住院老年人的理想体质指数范围探讨  

Exploring the range of ideal body mass index for hospitalized older adults

作　　者：武文斌[1] 周起 李虹[1] 张洁[1] 沈姞[1] 李晶[1] 施红[1] Wu Wenbin;Zhou Qi;Li Hong;Zhang Jie;Shen Ji;Li Jing;Shi Hong(Department of Geriatrics,Beijing Hospital,National Center of GerontologyInstitute of Geriatric Medicine,Chinese Academy of Medical Sciences,Beijing 100730,China;The Key Laboratory of Geriatrics,Beijing Institute of Geriatrics,Beijing Hospital,National Center of Gerontology,National Health Commission,Institute of Geriatric Medicine,Chinese Academy of Medical Sciences,Beijing 100730,China)

机构地区：[1]北京医院老年科国家老年医学中心、中国医学科学院老年医学研究院,北京100730 [2]北京医院国家老年医学中心、国家卫生健康委北京老年医学研究所、国家卫生健康委老年医学重点实验室、中国医学科学院老年医学研究院,北京100730

出　　处：《中华老年医学杂志》2023年第11期1285-1290,共6页Chinese Journal of Geriatrics

基　　金：国家重点研发计划(2020YFC2009006、2020YFC2009000、2021YFE0111800);中央高水平医院临床科研业务费(bj-2022-181、bj-2022-149)。

摘　　要：目的探讨具有良好身体功能住院老年人的理想体质指数(BMI)范围.方法收集2020年1月至2022年11月老年科住院患者老年综合评估的数据,纳入性别、年龄、BMI、民族及9项老年人身体功能相关指标(基本日常活动能力、工具性日常活动能力、衰弱、认知、抑郁、睡眠、吞咽功能、躯体活动、握力).使用Logistic回归研究各指标随BMI分组的剂量变化特征以初步确定BMI区间;计算具有良好功能状态老年人BMI的95%分布区间进行验证.结果共纳入1950例老年人,年龄60~103(77.2±8.9)岁,女性占50.8%;平均BMI为(23.4±3.6)kg/m^(2),体重过低及肥胖人群分别占8.9%(174例)及8.7%(171例).身体功能各指标下降率为12.1%~66.0%.老年人各功能指标随BMI升高呈现逐渐下降的趋势;以20.0~24.9 kg/m^(2)为参照,BMI<20.0 kg/m^(2)是身体功能异常的危险因素(OR:1.49.0~2.06,均P<0.01),BMI 28.0~29.9 kg/m^(2)造成功能异常的风险不显著,甚至对握力及认知状态有显著保护效应(OR=0.42、0.25,均P<0.01).共有214例老年人各项功能指标均正常,其BMI的95%分布区间为19.8~28.8 kg/m^(2).结论住院老年人保持良好身体功能的理想BMI范围约为20.0~29.9 kg/m^(2).Objective To investigate the ideal body mass index(BMI)range for hospitalized older adults with good functional ability.Methods Data on inpatients thorough comprehensive geriatric assessment,including sex,age,BMI,ethnicity,and 9 functional indicators(basic daily mobility,instrumental daily mobility,frailty,cognition,depression,sleep,swallowing function,somatic activity,and grip strength)were collected in the geriatric department between January 2020 and November 2022.To determine the ideal BMI range,Logistic regression was used to analyze the doseresponse relationships between BMI and functional ability.The findings were then validated by looking at the 5%-95%range of BMI among elderly people with normal functional ability.Results A total of 1950 hospitalized elderly adults were included in the study,with the age ranging from 60-103(77.2±8.9)years and women making up 50.8%of the participants.The average BMI was(23.4±3.6)kg/m^(2);8.9%(n=174)of the participants were low body weight and 8.7%(n=171)obese.Between 12.1%-66.0%of patients showed deterioration in the indicators of functional ability.With a higher BMI,there was a trend of decreasing functional ability in the elderly.Compared with people with a BMI between 20.0-24.9 kg/m,a BMI<20.0 kg/m^(2) was a risk factor for bodily functional abnormality(OR:1.49-2.06,all P<0.O1).There was no clear risk for functional abnormality if the BMI was between 28.0-29.9 kg/m^(2).In fact,in this BMI range,there was even a protective effect for grip strength and cognitive ability(OR=0.42,0.25,both P<0.01).Of 214 elderly participants with normal values in all parameters.the 95%confidence interval of BMI ranged from 19.8 to 28.8 kg/m^(2).Conclusions To maintain appropriate functional ability for elderly inpatients,the optimal BMI range isbetween 20.0kg/m^(2) and 29.9kg/m^(2).

关 键 词：人体质量指数 肥胖症 营养不良 老年综合评估 

分 类 号：R446.1[医药卫生—诊断学]