体质量超标或肥胖诊断中几种评价指标的差异和评价

目的 探讨青少年健康监控中选用适宜的指标判定体质量超标和肥胖.方法 采用国内较常用的Quetelet指数、BMI指数、Rohrer指数和Weight for height.分别按年龄、性别参照城乡标准值对1 080名中学生做出诊断和分析.结果 各指标的体质量超标和肥胖检出率在年龄、性别和城乡分布上差异较大.Rohrer和Weightfor height指标与体质量的相关性相对较高.各指数之间均存在着相关性,但BMI与其他指数的相关系数较小.结论 青少年体质量超标或肥胖诊断中,选择Rohrer和Weight for height指数可能优于其他指标.建议考虑骨骼构架等因素,研究更理想的评价体系.     

青少年肥胖与糖代谢异常发生的关系

目的探讨青少年肥胖与糖代谢异常发生的关系。方法将2016年6月-2017年3月本院收治的486例行健康体检的青少年作为研究对象,测量其身高、体质量,根据不同体质量指数(BMI)将青少年分为体质量过低、正常体质量、超重、肥胖。比较不同体质量指数人群血糖水平、胰岛素功能的差异,并分析肥胖糖代谢异常相关影响因素。结果肥胖、超重青少年服糖后0.5 h、1 h、2 h、3 h血糖水平高于正常体质量、体质量过低者;肥胖、超重青少年胰岛素水平、HOMA-IR水平高于正常体质量、体质量过低者,其HBCI水平低于正常体质量、体质量过低者,差异均有统计学意义(P0.05)。TC、胰岛素抵抗指数、HDL、腰臀比、BMI是肥胖青少年糖代谢异常独立影响因素(P0.05)。结论青少年肥胖存在一定程度的糖耐量异常、胰岛素功能障碍,临床应针对肥胖糖代谢异常的危险因素进行针对性干预措施。     

肥胖是祸不是福

肥胖是按WHO规定的体质指数或体重指数判定的。体质指数BMI=体重(kg)/身高(M)。我国成年人BMI分类标准是:18.5～23.9为适宜范围,24.0～27.9为超重,28以上为肥胖。以此标准被分为超重及肥胖的人群,其患高血压危险性可达体质指数适宜人群的3～4倍,患冠心     

社区老年人超重和肥胖与慢性病关系的调查

目的调查社区老年人超重和肥胖与慢性病的关系,为制定干预策略提供依据。方法用多层多阶段系统抽样法,调查鲤城社区老年学校学员的既往病史、测量体质指数,同时进行体格检查。结果共调查410人,其超重/肥胖率为32.9%(135/410),超重/肥胖组的高血压、高脂血症、脂肪肝、糖尿病、冠心病和高尿酸血症的患病率均高于正常体重组;高甘油三酯、高胆固醇血症检出率也高于正常体重组。结论老年人的超重/肥胖与慢性病的患病率有关,防控超重/肥胖是老年人健康干预的重点。     

超重和肥胖妇女孕期体质量管理及主要危险因素对产后盆底功能的影响

目的 探讨超重和肥胖妇女在孕期体质量管理及其主要危险因素对产后盆底功能障碍性疾病(FPFD)的影响。方法 选取2019年1—12月于广州市天河区妇幼保健院定档产检产妇914例作为研究对象,孕期以指导饮食和运动为体质量管理干预方案,记录整个孕期体质指数(BMI)、孕期增加体质量等指标,在产后6周复查时进行盆底肌功能检测,分析影响FPFD的相关因素,进一步采用多因素logistic回归分析超重和肥胖与FPFD的关联性,探讨体质量管理对产后盆底功能的影响。结果 分析结果显示,分娩方式、孕前BMI及孕期增加体质量是发生FPFD有关因素(P<0.05);多因素logistic回归分析结果显示,孕前BMI及孕期增加体质量是发生FPFD的独立危险因素,超重、肥胖、孕期增加体质量9～16 kg和孕期增加体质量≥16 kg均与产后FPFD发生有关,差异有统计学意义(P<0.05)。结论 超重和肥胖与FPFD的发生密切相关,进行孕期体质量管理有利于产后盆底功能恢复。     

