老年人肥胖与代谢综合征关系的调查与分析

The relationship between obesity and metabolic syndrome in the elderly

目的 探讨老年人全身肥胖和腹部肥胖与代谢综合征 (MS)的关系。 方法 横断面调查法调查 4 95 0名年龄 6 0～ 92岁的老年人 ,并用趋势 χ2 检验和多因素logistic回归进行有关分析。根据亚洲人肥胖标准诊断肥胖。高血糖、高血压、高甘油三酯、低HDL C在体内聚集数达 2个及以上被诊断为MS。 结果 (1)超重、肥胖和腹部肥胖随增龄而增多的趋势并不显著 (除男性腹部肥胖外 ,其余均为P >0 0 5 )。I度、II度全身肥胖者各有 80 2 %、97 2 %的老年人同时有腹部肥胖。 (2 )随年龄、体质指数 (BMI)和腹围 (WC)的增大 ,MS的现患率显著增高 (均为P <0 0 5 )。 75岁以上组与 6 0～ 6 4岁组比较 ,MS现患率增高接近 8 0 % ;与BMI <2 3 0kg/m2 人群相比 ,男性超重、I度肥胖、II度肥胖人群MS现患率分别高 14 4 %、2 9 1%、34 6 % ,女性分别高 10 0 %、2 3 1%、2 8 2 % ;腹部肥胖男性高 2 1 3% ,女性高 17 1%。调整糖尿病和高血压家族史后的标准OR值显示 ,3个变量对MS的作用强度依次男女均为BMI >WC >年龄。 (3)随两种肥胖类型的聚集并程度的加重 ,MS发生的危险性逐步增高。BMI≥ 2 5kg/m2 且腹部肥胖人群发生MS的危险性是BMI <2 3kg/m2 且无腹部肥胖人群的 4倍之多 ,调整年龄、性别、糖尿病和高血压家族史后 。

Objective To analyze the relationship of overall obesity and abdominal obesity with metabolic syndrome (MS) in the old population. Methods Data to be analyzed were collected from a cross sectional study carried out in a sample of 4 950 aged 60-92 years in Beijing city. Trend χ 2 and logistic regress were used for the related analysis. The recommended cut points of body mass index (BMI) and waist circumference (WC) for Asian were referred to determine the occurrence of over weight, I degree obesity, II degree obesity and abdominal obesity in this population. The occurrence of 2 or more of either hypertension, hyperglycemia, low HDL-C, or high triglycerides in an individual were defined as MS. Results (1) The increasing trends of the prevalent rate of obesity with ageing were not statistically significant (except abdominal obesity among the men,P>0.05). Overall obesity were more likely to be accompanied by abdominal obesity among this population. Eighty point two percent of I degree and 97.2% of II degree obesity people had abdominal obesity. (2) Age, BMI and WC all increased the occurrence of MS(P<0.05).The MS prevalence rate in the group aged 75 years and over was 8.0%, which was higher than in the 60-64year group. Compared with BMI<23.0 kg/m 2 group,the prevalence rate of MS was 14.4%?29.1%?34.6%higher in overweight, I degree, II degree obesity group,respectively for the men and 10.0%?23.1%?28.2%higher, respectively for the women. Abdominal obesity increased the rate of MS by 21.3% and 17.1%separately for the men and women.The standardized ORadjusted for family history of diabetes and hypertension showed the effect of BMI on MS was higher than that of WC, and WC higher than age for both men and women.(3) The risk for MS gradually increased along with the cluster of overall and abdominal obesity. The risk of having MS for the group with BMI ≥25 kg/m 2 and abdominal obesity was over 4 times higher than the control with BMI<23kg/m 2 and normal WC , independent of age, sex, family history of diabetes and hypertension. Conclusions BMI and WC are both risk factors for the development of metabolic syndrome in the old population. Preventing two types of obesity, especially overall obesity is strongly recommended for MS control.