ObjectiveTo systematically review the association between overweight, obesity, abdominal obesity, and cognitive impairment (CI) 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 CI 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.
目的 研究成都地區中老年人群體質量指數（BMI）及腹型肥胖對糖尿病患病率及空腹血糖水平的影響。 方法 2007年5月，采用隨機抽樣方法抽取50～80歲中老年人685人進行心血管危險因素調查，其男394人，女291人，年齡（63.3 ± 0.2）歲。 結果 成都地區中老年人群的超重和肥胖所占的比例較大（約44.3%），按BMI分組（BMI＜24 kg/m2；24 kg/ m2≤BMI＜28 kg/ m2；BMI≥28 kg/m2）的糖尿病患病率分別為14.0%、18.7%及23.3%，組間差異有統計學意義（P=0.031）。男女分別按腹型肥胖標準分組（男性切點=85 cm，女性切點=80 cm），男性糖尿病患病率在非腹型肥胖及腹型肥胖組分別為17.9%及18.7%組間差異無統計學意義（P=0.849），女性糖尿病患病率分別為9.7%及18.4%，組間差異有統計學意義（P=0.034）。整個人群中，空腹血糖無隨BMI增加而升高的趨勢（P=0.071）；女性人群中，空腹血糖隨腰圍的增加而升高（P=0.001）；而在男性人群中無此趨勢。在調整相關指標后，logistic回歸分析提示BMI對糖尿病患病率獨立影響，以BMI正常為參照，超重及肥胖的OR值分別為：1.412 [95%CI （0.818，2.437），P=0.215]及2.200 [95%CI（1.034，5.178），P=0.046]。在調整相關指標后，腹型肥胖在女性人群中對糖尿病患病率獨立影響，以非腹型肥胖為參考，腹型肥胖的OR值為：1.394 [95%CI（1.080，3.205），P=0.041]，而在男性人群中無此關系。 結論 成都地區中老年人群超重及肥胖所占的比重較大，BMI可影響糖尿病患病率及空腹血糖水平；腹型肥胖能夠影響女性人群糖尿病患病率及空腹血糖水平，但在男性人群中無此關系。