老年人饮水相关研究现状与展望

老年人随着年龄的增长，多项身体机能出现不同程度的衰退，渴觉敏感度较低，对脱水的反应迟缓且耐受性下降，因此老年人的饮水行为需引起关注。波兰、德国、美国、西班牙、英国等国家老年人饮水量调查结果显示老年人饮水不足和脱水的现象较为普遍，而我国缺乏老年人饮水量调查数据。饮水不足导致的脱水状态会降低机体的认知能力，还有可能是老年人认知损伤的危险因素之一。饮水不足还可能增加部分泌尿系统疾病、心血管疾病、肥胖、便秘和糖尿病等的发生风险。制定老年人水适宜摄入量，指导其足量饮水具有重要意义。美国医学研究所、澳大利亚国家卫生与医学研究会和新西兰卫生部、欧洲食品安全局、世界卫生组织等推荐老年人水适宜摄入量等同于成年人；印度医学研究委员会、菲律宾科技部食品和营养研究所、泰国卫生部营养司推荐老年人水适宜摄入量低于成年人。我国由于缺乏老年人饮水量调查数据，暂推荐老年人水适宜摄入量等同于成年人。有必要开展我国老年人饮水行为调查，为针对性地制定老年人适宜水摄入量提供基础数据；且需要加强饮水健康知识宣教，促进老年人形成健康饮水行为、维持适宜水合状态，进而促进机体健康。[营养学报，2023,45(1):21-26]     

上海市佘山镇65岁及以上老年人肥胖与血糖水平关联的横断面研究

[目的]了解上海市佘山镇≥65岁未诊断为糖尿病的老年人中肥胖与空腹血糖水平之间的关联性.[方法]收集2018年度佘山镇老年人体检数据,包括体质量指数(BMI)、腰围(WC)、腰臀比(WHR)、腰高比(WHtR),排除曾被诊断为糖尿病的患者,空腹血糖水平采用己糖激酶法获得.采用卡方检验比较不同肥胖状况不同性别空腹血糖水平...     

2007年某重点高校退休人员体质量指数分布情况

世界卫生组织将肥胖规定为导致疾病发生的10项危险因素之一.本研究通过对某高校退休人员632人的体质量指数分析,探讨退休人员体质量指数的变化特点,为体质量超标和肥胖的预防工作提供依据.     

肥胖大学生体质量指数相关因素分析

目的探讨肥胖大学生体质量指数与血清同型半胱氨酸、氧化低密度脂蛋白、血脂及血糖的相关性及其临床意义。方法 2010年入学体检大学生中以自愿参加方式,将体质量指数≥25的大学生55例设为肥胖组(n=55),体质量指数<25的大学生92例设为对照组(n=92),2组学生均无急慢性内科疾患。直接竞争ELISA法测定2组血清同型半胱氨酸、氧化低密度脂蛋白水平,测定总胆固醇、三酰甘油、低密度脂蛋白胆固醇、高密度脂蛋白胆固醇、血糖。结果 2组比较,肥胖组血清同型半胱氨酸高于对照组,氧化低密度脂蛋白高于对照组,差异均有统计学意义(P<0.05);肥胖组血清三酰甘油高于对照组,高密度脂蛋白低于对照组,差异有统计学意义(P<0.01);2组总胆固醇、低密度脂蛋白、血糖差异无统计学意义(P>0.05);肥胖组大学生体质量指数与血清同型半胱氨酸水平相关(r=0.321,P<0.05),体质量指数与血清氧化低密度脂蛋白水平不相关(r=0.263,P>0.05);多元线性回归分析显示,三酰甘油、同型半胱氨酸为肥胖组大学生体质量指数水平的独立影响因素。结论肥胖大学生易发生动脉粥样硬化性疾病。防治大学生肥胖及相关慢性病,是高校教育需重视的问题。     

