社区40岁及以上中老年人肥胖状态与第1秒用力呼气容积下降的关联研究

Association of obesity status with force volume in 1 second reduction in community middle-aged and elderly adults(≥40 years old)

目的了解社区40岁及以上中老年人肥胖状态与第1秒用力呼气容积(FEV_(1))下降的关联,为社区中老年人慢性呼吸系统疾病防治提供参考。方法基于2016年上海市郊区自然人群队列,于2021年采用随机抽样法抽取共3149名40岁及以上队列成员开展肺功能检查及问卷调查,根据体质指数(BMI)和腰围测量结果分为不同的肥胖类型。采用SPSS 22.0进行t检验、Mann-Whitney U检验、χ^(2)检验和多因素非条件logistic回归分析。结果3149名研究对象的FEV_(1)下降(FEV_(1)%Pred<80%)率为14.8%,男性(21.1%)高于女性(10.7%),差异有统计学意义(P<0.01)。研究对象的BMI超重率和肥胖率分别为43.7%和17.9%,中心性肥胖率为30.9%。多因素logistic回归分析结果显示,中心性肥胖与FEV_(1)下降高风险相关(OR=1.70),BMI超重(OR=0.63)或肥胖(OR=0.64)与FEV_(1)下降低风险相关,均有统计学意义(P<0.01)。在不同的肥胖类型中,BMI超重/肥胖+腰围正常者FEV_(1)下降的风险低于BMI偏瘦/正常+腰围正常者(OR=0.66),分性别分析后,男性居民中同样存在该关联(OR=0.63);BMI偏瘦/正常+中心性肥胖者的FEV_(1)下降风险高于BMI偏瘦/正常+腰围正常组(OR=1.93),该结果在女性中同样成立(OR=2.25),均有统计学意义(P<0.05)。结论中心性肥胖者相较于腰围正常者FEV_(1)下降率更高;而对于腰围正常者,BMI较低者FEV_(1)下降率更高。因此社区中老年人应调整生活方式以维持适当体重和减少腰围,从而预防肺功能下降。

Objective To understand the association of obesity status with force volume in 1 second(FEV_(1))reduction in community middle-aged and elderly adults(≥40 years old),and provide the reference for the prevention and treatment of chronic respiratory diseases in middle-aged and elderly adults in the communities.Methods Based on the 2016 Shanghai suburban natural population cohort,the random sampling method was used to select 3149 cohort members(≥40 years old)in 2021 as the subjects.The investigation was performed with pulmonary function examinations and questionnaires.The subjects were divided into different obesity types based on BMI and waist circumference measurements.The t test,Mann Witney U test,χ^(2) test and multifactorial unconditional logistic regression were used to analyze the data.The used software was SPSS 22.0.Results The rate of FEV_(1) reduction(FEV_(1)% Pred<80%)in the 3149 subjects was 14.8%,the FEV_(1) reduction rate(21.1%)in males was significantly higher than that(10.7%)in females(P<0.01).The BMI overweight and obesity rates of the subjects were 43.7% and 17.9%,respectively;and the central obesity rate was 30.9%.The results of multifactorial logistic regression analysis showed that central obesity was associated with a higher risk of FEV_(1) reduction(OR=1.70),and overweight(OR=0.63)or obesity(OR=0.64)of BMI was associated with lower risk of FEV_(1) reduction(P<0.01).In the different obesity types,the risk of lower FEV_(1) in those with overweight/obese BMI+normal waist circumference was lower than that in those with lean/normal BMI+normal waist circumference(OR=0.66),and the same association existed in the male population after subgender analysis(OR=0.63);the risk of lower FEV_(1) in those with lean/normal BMI+central obesity was higher than that in the group with lean/normal BMI+normal waist circumference(OR=1.93),the same result also existed in females(OR=2.25),P<0.05.Conclusion The rate of FEV_(1) reduction in residents with central obesity is higher than that in those with normal waist circumference;the FEV_(1) reduction rate in residents with low BMI is much higher.Therefore,middle-aged and elderly residents in the community should adjust their lifestyles to maintain appropriate body weight and reduce waist circumference in order to prevent lung function reduction.