{"title":"[中国中老年人中枢性肥胖、疼痛与虚弱的相关性研究]。","authors":"D C Hou, B Liang, L J Pei, G Chen","doi":"10.3760/cma.j.cn112338-20250312-00156","DOIUrl":null,"url":null,"abstract":"<p><p><b>Objective:</b> To explore the association of central obesity, pain, their joint effect, and interaction with frailty in middle-aged and old people in China. <b>Methods:</b> A total of 14 359 participants aged ≥45 years in 2011, 2013 and 2015 were selected from the China Health and Retirement Longitudinal Study to construct a cohort database. Cox proportional hazards regression models were used to estimate the association of waist-to-height ratio (WHtR) and pain with the risk for frailty. Joint effect and interaction analyses were performed. <b>Results:</b> In the follow-up of 77 783 person-years, frailty developed in 3 198 participants, with an incidence density of 41.11 per 1 000 person-years. Compared with the <i>Q</i><sub>1</sub> level of WHtR, its <i>Q</i><sub>2</sub>, <i>Q</i><sub>3</sub> and <i>Q</i><sub>4</sub> level increased risk for frailty by 17% (<i>HR</i>=1.17, 95%<i>CI</i>: 1.05-1.31), 24% (<i>HR</i>=1.24, 95%<i>CI</i>: 1.11-1.40), and 43% (<i>HR</i>=1.43, 95%<i>CI</i>: 1.25-1.63), respectively. Compared with painlessness, suffering from pain increased the risk for frailty by 97% (<i>HR</i>=1.97, 95%<i>CI</i>: 1.83-2.11), and having 1, 2, and ≥3 pain sites increased the risk by 42% (<i>HR</i>=1.42, 95%<i>CI</i>: 1.25-1.61), 86% (<i>HR</i>=1.86, 95%<i>CI</i>: 1.64-2.11), and 138% (<i>HR</i>=2.38, 95%<i>CI</i>: 2.18-2.60), respectively. The results of restricted cubic spline showed that WHtR level was associated with the risk for frailty in a J-type dose-response relationship (total <i>P</i><0.001, nonlinear <i>P</i><0.001), and pain quantity was positively associated with the risk in a nonlinear dose-response relationship (total <i>P</i><0.001, nonlinear <i>P</i><0.001). Threshold effect analysis revealed that the inflection points of WHtR and pain site number were 0.46 and 2.00, respectively (<i>P</i><0.001). Joint effect analysis showed that the <i>Q</i><sub>2</sub>, <i>Q</i><sub>3</sub> and <i>Q</i><sub>4</sub> levels of WHtR combined with pain increased the risk for frailty by 146% (<i>HR</i>=2.46, 95%<i>CI</i>: 2.11-2.87), 169% (<i>HR</i>=2.69, 95%<i>CI</i>: 2.30-3.16), and 157% (<i>HR</i>=2.57, 95%<i>CI</i>: 2.18-3.03). <b>Conclusions:</b> The risk for frailty increased with the level of WHtR and the number of pain sites in middle-aged and old people, and there was joint effect between WHtR and pain. Comprehensive management and intervention of obesity and pain are significant for the early prevention of frailty.</p>","PeriodicalId":23968,"journal":{"name":"中华流行病学杂志","volume":"46 9","pages":"1531-1539"},"PeriodicalIF":0.0000,"publicationDate":"2025-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"[Study of association of central obesity and pain with frailty in middle-aged and old people in China].\",\"authors\":\"D C Hou, B Liang, L J Pei, G Chen\",\"doi\":\"10.3760/cma.j.cn112338-20250312-00156\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><p><b>Objective:</b> To explore the association of central obesity, pain, their joint effect, and interaction with frailty in middle-aged and old people in China. <b>Methods:</b> A total of 14 359 participants aged ≥45 years in 2011, 2013 and 2015 were selected from the China Health and Retirement Longitudinal Study to construct a cohort database. Cox proportional hazards regression models were used to estimate the association of waist-to-height ratio (WHtR) and pain with the risk for frailty. Joint effect and interaction analyses were performed. <b>Results:</b> In the follow-up of 77 783 person-years, frailty developed in 3 198 participants, with an incidence density of 41.11 per 1 000 person-years. Compared with the <i>Q</i><sub>1</sub> level of WHtR, its <i>Q</i><sub>2</sub>, <i>Q</i><sub>3</sub> and <i>Q</i><sub>4</sub> level increased risk for frailty by 17% (<i>HR</i>=1.17, 95%<i>CI</i>: 1.05-1.31), 24% (<i>HR</i>=1.24, 95%<i>CI</i>: 1.11-1.40), and 43% (<i>HR</i>=1.43, 95%<i>CI</i>: 1.25-1.63), respectively. Compared with painlessness, suffering from pain increased the risk for frailty by 97% (<i>HR</i>=1.97, 95%<i>CI</i>: 1.83-2.11), and having 1, 2, and ≥3 pain sites increased the risk by 42% (<i>HR</i>=1.42, 95%<i>CI</i>: 1.25-1.61), 86% (<i>HR</i>=1.86, 95%<i>CI</i>: 1.64-2.11), and 138% (<i>HR</i>=2.38, 95%<i>CI</i>: 2.18-2.60), respectively. The results of restricted cubic spline showed that WHtR level was associated with the risk for frailty in a J-type dose-response relationship (total <i>P</i><0.001, nonlinear <i>P</i><0.001), and pain quantity was positively associated with the risk in a nonlinear dose-response relationship (total <i>P</i><0.001, nonlinear <i>P</i><0.001). Threshold effect analysis revealed that the inflection points of WHtR and pain site number were 0.46 and 2.00, respectively (<i>P</i><0.001). Joint effect analysis showed that the <i>Q</i><sub>2</sub>, <i>Q</i><sub>3</sub> and <i>Q</i><sub>4</sub> levels of WHtR combined with pain increased the risk for frailty by 146% (<i>HR</i>=2.46, 95%<i>CI</i>: 2.11-2.87), 169% (<i>HR</i>=2.69, 95%<i>CI</i>: 2.30-3.16), and 157% (<i>HR</i>=2.57, 95%<i>CI</i>: 2.18-3.03). <b>Conclusions:</b> The risk for frailty increased with the level of WHtR and the number of pain sites in middle-aged and old people, and there was joint effect between WHtR and pain. Comprehensive management and intervention of obesity and pain are significant for the early prevention of frailty.</p>\",\"PeriodicalId\":23968,\"journal\":{\"name\":\"中华流行病学杂志\",\"volume\":\"46 9\",\"pages\":\"1531-1539\"},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2025-09-10\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"中华流行病学杂志\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.3760/cma.j.cn112338-20250312-00156\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"Medicine\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"中华流行病学杂志","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.3760/cma.j.cn112338-20250312-00156","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"Medicine","Score":null,"Total":0}
[Study of association of central obesity and pain with frailty in middle-aged and old people in China].
Objective: To explore the association of central obesity, pain, their joint effect, and interaction with frailty in middle-aged and old people in China. Methods: A total of 14 359 participants aged ≥45 years in 2011, 2013 and 2015 were selected from the China Health and Retirement Longitudinal Study to construct a cohort database. Cox proportional hazards regression models were used to estimate the association of waist-to-height ratio (WHtR) and pain with the risk for frailty. Joint effect and interaction analyses were performed. Results: In the follow-up of 77 783 person-years, frailty developed in 3 198 participants, with an incidence density of 41.11 per 1 000 person-years. Compared with the Q1 level of WHtR, its Q2, Q3 and Q4 level increased risk for frailty by 17% (HR=1.17, 95%CI: 1.05-1.31), 24% (HR=1.24, 95%CI: 1.11-1.40), and 43% (HR=1.43, 95%CI: 1.25-1.63), respectively. Compared with painlessness, suffering from pain increased the risk for frailty by 97% (HR=1.97, 95%CI: 1.83-2.11), and having 1, 2, and ≥3 pain sites increased the risk by 42% (HR=1.42, 95%CI: 1.25-1.61), 86% (HR=1.86, 95%CI: 1.64-2.11), and 138% (HR=2.38, 95%CI: 2.18-2.60), respectively. The results of restricted cubic spline showed that WHtR level was associated with the risk for frailty in a J-type dose-response relationship (total P<0.001, nonlinear P<0.001), and pain quantity was positively associated with the risk in a nonlinear dose-response relationship (total P<0.001, nonlinear P<0.001). Threshold effect analysis revealed that the inflection points of WHtR and pain site number were 0.46 and 2.00, respectively (P<0.001). Joint effect analysis showed that the Q2, Q3 and Q4 levels of WHtR combined with pain increased the risk for frailty by 146% (HR=2.46, 95%CI: 2.11-2.87), 169% (HR=2.69, 95%CI: 2.30-3.16), and 157% (HR=2.57, 95%CI: 2.18-3.03). Conclusions: The risk for frailty increased with the level of WHtR and the number of pain sites in middle-aged and old people, and there was joint effect between WHtR and pain. Comprehensive management and intervention of obesity and pain are significant for the early prevention of frailty.
期刊介绍：
Chinese Journal of Epidemiology, established in 1981, is an advanced academic periodical in epidemiology and related disciplines in China, which, according to the principle of integrating theory with practice, mainly reports the major progress in epidemiological research. The columns of the journal include commentary, expert forum, original article, field investigation, disease surveillance, laboratory research, clinical epidemiology, basic theory or method and review, etc.
The journal is included by more than ten major biomedical databases and index systems worldwide, such as been indexed in Scopus, PubMed/MEDLINE, PubMed Central (PMC), Europe PubMed Central, Embase, Chemical Abstract, Chinese Science and Technology Paper and Citation Database (CSTPCD), Chinese core journal essentials overview, Chinese Science Citation Database (CSCD) core database, Chinese Biological Medical Disc (CBMdisc), and Chinese Medical Citation Index (CMCI), etc. It is one of the core academic journals and carefully selected core journals in preventive and basic medicine in China.
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