老年人健康评价的指标和方法初探

为了探索老年人健康状况评价的适宜指标和方法，采用横断面调查法，对某市112名退休职工（平均年龄61．4岁，按退休前的劳动内容分为体力、脑力和脑体混合3组）进行生活能力指数、体力功能、脑力功能和营养状况测试．结果表明，反映营养状况的Kaup指数均值均超过医学正常值上限，呈过度肥胖，以腹部和大腿更突出．男性各分析指标在不同年龄组间无显著性差异（P＞0．05），也无明显的变化规律；但退休前的劳动类型对老年人晚年的健康状况影响较大，生活能力指数（LCI）、体力指数（PHI）、脑力功能的3项指标（短时记忆、译码、划字）在3种劳动类型的退休职工中差异均有显著性（P＜0．05），均以脑力、脑体混合退休职工组高于体力退休职工组；同时用来评价体力功能的PHI指标较其包容的6项指标的实测值更稳定、更简便．提示在今后老年人健康状况研究中生活能力指数（LCI）、体力指数（PHI）、脑功能3项指标、Kaup指数和皮脂厚度等具有潜在的运用价值．     

The danger of weight loss in the elderly

Aging is generally accompanied by weight loss made up of both fat mass and fat-free mass. As more people, including elderly, are overweight or obese, weight loss is recommended to improve health. Health risks are decreased in overweight children and adults by dieting and exercise, but the health benefits of weight loss in elderly, particularly by calorie restriction, are uncertain. Rapid unintentional weight loss in elderly is usually indicative of underlying disease and accelerates the muscle loss which normally occurs with aging. Intentional weight loss, even when excess fat mass is targeted also includes accelerated muscle loss which has been shown in older persons to correlate negatively with functional capacity for independent living. Sarcopenic obesity, the coexistence of diminished lean mass and increased fat mass, characterizes a population particularly at risk for functional impairment since both sarcopenia (relative deficiency of skeletal muscle mass and strength) and obesity have been shown to predict disability. However, indices of overweight and obesity such as body mass index (BMI) do not correlate as strongly with adverse health outcomes such as cardiovascular disease in elderly as compared to younger individuals. Further, weight loss and low BMI in older persons are associated with mortality in some studies. On the other hand, studies have shown improvement in risk factors after weight loss in overweight/obese elderly. The recent focus on pro-inflammatory factors related to adiposity suggest that fat loss could ameliorate some catabolic conditions of aging since some cytokines may directly impact muscle protein synthesis and breakdown. Simply decreasing weight may also ease mechanical burden on weak joints and muscle, thus improving mobility. However, until a strategy is proven whereby further loss of muscle mass can be prevented, weight loss by caloric restriction in individuals with sarcopenic obesity should likely be avoided.     

使用ROC曲线分析肥胖指标对高血压患病预警的回顾性研究

目的分析不同肥胖指标在预测高血压工作特征曲线下的面积,比较4项指标的预测价值,找出最优的预测方式。方法调查社区中老年人高血压发病率,测量体重、身高、腰围和臀围4项指标,绘制ROC曲线,计算曲线下面积。结果体质指数在4项指标中的曲线下面积最大,为0．6992。在控制腰臀比的情况下,体质指数的预测价值更高,腰臀比〈0．9组的体质指数曲线下面积为0．7399。结论在控制腰臀比的情况下,体质指数对高血压的预测价值更高。     

Overweight and obesity among children who are deaf: Quantitative and qualitative findings

The current study examined rates of overweight and obesity among children attending schools for the deaf, including factors associated with greater prevalence of overweight. Further, interviews were conducted with school staff to assess school perceptions of overweight and weight management. Although prevalence of overweight and obesity was high (approximately 28%), this rate was not greater than that of youth in the general population, and body mass index was higher among females. Several themes regarding factors contributing to overweight among deaf children, barriers for weight management, and possible components for weight management interventions emerged in interviews with school staff.     

