【摘要】 目的 了解社区40岁及以上中老年人肥胖状态与第1秒用力呼气容积（FEV₁）下降的关联，为社区中老年人慢性呼吸系统疾病防治提供参考。方法 基于2016年上海市郊区自然人群队列，于2021年采用随机抽样法抽取共3 149名40岁及以上队列成员开展肺功能检查及问卷调查，根据体质指数（BMI）和腰围测量结果分为不同的肥胖类型。采用SPSS 22.0进行t检验、Mann-Whitney U检验、χ²检验和多因素非条件logistic回归分析。结果 3 149名研究对象的FEV₁下降（FEV₁%Pred<80%）率为14.8%，男性（21.1%）高于女性（10.7%），差异有统计学意义（P<0.01）。研究对象的BMI超重率和肥胖率分别为43.7%和17.9%，中心性肥胖率为30.9%。多因素logistic回归分析结果显示，中心性肥胖与FEV₁下降高风险相关（OR=1.70）,BMI超重（OR=0.63）或肥胖（OR=0.64）与FEV₁下降低风险相关，均有统计学意义（P<0.01）。在不同的肥胖类型中，BMI超重/肥胖+腰围正常者FEV₁下降的风险低于BMI偏瘦/正常+腰围正常者（OR=0.66），分性别分析后，男性居民中同样存在该关联（OR=0.63）;BMI偏瘦/正常+中心性肥胖者的FEV₁下降风险高于BMI偏瘦/正常+腰围正常组（OR=1.93），该结果在女性中同样成立（OR=2.25），均有统计学意义（P<0.05）。结论 中心性肥胖者相较于腰围正常者FEV₁下降率更高；而对于腰围正常者，BMI较低者FEV₁下降率更高。因此社区中老年人应调整生活方式以维持适当体重和减少腰围，从而预防肺功能下降。更多还原

【Abstract】 Objective To understand the association of obesity status with force volume in 1 second （FEV₁） reduction in community middle-aged and elderly adults（≥40 years old）,and provide the reference for the prevention and treatment of chronic respiratory diseases in middle-aged and elderly adults in the communities.Methods Based on the 2016 Shanghai suburban natural population cohort,the random sampling method was used to select 3 149 cohort members（≥40 years old） in 2021 as the subjects.The investigation was performed with pulmonary function examinations and questionnaires.The subjects were divided into different obesity types based on BMI and waist circumference measurements.The t test,Mann Witney U test，χ²test and multifactorial unconditional logistic regression were used to analyze the data.The used software was SPSS 22.0.Results The rate of FEV₁reduction（FEV₁%Pred<80%） in the 3 149 subjects was 14.8%,the FEV₁reduction rate（21.1%） in males was significantly higher than that（10.7%） in females（P<0.01）.The BMI overweight and obesity rates of the subjects were 43.7%and 17.9%,respectively;and the central obesity rate was 30.9%.The results of multifactorial logistic regression analysis showed that central obesity was associated with a higher risk of FEV₁reduction（OR=1.70）,and overweight（OR=0.63） or obesity（OR=0.64） of BMI was associated with lower risk of FEV₁reduction（P<0.01）.In the different obesity types,the risk of lower FEV₁in those with overweight/obese BMI+normal waist circumference was lower than that in those with lean/normal BMI+normal waist circumference （OR=0.66）,and the same association existed in the male population after subgender analysis （OR=0.63）;the risk of lower FEV₁in those with lean/normal BMI+central obesity was higher than that in the group with lean/normal BMI+normal waist circumference （OR=1.93）,the same result also existed in females（OR=2.25）,P<0.05.Conclusion The rate of FEV₁reduction in residents with central obesity is higher than that in those with normal waist circumference;the FEV₁reduction rate in residents with low BMI is much higher.Therefore,middle-aged and elderly residents in the community should adjust their lifestyles to maintain appropriate body weight and reduce waist circumference in order to prevent lung function reduction.更多还原