肥胖是非传染性疾病（NCD）的主要危险因素，而非传染性疾病已成为当今死亡的主要原因。本研究的目的是探讨成年期体重指数 (BMI) 总变化与老年人肥胖相关复杂多发病风险之间的关联，表征 BMI 波预测主要慢性疾病的能力。 在这项回顾性研究中对 1999 年至 2018 年国家健康与营养检查调查 (NHANES) 中的 15,520 名参与者进行了分析。BMI 分为肥胖（≥30.0 kg/m²）、超重（25.0-29.9 kg/m²）、正常体重（18.5-24.9千克/平方米），并且体重不足（<18.5 千克/平方米）。 BMI 变化模式与高血压、癌症、慢性阻塞性肺病、心血管疾病和糖尿病等主要健康结果之间关系的优势比 (OR) 和 95% 置信区间 (CI) 以及 BMI 的人群归因分数 (PAF) 为与保持非肥胖的参与者相比，稳定肥胖的参与者在晚年罹患至少一种慢性疾病的风险最高，从 25 岁开始，比值比为 2.76（95% CI：2.20 至 3.45）到基线前 10 年，从 25 岁到基线为 2.90（2.28 至 3.68），从基线前 10 年为 2.49（2.11 至 2.95）。所有时期从非肥胖到肥胖的体重变化模式（从 25 岁到基线前 10 岁：OR = 1.82；95% CI，1.57 到 2.11；从 25 岁到基线：OR = 1.87；95% CI，1.59 至 2.19；从基线前 10 年到基线：OR = 1.62；95% CI，1.26 至 2.08），从肥胖转向非肥胖，基线前 10 年（OR = 1.89；95% CI） ，1.39 至 2.57）与慢性病风险增加相关。中年肥胖状况可以解释老年人8.6%的慢性病发生风险。保持稳定的健康体重并在成年早期和中年减肥对于提高老龄化过程中的生活质量非常重要。需要更有效的战略和政策来减少肥胖的患病率。版权所有 © 2024 龚、唐和周。

Obesity is a major risk factor for non-communicable diseases (NCDs), which has been the leading cause of death nowadays. The aim of this study is to examine the association between total changes in body mass index (BMI) across adulthood and the risk of obesity-related complex multimorbidity in elderly, characterizing the capacity of BMI waves in predicting major chronic diseases.In this retrospective study, 15,520 participants were analyzed from the National Health and Nutrition Examination Survey (NHANES) from 1999 and 2018. BMI was categorized as obesity (≥30.0 kg/m²), overweight (25.0-29.9 kg/m²), normal weight (18.5-24.9 kg/m²), and underweight (<18.5 kg/m²). Odds ratios (ORs) with 95% confidence interval (CIs) for the relationship between BMI change patterns and major health outcomes included hypertension, cancer, chronic obstructive pulmonary disease, cardiovascular disease, and diabetes, and population attributable fractions (PAFs) of BMI were evaluated.In comparison with participants who remained non-obese, those who are stable obese showed the highest risks of developing at least one chronic disease in later life, with odds ratios of 2.76 (95% CI: 2.20 to 3.45) from age 25 years to 10 years before baseline, 2.90 (2.28 to 3.68) from age 25 years to baseline, and 2.49 (2.11 to 2.95) in the 10-year period before baseline. Moving from non-obese to obese weight-change pattern in all periods (from age 25 years to 10 years before baseline: OR = 1.82; 95% CI, 1.57 to 2.11; from age 25 years to baseline: OR = 1.87; 95% CI, 1.59 to 2.19; from 10 years before baseline to baseline: OR = 1.62; 95% CI, 1.26 to 2.08) and moving from obese to non-obese, the 10-year period before baseline (OR = 1.89; 95% CI, 1.39 to 2.57) was associated with increased risk of chronic diseases. Midlife obesity status can explain the 8.6% risk of occurrence of the chronic diseases in elderly.Maintaining a stable healthy weight and losing weight in early adulthood and midlife are important for better life quality during the aging process. More effective strategies and policies to reduce the prevalence of obesity are needed.Copyright © 2024 Gong, Tang and Zhou.