【摘要】 目的 探讨浙江省金华市老年人不同肥胖指标与肺功能的关系，为制定居民体质改善以及肺功能损害预防策略提供理论支持。方法 2022年5—12月，采用分层随机整群抽样的方法，招募≥65岁的老年人为研究对象，进行问卷调查、体格检查以及肺功能检查。利用多因素线性回归模型探索不同肥胖指标与肺功能的相关性，比较不同性别和是否吸烟人群中的不同肥胖指标与肺功能的相关性。结果 本研究共纳入27 554名研究对象，不同性别老年人的年龄、文化程度、家庭收入、吸烟情况、血压、体质量指数（body mass index,BMI）、腰围（waist circumference,WC）、臀围、腰臀比（waist-to-hip ratio,WHR）、腰高比、用力肺活量（forced vital capacity,FVC）占预计值百分比（FVC%pred）、第1秒用力呼气容积（forced expiratory volume in one second,FEV₁）占预计值百分比（FEV₁%pred）、FEV₁/FVC、呼气峰流量（peak expiratory flow,PEF）占预计值百分比（PEF%pred）差异有统计学意义（P<0.01）。多元线性回归分析显示，调整混杂因素后，肥胖人群的FVC%pred （β=-3.64,95%CI：-5.23--2.05）和FEV₁%pred （β=-3.37,95%CI：-6.15--0.59）较低；WC越高，FVC%pred （β=-4.10,95%CI：-5.32--2.87）和FEV₁%pred （β=-3.35,95%CI：-5.49--1.21）则越低；WHtR与FEV₁/FVC呈负相关关系（β=-0.006,95%CI-0.008--0.004）。性别分层结果显示，男性中，肥胖与FVC%pred（β=-4.61,95%CI：-6.60--2.61）、FEV₁%pred （β=-4.30,95%CI：-5.59--3.01）、PEF%pred （β=-1.42,95%CI：-2.81--0.04）呈负相关；女性中，肥胖与FEV₁/FVC呈正相关（β=0.010,95%CI:0.005-0.014）。吸烟分层结果显示，在吸烟人群中，肥胖与FVC%pred （β=-3.57,95%CI：-5.17--1.96）、FEV₁%pred （β=-3.51,95%CI：-6.97--0.04）和FEV₁/FVC （β=0.004,95%CI:0.001-0.08）存在相关性；在不吸烟人群中，肥胖与FEV₁%pred呈负相关（β=-1.03,95%CI：-3.64--1.58）；在吸烟或不吸烟人群中，WC与FVC%pred （β=-6.17,95%CI：-9.48--2.85）、FEV₁%pred （β=-3.97,95%CI：-5.49--2.45）均呈负相关。结论 肥胖老年人肺功能降低的风险更高，尤其全身性肥胖影响老年人肺功能降低，应关注老年人的肥胖情况，针对性地提供老年人肺功能下降的防控策略。更多还原

【Abstract】 Objective To explore the association between different obesity indexes and lung function in the elderly in Jinhua City,Zhejiang Province,and to provide theoretical support for the formulation of strategies to improve physical fitness and prevent lung function impairment.Methods A cross-sectional study was used from May to December 2022 to recruit elderly people aged 65 and above.Participants underwent a questionnaire survey,physical examinations,and pulmonary function tests.Multiple linear regression models were utilized to explore the association between different obesity indicators and lung function,comparing results across genders and smoking statuses.Results A total of 27 554 elderly participants were included in the study.There were significant differences in age,education level,household income,smoking status,blood pressure,body mass index（BMI）,waist circumference （WC）,hip circumference（HC）,waist-to-hip ratio （WHR）,waist-to-hipht ratio（WHtR）,forced vital capacity （FVC） as a percentage of predicted value （FVC%pred）,forced expiratory volume in one second （FEV1） as a percentage of predicted value （FEV1%pred）,FEV1/FVC ratio,and peak expiratory flow （PEF） as a percentage of predicted value （PEF%pred） among different genders （P<0.01）.Multiple linear regression analysis showed that the FVC%pred （β=-3.64,95%CI-5.23--2.05） and FEV₁%pred （β=-3.37,95%CI-6.15--0.59） of obesity were lower after adjusting for confounding factors.The higher the WC,the lower the FVC%pred （β=-4.10,95%CI-5.32--2.87） and FEV₁%pred （β=-3.35,95%CI-5.49--1.21）.WHtR was negatively correlated with FEV₁/FVC （β:-0.006,95%CI:-0.008--0.004）.The results of gender stratification showed that obesity was negatively correlated with FVC%pred （β=-4.61,95%CI:-6.60--2.61）,FEV₁%pred （β=-4.30,95%CI:-5.59--3.01）and PEF%pred （β=-1.42,95%CI:-2.81--0.04） in males.In females,obesity was positively correlated with FEV₁/FVC （β=0.010,95%CI:0.005-0.014）.In addition,smoking stratification results showed that obesity was associated with FVC%pred （β=-3.57,95%CI:-5.17--1.96）,FEV₁%pred （β=-3.51,95%CI:-6.97--0.04） and FEV₁/FVC （β=0.004,95%CI:0.001-0.08）.Among non-smokers,obesity was negatively correlated with FEV₁%pred （β=-1.03,95%CI:-3.64--1.58）.In smokers and non-smokers,the WC was negatively correlated with both FVC%pred （β=-6.17,95%CI:-9.48--2.85） and FEV₁%pred （β=-3.97,95%CI:-5.49--2.45）.Conclusions The risk of reduced lung function is higher in obese elderly people,particularly due to general obesity.Attention should be paid to the obesity status of the elderly,and targeted prevention and control strategies should be implemented to address declines in lung function.更多还原