超重和肥胖及腹型肥胖与老年人认知功能障碍相关性的Meta分析  

Association of overweight and obesity and abdominal obesity with cognitive impairment in older adults:a meta-ana

作　　者：朱鑫鑫 谢湘萁 王秋婷 隆丽芳 谢嘉欣 唐柔 张雨晴 林美珍[5] ZHU Xinxin;XIE Xiangqi;WANG Qiuting;LONG Lifang;XIE Jiaxin;TANG Rou;ZHANG Yuqing;LIN Meizhen(College of Nursing,Hunan University of Traditional Chinese Medicine,Changsha 410208,P.R.China;The Second Clinical Medical School of Guangzhou University of Chinese Medicine,Guangzhou 510006,P.R.China;Department of Hepatobiliary Surgery,Guangdong Provincial Hospital of Traditional Chinese Medical,Guangzhou 510120,P.R.China;Department of Gastrointestinal Surgery,Guangdong Provincial Hospital of Traditional Chinese Medicine,Guangzhou 510120,P.R,China;Hospital Infection Management Office,Guangdong Provincial Hospital of Traditional Chinese Medicine,Guangzhou 510120,P.R.China)

机构地区：[1]湖南中医药大学护理学院,长沙410208 [2]广州中医药大学第二临床医学院,广州510006 [3]广东省中医院肝胆外科,广州510120 [4]广东省中医院胃肠外科,广州510120 [5]广东省中医院医院感染管理办公室,广州510120

出　　处：《中国循证医学杂志》2025年第2期180-189,共10页Chinese Journal of Evidence-based Medicine

基　　金：国家中医药管理局中医药国际合作专项(编号:14276);广东省中医院中医药科学技术研究专项(编号:YN2022HL01)。

摘　　要：目的系统评价超重和肥胖及腹型肥胖与老年人认知功能障碍(CI)的相关性。方法计算机检索CNKI、WanFang Data、VIP、CBM、PubMed、Web of Science、Embase、Cochrane Library数据库,检索时限均为建库至2024年7月,搜集有关老年人超重、肥胖/腹型肥胖与CI相关性的研究。由2名研究者独立筛选文献,提取资料并评价纳入研究的偏倚风险后,使用Stata 15.0软件进行Meta分析。结果共纳入38篇文献,包括1783087例研究对象。Meta分析结果显示:与体重正常的人群相比,超重[OR=0.96,95%CI(0.91,1.02),P=0.201]与老年人CI发生风险无关,肥胖[OR=1.14,95%CI(1.02,1.28),P=0.03]、腹型肥胖[OR=1.16,95%CI(1.11,1.21),P<0.001]可能是老年人CI发生的危险因素。针对研究类型、BMI标准、认知诊断标准、国家发展水平、腹型肥胖诊断标准、随访时间进行亚组分析,超重与老年人相关性的各亚组中,随访时间≤5年[OR=0.68,95%CI(0.58,0.80)]相较于其它随访时间节点的研究结果中CI所占比例更低。肥胖与老年人CI相关性的各亚组中,随访时间≤5年[OR=0.71,95%CI(0.50,1.01)]相较于其它随访时间节点的研究结果,与老年人CI发生风险无关;腹型肥胖与老年人CI相关性的各亚组中,相较于其它随访时间节点的研究结果,仅在随访时间5~10年[OR=1.21,95%CI(1.15,1.27)]发现腹型肥胖会增加老年人CI发生风险。结论当前证据表明,肥胖、腹型肥胖可能增加老年人CI的发生风险,合理管理体重对预防和延缓老年人CI进展具有重要意义。Objective To systematically review the association between overweight,obesity,abdominal obesity,and cognitive impairment(CI)in the elderly.Methods The CNKI,WanFang Data,VIP,CBM,PubMed,Web of Science,Embase,and Cochrane Library databases were electronically searched for studies on the relationship between overweight,obesity/abdominal obesity,and CI in the elderly from their inception to July 2024.Two researchers independently screened the literature,extracted data,and assessed the risk of bias of the included studies.Meta-analysis was performed using Stata 15.0 software.Results A total of 38 studies involving 1783087 subjects were included.Meta-analysis results showed that compared with normal-weight individuals,overweight(OR=0.96,95%CI 0.91 to 1.02,P=0.201)was not statistically significant in the risk of CI in the elderly.Obesity(OR=1.14,95%CI 1.02 to 1.28,P=0.03)and abdominal obesity(OR=1.16,95%CI 1.11 to 1.21,P<0.001)may be risk factors for CI in the elderly.Subgroup analysis was conducted based on study type,BMI standards,cognitive diagnostic standards,national development level,abdominal obesity diagnostic standards,and follow-up time.Among the subgroups analyzing the correlation between overweight and CI in the elderly,follow-up time≤5 years(OR=0.68,95%CI 0.58 to 0.80)showed a lower proportion of CI compared to other follow-up periods.In the subgroups analyzing the correlation between obesity and CI in the elderly,follow-up time≤5 years(OR=0.71,95%CI 0.50 to 1.01)was not statistically significant compared to other follow-up periods.For abdominal obesity,a significant association with increased CI risk in the elderly was found only in the subgroup with a follow-up time of 5-10 years(OR=1.21,95%CI 1.15 to 1.27),compared with other follow-up periods.Conclusion Current evidence suggests that obesity and abdominal obesity may increase the risk of CI in the elderly.Proper weight management is crucial for preventing and delaying the progression of CI in the elderly.

关 键 词：超重 肥胖 腹型肥胖 老年人 认知功能障碍 META分析 

分 类 号：R749.1[医药卫生—神经病学与精神病学] R589.2[医药卫生—临床医学]