西北农村老年人不同肥胖指标与衰弱的相关性研究

BackgroundFrailty was an age-related geriatric syndromewith its prevalence among Chinese older adults being notably high and demonstrating a rising trend over time. Obesity was closely associated with the development of numerous diseasesbut its relationship with frailty remained controversial. This uncertainty was potentially attributable to limitations of conventional obesity indicators in characterizing adipose tissue distribution. Thereforeinvestigating the associations between multiple adiposity metrics and frailty was important for to advance the understanding of frailty pathogenesis and developing preventive interventions. ObjectiveThis study investigates the relationship between various obesity indicators and frailtyproviding a scientific basis for the early prevention and control of frailty in older adults. MethodsIn this studya total of 1429 elderly people aged 60 years and above were surveyed in six rural villages in Jingyuan CountyGansu Provincefrom March to May 2023. After further exclusionsa final sample of 1 153 participants was included in the analysis. The FRAIL scale was utilized to assess the frailty status of the elderly. Based on Chinese obesity criteriawaist circumference and BMI were categorizedand waist-to-hip ratioWHRwaist-to-height ratioWHtRbody roundness indexBRIand Chinese visceral adiposity indexCVAIwere grouped by quartiles. Multivariate Logistic regressionrestricted cubic splinesand receiver operating characteristicROCcurve analysis were employed to explore the relationship between different obesity indicators and frailty. ResultsThis study included 1 153 elderly participants aged 60 yearscomprising 474 males41.11%and 679 females58.89%with a mean age of 70.864.76 years. Based on FRAIL scale assessments226 participants were identified as frail and 927 as non-frailresulting in a frailty prevalence of 19.60%.The adjusted multivariate Logistic regression analysis revealed that central obesitymoderate to severe obesityreferencenormal BMIQ3 and Q4referenceQ1levels of WHRand Q4referenceQ1levels of WHtRBRIand CVAI were significant risk factors for frailty in the elderly populationP<0.05with progressively increasing risks of frailty associated with elevated levels of waist circumferenceBMIWHRWHtRBRIand CVAIPtrend<0.05. The restricted cubic splineRCScurve indicated that waist circumferenceBMIWHtRBRIand CVAI were linearly and positively correlated with the risk of frailty in the elderlyPlinear<0.05. The ROC curve analysis demonstrated that that the predictive capacity for frailty in the elderly was possessed by waist circumferenceBMIWHRWHtRBRIand CVAIwith area under the curveAUCof 0.55795%CI=0.515-0.5980.57095%CI=0.528-0.6120.55895%CI=0.515-0.6000.61095%CI=0.568-0.6520.61095%CI=0.568-0.652and 0.58695%CI=0.546-0.626respectivelyP<0.05. AdditionallyWHtRBRIand CVAI demonstrated better predictive ability compared to waist circumferenceZ=-5.443P<0.001Z=-5.443P<0.001Z=-2.595P=0.009and both WHtR and BRI showed better predictive ability compared to BMIZ=-2.885P=0.004Z=-2.884P=0.004. ConclusionIn rural communities of Northwest Chinaamong the elderly population aged 60 and aboveobesity indicators such as waist circumferenceBMIWHRWHtRBRIand CVAI were positively correlated with the risk of frailty in the elderly. Among these indicatorsWHtR and BRI showed better predictive ability for frailty.