【摘要】 目的 了解上海市老年人不同肥胖类型与常见慢性病及多病共存关系，为制定社区老年人慢性病防治策略提供参考依据。方法 采取整群抽样法，选择2024年3—11月上海市某社区卫生服务中心体检数据完整的≥60岁老年人，采用多因素logistic回归模型，分析不同肥胖类型与高血压、糖尿病、血脂异常、高尿酸血症、非酒精性脂肪肝等5种慢性病的关系。结果 共纳入17 956名≥60岁老年人，体质量指数(BMI)型肥胖检出率为16.96%,腰围(WC)型中心性肥胖检出率为37.15%,腰围/臀围比(WHR)型中心性肥胖检出率为59.91%;高血压患病率为62.75%,糖尿病为23.57%,血脂异常为30.78%,高尿酸血症为20.02%,非酒精性脂肪肝为38.56%。5种慢性病1种未患的占15.20%,患1种的占30.54%,患2种的占27.93%,患3种的占17.34%,患4种的占7.68%,患5种的占1.31%。logistic回归分析显示，BMI型肥胖人群患1～5种慢性病的风险是非BMI型肥胖人群的1.841～5.000倍，WC型中心性肥胖人群患1～5种慢性病风险是非WC型中心性肥胖人群的1.479～5.158倍，WHR型中心性肥胖患2～5种慢性病的风险是非WHR型中心性肥胖人群的1.317～1.736倍(P值均<0.05)。结论 上海市老年人肥胖现状不容乐观，不同类型肥胖与5种常见慢性病发病及多病共存风险均有一定关联，应积极开展老年人肥胖防治工作。更多还原

【Abstract】 Objective To understand the relationship between different types of obesity and common chronic diseases as well as multiple commorbidities among elderly people in Shanghai, so as to provide reference for formulating strategies for the prevention and treatment of chronic diseases among elderly people in the community. Methods The cluster sampling method was used to select the elderly people aged ≥60 with complete physical examination data from a community health service center in Shanghai from March to November 2024.The multi-factor logistic regression model was used to analyze the relationship between different types of obesity and five chronic diseases, including hypertension, diabetes, dyslipidemia, hyperuricemia and non-alcoholic fatty liver disease. Results A total of 17 956 elderly people aged ≥60 were included, with the detection rates of body mass index(BMI)-type obesity being 16.96%,waist circumference(WC)-type central obesity being 37.15%,and waist-to-hip ratio(WHR)-type central obesity being 59.91%.The morbidity rate of hypertension was 62.75%,diabetes 23.57%,dyslipidemia 30.78%,hyperuricemia 20.02% and non-alcoholic fatty liver disease 38.56%.In terms of the five chronic diseases, 15.20% of the elderly people did not suffer from any disease, 30.54% suffered from one disease, 27.93% suffered from two diseases, 17.34% suffered from three diseases, 7.68% suffered from four diseases and 1.31% suffered from five diseases.Logistic regression analysis showed that the risk of developing 1 to 5 chronic diseases for BMI-type obese people was 1.841-5.000 times higher than that for non-BMI-type obese people, the risk of developing 1 to 5 chronic diseases for WC-type central obese people was 1.479-5.158 times higher than that for non-WC-type central obese people, and the risk of developing 2 to 5 chronic diseases for WHR-type central obese people was 1.317-1.736 times higher than that for non-WHR-type central obese people(P<0.05 in all cases). Conclusions The current situation of obesity among the elderly people in Shanghai is not optimistic.There is correlation between different types of obesity and the incidence of five common chronic diseases as well as the risk of multiple commorbidities, so active efforts should be made to prevent and control obesity among the elderly people.更多还原