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目的评价中年肥胖与远期患痴呆症危险性之间的关系,以体重指数(BMI)和皮褶厚度代表肥胖程度。设计前瞻性分析一个多种族人群的系列研究资料。背景北加利福尼亚州Kaiser长期医疗组是一个健康保护组织。参加者在1964至1973年间当时年龄在40～45岁间的男女共10276人参加详细健康检查者,在1994年仍参加该健康检查项目的成员。主要结局测定1994年1月至2003年4月确诊的痴呆症患者。确诊时间由Cox比例危险模型分析,从年龄、性别、种族、教育情况、吸烟、饮酒、婚姻状况、糖尿病、高血压、高脂血症、卒中和缺血性心脏病等方面进行了校正。结果在所有入选者中有713例(6.9%)诊断痴呆症。肥胖者(BMI≥30)患痴呆症的危险增加74%(危险比例1.74,95%可信区间1.34～2.26),而超重者(BMI25.0～29.9)患痴呆症的危险与那些正常体重者(BMI18.6～24.9)相比增加35%。以肩胛下或三头肌皮褶厚度的分布情况来评价,在第5百分位以下者与第95百分位以上者相比患痴呆症的危险分别增加72%和59%,数值分别为(1.72,1.36～2.18和1.59,1.24～2.04)。结论中年肥胖独立于其他因素增加远期患痴呆症的危险。
Objective To evaluate the relationship between middle-aged obesity and risk of dementia in the long-term. Body mass index (BMI) and skinfold thickness represent the degree of obesity. Design prospective analysis of a multi-ethnic population series of research data. Background The Kaiser Long-Term Medical Unit in Northern California is a health protection organization. A total of 10,276 men and women, aged between 40 and 45, participated in the detailed health checkups between 1964 and 1973 and were still members of the health checkup program in 1994. The primary outcome measure was dementia patients diagnosed between January 1994 and April 2003. The timing of the diagnosis was analyzed by the Cox proportional hazards model and adjusted for age, gender, ethnicity, educational status, smoking, drinking, marital status, diabetes, hypertension, hyperlipidemia, stroke and ischemic heart disease. Results 713 (6.9%) of all enrolled patients were diagnosed with dementia. The risk of developing dementia increased by 74% in obese (BMI ≥30) (hazard ratio 1.74, 95% confidence interval 1.34-2.26), while those who were overweight (BMI 25.0-29.9) had a higher risk of dementia than those with normal weight (BMI 18.6 ~ 24.9) compared to 35% increase. The prevalence of dementia increased by 72% and 59%, respectively, in patients with sub-5 percentile and 95th percentile or more, based on the distribution of subcutaneous or triceps skinfold thickness (1.72, 1.36-2.18 and 1.59, 1.24-2.04). Conclusion Middle-aged obesity increases the risk of dementia in the long run independent of other factors.