背景:中心性肥胖被认为是老年人群跌倒的危险因素。腰围(WC),脂质积累产物(LAP),内脏肥胖指数(VAI),在越来越多的研究中,中国内脏肥胖指数(CVAI)被认为是腹部脂肪沉积的替代指标。然而,这些指数与老年人群跌倒之间的纵向关系仍不明确。本研究旨在探讨老年社区居民腹部肥胖指数与跌倒之间的关系。
方法:我们的研究包括2021年来自广州瀑布和健康状况跟踪队列的3501名年龄≥65岁的个体,然后在2022年进行前瞻性随访。感兴趣的结果是跌倒的发生。采用Kaplan-Meier曲线和多变量Cox回归分析探讨腹型肥胖指数与跌倒的关系。此外,采用限制性三次样条分析(RCS)检验腹型肥胖指数与跌倒风险之间的非线性关系.
结果:经过551天的中位随访期,共有1022名参与者经历了跌倒。在中心性肥胖和LAP第四四分位数(Q4)内的个体中,跌倒的累积发生率较高。VAI,和CVAI。中心性肥胖的参与者和LAP第四季度的参与者,VAI,和CVAI与更高的跌倒风险相关,危险比(HR)为1.422(HR95CI:1.255-1.611),1.346(1.176-1.541),1.270(1.108-1.457),1.322(1.154-1.514),分别。WC中的每1-SD增量,LAP,VAI,和CVAI是参与者跌倒风险显著增加。亚组分析进一步显示,这些结果基本稳定,在这些女性中似乎明显更强,65-69岁,体重指数(BMI)≥28kg/m2。此外,RCS曲线显示,随着腹部指数的增加,跌倒风险总体呈上升趋势。
结论:腹部肥胖指数,作为WC,LAP,VAI,CVAI与老年社区居民跌倒显著相关。建议降低腹型肥胖指数作为预防跌倒的策略。
BACKGROUND: Central obesity was considered as a risk factor for falls among the older population. Waist circumference (WC), lipid accumulation product (LAP), visceral adiposity index (VAI), and the Chinese visceral adiposity index (CVAI) are considered as surrogate markers for abdominal fat deposition in increasing studies. Nevertheless, the longitudinal relationship between these indices and falls among the older population remains indistinct. This study aimed to explore the association between abdominal obesity indices and falls among older community-dwellers.
METHODS: Our study included 3501 individuals aged ≥ 65 years from the Guangzhou Falls and Health Status Tracking Cohort at baseline in 2021 and then prospectively followed up in 2022. The outcome of interest was the occurrence of falls. The Kaplan-Meier curves and multivariable Cox regression analysis were used to explore the associations between abdominal obesity indices and falls. Moreover, the restricted cubic spline analysis (RCS) was conducted to test the non-linear relationships between abdominal obesity indices and hazards of falls incident.
RESULTS: After a median follow-up period of 551 days, a total of 1022 participants experienced falls. The cumulative incidence rate of falls was observed to be higher among individuals with central obesity and those falling within the fourth quartile (Q4) of LAP, VAI, and CVAI. Participants with central obesity and those in Q4 of LAP, VAI, and CVAI were associated with higher risk of falls, with hazard ratios (HRs) of 1.422 (HR 95%CI: 1.255-1.611), 1.346 (1.176-1.541), 1.270 (1.108-1.457), 1.322 (1.154-1.514), respectively. Each 1-SD increment in WC, LAP, VAI, and CVAI was a significant increased risk of falls among participants. Subgroup analysis further revealed these results were basically stable and appeared to be significantly stronger among those females, aged 65-69 years, and with body mass index (BMI) ≥ 28 kg/m2. Additionally, RCS curves showed an overall upward trend in the risk of falls as the abdominal indices increased.
CONCLUSIONS: Abdominal obesity indices, as WC, LAP, VAI, and CVAI were significantly associated with falls among older community-dwellers. Reduction of abdominal obesity indices might be suggested as the strategy of falls prevention.