中国老年人体重指数和死亡的相关性：一项队列研究

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【关键词】 肥胖症；老年人；体重指数；肥胖悖论；死亡风险；Cox回归 【中图分类号】 R 589.25 【文献标识码】 ADOI： 10.12114/j.issn.1007-9572.2024.0488

【Abstract】BackgroundObesityisasignificant public health isse，asobesityandbeing overweightarerisk factors forvariouschronicdiseases.However，the"obesityparadox"proposedinrecentyearshasgarneredwidespreadatention.The relationship betweenBody Mass Index（BMI）and mortalityin theelderlyremains uclear.ObjectiveToexplore theimpact of BMIonmortalityintheelderlyin China.MethodsThedemographic features，BMI，chronicdiseasesandlaboratorytests among theelderlyatagesof6OyearsandgreaterwererecruitedfromApril2O15toDecember2O15.Thepatientswerefollowedup withacut-offdateofApril3O，2O24，withallcausemortalityanddeathfromcardiovascularcausesastheendpointevents.A multivariableCoxproportionalhazardsregresionmodelwasusedtoexaminetheassociationbetweenBMIandtheriskofdeath. ResultsOtally 599 subjects were enrolled，including 477 men（ 79.6% ）and an average age of（ 77±8 ）years. There were 18 subjects （ 3.0% ）with underweight，273（ 45.6% ）with overweight and 87（ 14.5% ）with obesity.During the follow-up period（8.81 years），158subjectsdied.RestrictedcubicsplinesrevealedaU-shapedasociationbetweenBMIandmortaity.MultivariableCox proportionalhazardsregressionanalysisrevealedanincreasedriskofall-causes mortalityamong theunderweightelderly （HR=2.76，95%CI=1.37-5.55）afer adjustment for age，gender，chronic diseases，and soon.Additionaly，alow BMI is an independentrisk factorforcardiovascular event mortalityinthe elderly（HR=5.55，95%CI=1.83-16.78）.However，no associationwasobservedbetweenoverweightandobesityanddeath.ConclusionTherelationshipbetweenBMIandmortality formsaU-shapedcurve，withunderweightbeinganindependentrisk factorfor mortalityintheelderly.Noassociationhas beenfoundbetweenbeing overweight/obeseandanincreasedriskofmortality.Therefore，atentionshouldbegivento weight management in the elderly.

【Key words】 Obesity；Aged；Body mass index；Obesity paradox；Mortality risk；Cox regression

随着生活质量的不断提升，肥胖人群数量持续增长。（剩余11977字）