体重指数、腰围和高龄老年人死亡风险的关联

目的 分析体重指数、腰围与高龄老年人死亡风险的关联,为完善高龄老人的体重管理提供科学依据。方法 采用中国老年人健康长寿影响因素调查（Chinese Longitudinal Healthy Longevity Survey, CLHLS）2011—2018队列数据库4 508例样本,暴露变量为体重指数（body mass index, BMI）和腰围（waist circumference, WC）,结局为死亡。采用Cox比例风险回归模型分析体重指数、腰围和高龄老年人死亡风险的关联。结果 中位随访时间为3.08年,死亡3 416人。按照BMI分类,体重过轻对高龄老年人死亡风险最大（HR=1.31,95%CI:1.19～1.43）,超重是老年人死亡风险的保护因素（HR=0.85,95%CI:0.74～0.98）。按照WC分类,中心型肥胖是老年人死亡风险保护因素(HR=0.84,95%CI:0.76～0.93)。BMI和WC构建的综合体重表型结果显示,BMI超重合并腰围肥胖是老年人死亡风险的保护因素（HR=0.82,95%CI:0.69～0.97）,而BMI过轻合并腰围肥胖是老年人死亡风险...     

母亲孕前体质量指数孕期增重与子代学龄前期体成分的关系

  目的  探索孕前体质量指数、孕期增重与子代学龄前期肥胖和体成分的关系,为指导母亲从孕前开始合理控制体重和预防儿童肥胖提供依据。  方法  于2020年9—12月在天津市3所幼儿园招募1 333名学龄前儿童。结构化问卷收集儿童生活方式信息;检测儿童身高、体重、体脂肪组织质量,计算体脂肪百分比(FM%)、脂肪质量指数(FMI)、非脂肪质量指数(FFMI)。获取儿童母亲孕产期医疗记录,将母亲按孕前体重状态和孕期增重分组。采用χ2检验、t检验、线性回归模型及Logistic回归方法分析不同组间儿童肥胖及体成分差异。  结果  纳入研究的学龄前儿童超重及肥胖检出率为12.7%和7.7%。调整母亲分娩年龄及产次,儿童出生孕周、性别及年龄和生活方式后,母亲孕前BMI、孕期增重与子代学龄前期的肥胖及体成分指标的相关性均有统计学意义(P值均 < 0.05)。孕前正常体重母亲孕期增重过多会增加子代高FM%及高FMI的风险(OR值分别为1.81,1.68,P值均 < 0.05);孕前超重肥胖母亲,子代肥胖风险及体成分与母亲孕期增重相关性均无统计学意义。  结论  母亲孕前体重状态、孕期增重与子代学龄前期肥胖及体成分均存在关联。建议母亲孕前及孕产期合理控制体重。     

Birth weight, weight at 1 y of age, and body composition in older men: findings from the Hertfordshire Cohort Study

BACKGROUND: Size in early life is related to adult body mass index, and early environmental influences have been proposed to have lifelong consequences for obesity. However, body mass index also reflects fat-free mass, and few studies have examined the relation between size in early life and direct measures of body composition in older people. OBJECTIVE: We investigated the associations of birth weight and weight at 1 y of age with body composition in older men. DESIGN: We carried out a retrospective cohort study in Hertfordshire, United Kingdom. Men who were born between 1931 and 1939 and for whom there were records of birth weight and weight at 1 y of age (n = 737) participated in the study. The main outcome measures were adult body mass index, fat-free mass, and fat mass. RESULTS: Birth weight was significantly and consistently positively associated with adult body mass index and fat-free mass but not with measures of adult fat mass. In contrast, weight at 1 y of age was associated with adult body mass index, fat-free mass, and fat mass. CONCLUSIONS: The consistently reported positive relation between birth weight and adult body mass index may reflect prenatal and maternal influences on fat-free mass rather than on fat mass in older people. The postnatal environment may be more influential than prenatal factors in the development of obesity in later life.     

育龄妇女在围孕期服用叶酸依从性递进指标界定

出生缺陷中神经管畸形发病率高且危害大.育龄妇女在孕前3个月至孕早期3个月内每日服用0.4 mg叶酸可有效预防50％ ～ 80％神经管畸形的发生[1,2].为了解农村孕妇围孕期叶酸服用依从性现状及探讨其判断标准,进行了相关研究。     

Obesity in the elderly: who should we be treating, and why, and how?

