3%、13.8%、11.2%、7.4%、5.6%.人群总死亡率及不吸烟者总死亡率均以BMI值23.6～26.2组最小,以此BMI组为参照,BMI＜21.2组上述二组人群总死亡的RR值分别为1.7和1.9,在BMI≥26.2组以上二组人群总死亡的RR值分别为1.3和1.5.BMI与心血管病死亡呈正相关,BMI≥26.2组较BMI＜21.2组心血管病死亡的RR值为1.2;BMI与肺心病、消化道肿瘤、肺癌、肺炎及不明原因突然死亡分别均呈U型关系,均以BMI值23.6～26.2组死亡率最低,与此BMI组相比,BMI＜21.2组因上述5种疾病死亡的RR值分别为14.8、1.1、5.6、2.4和2.6,BMI≥26.2组因上述5种疾病死亡的RR值分别为3.0、1.9、3.7、2.2和1.5.各BMI组均以心血管病死亡构成比最大(28.0%～54.8%).结论北京市中老年人体质指数与总死亡呈U型相关;心脑血管疾病仍是目前影响人们健康的最主要疾病,其死亡危险性随BMI的增加而增加.     

Body mass index and measures of adiposity among elderly adults

OBJECTIVE: To evaluate the nutritional status of elderly persons and to compare the correlation between the body mass index (BMI=kg/m2) with measures of adiposity and fat distribution among elderly and middle-aged adults. METHODS: Elderly persons (N=699; 60 years or older) and middle-aged adults (N=1,306; 40-59.9 years) participating in a population-based survey conducted in 1996 in the municipality of Rio de Janeiro were evaluated as to body mass index, arm, waist, and hip circumferences, skinfolds, and arm fat and muscle areas using standardized procedures. The cutoff points proposed by the World Health Organization for waist circumference, waist-to-hip ratio, and body mass index were used. Analyses were performed using the Spearman correlation coefficient and linear regression adjusted for age. RESULTS: About 50% of elderly subjects were classified as overweight and more than 50% of women in all age groups had waist circumference and waist-to-hip ratio outside the normal range. Among men, these percentages were about 40% for waist circumference and 20% for waist-to-hip ratio. Among elderly subjects, the partial correlation (adjusted for age) between body mass index and measures of adiposity (waist circumference, skinfolds, and arm fat area) ranged from 0.45 to 0.85 for men and 0.55 to 0.86 for women. Weight and waist circumference were the variables more strongly correlated with body mass index among both elderly persons and adults. CONCLUSIONS: The prevalence of overweight among elderly persons was high for both men and women. Body mass index shows a similar relationship with adiposity regardless of ageing.     

体重指数对10年累积高血压发病危险的预测作用

目的 探讨北京地区队列人群基线(1992年)BMI水平及10年(1992-2002年)BMI水平的变化与高血压发生的关系.方法 采用前瞻性队列研究的方法,于1992年对北京大学社区和首都钢铁公司地区35～64岁人群进行基线心血管病危险因素调查,并持续10年对心血管病的发病情况进行随访.在2002年对相同人群再次进行了危险因素调查.两次调查资料完整,且对基线无高血压的2115人进行分析.结果 调查的35～64岁人群10年高血压累积发病率为34.8%.随着基线BMI水平的增加,10年后高血压的累积发病率呈增加趋势(P<0.001),男女两性的变化趋势一致.在45～54岁组和55～64岁组,随着基线BMI水平的增加,10年高血压的累积发病率也呈线性增加趋势(P<0.05).多因素logistic回归分析显示,BMI≥28 kg/m2组的高血压发病危险是BMI<24 kg/m2组的3.6倍;10年BMI水平每增加1 kg/m2,累积发生高血压的危险增加17.5%.1992年和2002年BMI均正常者中有22.0%的人发生高血压,1992年和2002年BMI均判为肥胖者中有56.3%的人发生高血压.结论 BMI是高血压发病的一个独立危险因素,随着基线BMI水平的增加高血压的发病危险也增加.     

