目的 研究成都地区中老年人群体质量指数（BMI）及腹型肥胖对糖尿病患病率及空腹血糖水平的影响。 方法 2007年5月，采用随机抽样方法抽取50～80岁中老年人685人进行心血管危险因素调查，其男394人，女291人，年龄（63.3 ± 0.2）岁。 结果 成都地区中老年人群的超重和肥胖所占的比例较大（约44.3%），按BMI分组（BMI＜24 kg/m2；24 kg/ m2≤BMI＜28 kg/ m2；BMI≥28 kg/m2）的糖尿病患病率分别为14.0%、18.7%及23.3%，组间差异有统计学意义（P=0.031）。男女分别按腹型肥胖标准分组（男性切点=85 cm，女性切点=80 cm），男性糖尿病患病率在非腹型肥胖及腹型肥胖组分别为17.9%及18.7%组间差异无统计学意义（P=0.849），女性糖尿病患病率分别为9.7%及18.4%，组间差异有统计学意义（P=0.034）。整个人群中，空腹血糖无随BMI增加而升高的趋势（P=0.071）；女性人群中，空腹血糖随腰围的增加而升高（P=0.001）；而在男性人群中无此趋势。在调整相关指标后，logistic回归分析提示BMI对糖尿病患病率独立影响，以BMI正常为参照，超重及肥胖的OR值分别为：1.412 [95%CI （0.818，2.437），P=0.215]及2.200 [95%CI（1.034，5.178），P=0.046]。在调整相关指标后，腹型肥胖在女性人群中对糖尿病患病率独立影响，以非腹型肥胖为参考，腹型肥胖的OR值为：1.394 [95%CI（1.080，3.205），P=0.041]，而在男性人群中无此关系。 结论 成都地区中老年人群超重及肥胖所占的比重较大，BMI可影响糖尿病患病率及空腹血糖水平；腹型肥胖能够影响女性人群糖尿病患病率及空腹血糖水平，但在男性人群中无此关系。
ObjectiveTo systematically review the association between overweight, obesity, abdominal obesity, and cognitive impairment in the elderly. MethodsThe 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 cognitive impairment 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. ResultsA total of 38 studies involving 1 783 087 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. ConclusionCurrent 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.