65岁及以上老年人群中基于脂肪组织过多引起的慢性疾病患病情况及影响因素分析

Prevalence and Root Cause Analysis of Adiposity-based Chronic Disease in Older Adults Aged 65 Years and Older

背景美国临床内分泌学家协会和美国内分泌学会提出基于脂肪组织过多引起的慢性疾病(ABCD)模型来评价肥胖,目前国内针对ABCD的研究极少,应用效能也尚不清楚。目的运用ABCD这一新的肥胖评价指标,了解中国65岁及以上老年人群中ABCD的患病情况及其影响因素。方法选择2021年1—12月参加广东省深圳市坪山区28家社区健康服务中心体检的65岁及以上老年人5562名,通过问卷调查、体格检查、实验室检测获取研究对象基本特征,根据ABCD模型的诊断标准对样本人群进行ABCD分期,计算ABCD及各个分期的患病率,采用多因素Logistic回归分析探究ABCD分期与不同心脏代谢危险因素风险的关系。结果本研究中ABCD患病率为71.0%,0期、1期、2期患病率分别为4.8%(267/5562)、32.5%(1808/5562)、33.7%(1874/5562)。多因素Logistic回归分析结果显示,以ABCD正常为参照组,除高总胆固醇与饮酒外,糖尿病、高血压、三酰甘油升高、高密度脂蛋白胆固醇降低、低密度脂蛋白胆固醇升高、吸烟与ABCD分期存在关联(P<0.05);ABCD 1期发生高血压、三酰甘油升高、高密度脂蛋白胆固醇降低、低密度脂蛋白胆固醇升高的风险分别是正常人群的2.393倍、1.515倍、1.940倍、1.688倍、1.376倍;ABCD 2期发生糖尿病、高血压、三酰甘油升高、高密度脂蛋白胆固醇降低、低密度脂蛋白胆固醇升高的风险分别是正常人群的2.918倍、4.231倍、9.282倍、4.128倍、2.970倍、1.672倍。吸烟是ABCD1期和2期的保护因素,OR(95%CI)分别为0.577(0.480~0.693)、0.752(0.633~0.893)。结论本研究中65岁及以上老年人ABCD患病情况存在男女差异,患病率与高血压、糖尿病、吸烟等心脏代谢危险因素存在关联,ABCD模型在中国老年人群中应用效果良好。

Background The American Association of Clinical Endocrinologists and the American Society of Endocrinology have proposed an adiposity-based chronic disease(ABCD)model for evaluating obesity,and there has been very few studies of ABCD in China,and the efficacy of its application is unclear.Objective To understand the prevalence of ABCD and its root cause in the Chinese elderly population aged 65 years and above using ABCD,a new obesity evaluation index.Methods Five thousand five hundred and sixty-two elderly people aged 65 years and above who participated in medical checkups at 28 community health centers in Pingshan District,Shenzhen City,Guangdong Province,from January to December 2021 were selected to obtain the basic characteristics of the study subjects through questionnaires,physical examinations,and laboratory tests,and to stage the sample population according to the diagnostic criteria of the ABCD model,and calculate the prevalence rates of ABCD and the individual stage,and multifactorial Logistic regression analysis was used to explore the relationship between ABCD staging and different cardiometabolic risk factor risks.Results The prevalence of ABCD in this study was 71.0%,and the prevalence of stage 0,1,and 2 were 4.8%(267/5562),32.5%(1808/5562),and 33.7%(1874/5562),respectively.The results of multifactorial Logistic regression analysis showed that,using ABCD normal as the reference group,diabetes mellitus,hypertension,high triacylglycerol,low HDL-C,high LDL-C,and cigarette smoking,in addition to high total cholesterol and alcohol consumption,were associated with the stage of ABCD(P<0.05);The risk of developing hypertension,high triacylglycerol,low HDL-C,and high LDL-C in ABCD stage 1 was 2.393,1.515,1.940,1.688,and 1.376 times higher than that of the normal population,respectively;The risk of diabetes,hypertension,high triacylglycerol,low HDL-C,and high LDL-C in ABCD stage 2 was 2.918,4.231,9.282,4.128,2.970,and 1.672 times higher than that of the normal population,respectively.Smoking was a protective factor for ABCD stage 1 and 2,with OR(95%CI)of 0.577(0.480-0.693)and 0.752(0.633-0.893),respectively.Conclusion In this study,there were male-female differences in the prevalence of ABCD in the elderly aged 65 years and older,and the prevalence was associated with cardiometabolic risk factors such as hypertension,diabetes,and smoking,and the ABCD model has been well applied in the Chinese elderly population.