Association between body composition and body mass index in young Japanese women

The National Nutrition Survey of Japan indicated a trend toward a decreasing body mass index (BMI; kg/m2) among young Japanese women. Current studies suggest that not-high BMI often does not correlate with not-high body fat percentage. Recently, the classification of BMI in adult Asians was proposed by the International Obesity Task Force. The addition of an "at risk of overweight" category, BMI as 23.0-24.9, was intended to prevent chronic diseases. We investigated the association between body fat percentage (BF%) and BMI to evaluate the screening performance of BMI focused on individual preventive medicine. The subjects consisted of 605 female college students. The subjects' ages (y), heights (cm), body weights (kg), BMIs, and BF percents with underwater weighing expressed as the means +/- SD were 19.6 +/- 0.5, 158.7 +/- 5.6, 53.8 +/- 7.2, 21.3 +/- 2.4, and 24.9 +/- 4.9, respectively. We defined high BF% as +/- 85th percentile of BF% (29.8%). High-BF% individuals are often not classified into BMI > or = 23.0 because their BMI readings are very broad (18.4-31.7). In comparison to the screening performances (specificity and sensitivity), BMI > or = 23.0 (85.3% and 52.1%, respectively), rather than BMI > or = 25.0 (96.7% and 29.8%, respectively), is recommended for the mass evaluation of fatness. For this reason, the BMI "at risk of overweight" category is characterized as the threshold of increasing the appearance ratio of high-BF% individuals. In conclusion, the BMI > or = 25.0 kg/m2 category is determined as high BF%, regardless of body composition measurement for mass evaluation as a result of quite high specificity. Even so, body composition measurement is necessitated by the individual evaluation of fatness focused on preventive medicine because BMI performed a poor representation of body composition, especially BMI < 25.0 kg/m2 individuals.     

Predictors of body mass index among low-income community-dwelling older adults

This study investigated demographic, behavioral, and functional predictors of overweight and obesity, using secondary data from 705 community-dwelling individuals aged 65 years and older receiving or seeking Medicaid personal care services. Half of the participants were obese, while an additional 28% were overweight. The relationships between body mass index (BMI) levels and selected independent variables were analyzed. Females were more likely to be obese, while those who were older (75 years or older), more cognitively impaired, and smoked were less likely to obese. Comparing obesity with being overweight, being female and reporting more pain symptoms increased the odds of being obese, whereas being older (75 years or older) and being more cognitively impaired decreased the odds. The especially high rates of obesity in Texas have a profound impact on personal health and may result in increased health care costs that threaten public programs as well.     

黑龙江省部分地区成年人既往最大体重指数与2型糖尿病关系的研究

目的 研究社区成年人2型糖尿病(T2DM)的患病情况和分布,探讨既往最大体重指数(MAxBMI)与T2DM的关系.方法 2005年6-8月对牡丹江市4个区和1个县级市分层整群抽样20岁以上社区常住居民,研究T2DM患病状况及其与不同水平MAXBMI和当前BMI的关系.结果纳入研究的社区居民为1071名,T2DM患病率7.09%;以MAXBMI为肥胖的T2DM患病率为12.10%.随MAXBMI水平升高,患T2DM的危险增大(趋势X~2=17.387 23,P<0.0001).多因素分析显示,MAXBMI高者患T2DM的OR值为3.06(P=0.0013).分组后的分层分析显示,T2DM患者中血糖水平在MAXBMI≥27.4 kg/m~2组,比MAXBMI低水平组显著升高(P=0.0408);血糖正常组,MAXBMI处于高值(≥25.4 kg/m~2)的人群比低值人群当前BMI相对MAXBMI下降的更大,血糖水平更高.结论 在T2DM患者和血糖正常组人群中,MAXBMI值与T2DM具有相关性;可作为肥胖指标预测糖尿病患病的风险.     

围青春期女生身体成分与体质量指数协同变化关系

探索围青春期女生身体成分与体质量指数(BMI)的关系,为有针对性进行肥胖预防提供理论基础.方法 以2015年1-12月天津市体质检测中心测试的10~16岁中小学女生2 023名为研究对象,测试其基本形态指标和身体成分.结果 10~ 16岁女生的BMI与体脂、体脂/身高2、体重、体脂百分比呈中高度相关(r值分别为0.905,0.891,0.844和0.878,P值均<0.01);BMI与去脂体重、去脂体重/身高2呈低到中度相关(r值分别为0.507,0.636,P值均<0.01).11~16岁各年龄组体重、去脂体重均高于10岁时的体重、去脂体重,差异均有统计学意义(P值均<0.05).12~ 16岁各年龄组的脂肪重量均高于10岁时的脂肪重量,差异均有统计学意义(P值均<0.05).13,15,16岁时的BMI、体脂重量/身高2值高于10岁时的BMI、体脂重量/身高2;12,15,16岁时的去脂体重/身高2高于10岁时的去脂体重/身高2,差异均有统计学意义(P值均<0.05).结论 围青春期尤其是12~13岁女生体质量指数和身体成分变动幅度大.应为不同年龄段的女生制定不同的体力活动及营养健康计划.