PURPOSE OF REVIEW: To investigate emerging data on the relationship between obesity, increased morbidity and mortality, and decreased function in the elderly. To examine what is known about the effectiveness of interventions, and how treatment might be improved. RECENT FINDINGS: Obesity is a common problem in the elderly, although its prevalence decreases in extreme old age. Decreased physical activity and decreased energy expenditure with ageing predispose to fat accumulation and fat redistribution. Reduction in muscle mass (sarcopenic obesity) is an important determinant of physical function and metabolic rate. Chronic inflammation and endocrine changes contribute to the changes in metabolism and body composition that accompany ageing, and are potential therapeutic targets. Body weight and body mass index are imperfect indicators of risk from obesity. The focus of treatment should be on reduction of intra-abdominal fat and preservation of muscle mass and strength. A number of recent studies have confirmed the effectiveness of exercise interventions in the elderly. Progressive resistance training, rather than endurance exercise, may be more effective in many cases. Reduced function and decreased quality of life accompany development of the complications of obesity such as diabetes and vascular disorders. There is considerable scope to impede the development of these complications in the elderly with lifestyle interventions. SUMMARY: Sarcopenic obesity, with accumulation of intra-abdominal fat, is a major determinant of health status in the elderly. As in the younger population, prevention and treatment programmes have the potential to decrease the impact of diabetes, vascular disease, and other complications of obesity.     

L’obésité du sujet âgé

Our population is ageing, and obesity is increasing in the elderly. BMI value associated with the lowest relative mortality is slightly higher in older than in younger (between 25 and 32 kg/m²). Nevertheless, the combined effect of aging and obesity increases the risk of comorbidities, including type 2 diabetes mellitus, cardiovascular risk, respiratory insufficiency, obstructive sleep apneas, cancer, urinary incontinence and dementia. The medical consequences of obesity are alleviated by modest, achievable weight loss (5–10 kg) with an evidence-based maintenance strategy. A combination of exercise and modest calorie restriction appears to be the optimal method of reducing fat mass and preserving muscle mass. The clinical outcomes have been evaluated in diabetes mellitus and in cardiovascular diseases, showing favorable effects on the morbidity and probably on the mortality. Very-low-energy diets have to be avoided for elderly patients. The risk of muscle loss increases with the level of diet restriction. In older people, the risks of laparoscopic bariatric surgery are not higher than in younger but the benefits have not been evaluated. The sarcopenic obesity (excess in body fat and loss of muscle mass and function) burdens the functional consequences of obesity in older people. Since sarcopenia is frequent in the elderly, a screening should be done in obese patients for whom a restrictive diet is not recommended. In renal or cardiac insufficiency, only physical activity can be recommended. In elderly people, weight management interventions using moderate calorie restriction and physical activity exercise are recommended. Daily protein intake must be maintained. Health benefits and risks from long-term weight management in obese elderly have to be studied in randomized controlled studies.     

The Influence of U.S. Chain Restaurant Food Consumption and Obesity in China and South Korea: An Ecological Perspective of Food Consumption,Self-Efficacy in Weight Management,Willingness to Communicate About Weight/Diet,and Depression

This study examined the impact of U.S. chain restaurant food consumption in China and South Korea from an ecological perspective. Specifically, it explored the relationships among several environmental and individual variables that have been found to affect obesity/weight management in previous research, including the prevalence/popularity of U.S. chain restaurants in these countries, frequency of U.S. chain restaurant food consumption, self-efficacy in weight management, willingness to communicate about weight/diet, self-perceptions of weight/obesity stigma, body mass index (BMI), and depression. The results indicated that willingness to communicate about weight/diet predicted increased self-efficacy in weight management. Higher BMI scores were found to predict increased weight/obesity stigma, and increased frequency of U.S. restaurant food consumption, weight/obesity stigma, and reduced self-efficacy in weight management were found to predict increased levels of depression. The theoretical and practical implications of the findings are discussed, along with limitations and directions for future research.