目的 比较体质量指数(body mass index,BMI)和瘦体质量指数(lean body mass index,LBMI)对中国老年人全因死亡风险的不同影响,为更加科学、准确、便捷地衡量老年人的体质,分析和评价中国老年人的健康危险因素提供参考.方法 本研究基于中国老年健康影响因素跟踪调查-追踪数据(1998-2018),选择2014-2018年随访数据中满足纳入、排除标准的5 990例为研究对象.根据BMI和LBMI对研究对象进行分组,建立单因素和多因素Cox比例风险模型,比较BMI和 LBMI对老年人死亡风险的影响.同时根据性别、年龄、日常活动能力和合并症数量分组,进行亚组分析,研究LBMI在不同亚组之间的影响.结果 研究对象中女性较多(52.9%,3 167/5 990),年龄为(84.7±10.1)岁,多居住在农村(55.1%,3 298/5 990),多不吸烟(82.7%,4 952/5 990)、不饮酒(84.3%,5 050/5 990),32.8%(1 966/5 990)有高血压、5.6%(334/5 990)有糖尿病、12.9%(774/5 990)有心脏病.BMI对老年人全因死亡的影响分析中单因素分析显示,随着BMI增大,老年人的死亡风险降低;经过了多因素(年龄、性别、居住环境、婚姻情况、平均动脉压、子女数量、吸烟、饮酒、高血压、糖尿病、心脏病、脑血管病、肿瘤、日常活动能力障碍、合并症数量)校正,相对于正常组,消瘦组(BMI<18.5 kg/m2)老年人死亡风险最大,HR为1.15(95%CI:1.01～1.30);超重组(24.0 kg/m2≤BMI<28.0 kg/m2)的死亡风险更小,HR为0.78(95%CI:0.67～0.91).LBMI对老年人死亡风险影响分析中单因素分析显示,相对于LBMI适中,LBMI越小,老年人死亡风险越大.多因素分析结果显示,相对于LBMI适中,LBMI减小,死亡风险增大;而LBMI继续增大,老年人死亡风险差异无统计学意义.结论 在评估老年人体质和生活质量方面,LBMI具有更好的代表性和应用价值.
Effects of BMI and lean body mass index on all-cause mortality in elderly Chinese
Objective To compare the different effects of body mass index(BMI)and lean body mass index(LBMI)on the risk of all-cause death among elderly Chinese individuals.For the more scientific,accurate and convenient measurement of the elderly physique,analysis and evaluation of the health risk factors of the elderly in China.Methods This study is based on follow-up data from 2014 to 2018,involving 5 990 participants who met the inclusion criteria in the Chinese Longitudinal Healthy Longevity Survey.Participants were grouped according to their BMI and LBMI,and both univariate and multivariate Cox proportional hazard models were established to compare the effects of BMI and LBMI on the risk of death in the elderly.According to gender,age,activities of daily living,and comorbidities,subgroup analysis was conducted to study the influence of LBMI in different subgroups.Results The study population predominantly comprised females(52.9%,3 167/5 990),with an average age of(84.7±10.1)years,and most participants lived in rural areas(55.1%,3 298/5 990).A majority were non-smokers(82.7%,4 952/5 990)and non-drinkers(84.3%,5 050/5 990).The prevalence of hypertension was 32.8%(1 966/5 990),diabetes 5.6%(334/5 990),and heart disease 12.9%(774/5 990).In the analysis of the impact of BMI on all-cause death in the elderly,univariate analysis showed that an increase in BMI was associated with a reduced risk of mortality.After adjusted by multiple factors(age,gender,living environment,marital status,average arterial pressure,number of children,smoking,drinking,hypertension,diabetes,heart disease,cerebrovascular disease,tumor,ADL/IADL,number of complications),compared to the normal group,the emaciated group(BMI<18.5 kg/m2)had the highest risk of death(HR=1.15,95%CI:1.01-1.30);the overweight group(24.0 kg/m2≤BMI<28.0 kg/m2)had a lower risk of death(HR=0.78,95%CI:0.67-0.91).In the analysis of the impact of LBMI on the risk of death in the elderly,compared to moderate LBMI,lower LBMI was associated with a higher risk of death.Multivariate analysis showed that compared with moderate LBMI,a decrease in LBMI increased the risk of death,whereas an increase in LBMI did not show statistically significant differences in mortality risk in the elderly.Conclusion In measuring fitness and quality of life in the elderly,LBMI has better representativeness and practical value.
Body mass indexlean body mass indexelderlyall-cause mortality
NETL
NSTL
万方数据
