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Article(id=1241676524559061825, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1241676522256388920, articleNumber=null, orderNo=null, doi=10.20043/j.cnki.MPM.202407128, pmid=null, cstr=null, oa=null, hot=null, price=null, onlineType=0, articleFormat=0, articleType=null, articleTypeStr=null, receivedDate=1720540800000, receivedDateStr=2024-07-10, revisedDate=null, revisedDateStr=null, acceptedDate=null, acceptedDateStr=null, onlineDate=1773968352688, onlineDateStr=2026-03-20, pubDate=1731168000000, pubDateStr=2024-11-10, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1773968352688, onlineIssueDateStr=2026-03-20, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1773968352688, creator=13701087609, updateTime=1773968352688, updator=13701087609, issue=Issue{id=1241676522256388920, tenantId=1146029695717560320, journalId=1227665162245664772, year='2024', volume='51', issue='21', pageStart='3841', pageEnd='4032', issueExtLink='null', onlineDate='null', pubDate='null', beforeIssueId=null, nextIssueId=null, price=null, status=1, issueComplete=1, articleOrder=1, issueType=-1, specialIssue=null, createTime=1773968352140, creator=13701087609, updateTime=1773968629818, updator=13701087609, preIssue=null, nextIssue=null, ext={EN=IssueExt(id=1241677686985249701, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1241676522256388920, language=EN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=), CN=IssueExt(id=1241677686985249702, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1241676522256388920, language=CN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=)}, issueFiles=null}, startPage=3980, endPage=3985, ext={EN=ArticleExt(id=1241676526559744873, articleId=1241676524559061825, tenantId=1146029695717560320, journalId=1227665162245664772, language=EN, title=Analysis of the relationship between obesity and self-perceptions of aging in middle-aged and older adults, columnId=1228016572451718132, journalTitle=Modern Preventive Medicine, columnName=Health and Social Behavior, runingTitle=null, highlight=null, articleAbstract=
Objective

Self-perceptions of aging (SPA) are a critical issue in the mental health of middle-aged and older adults, yet the complex relationship with obesity remains insufficiently explored. This study analyzes the impact of obesity on SPA among this demographic.

Methods

Utilizing longitudinal follow-up data from the Health and Retirement Study (HRS) in the United States, logistic regression was employed to examine the relationship between Body Mass Index (BMI) and SPA, while restricted cubic splines (RCS) were used to reveal potential nonlinear associations.

Results

After adjusting for baseline age, gender, race, education level, marital status, number of chronic diseases, depressive symptoms, functional limitations, and baseline SPA levels, grade 2/3 obesity was associated with negative SPA (OR=1.50, 95%CI: 1.08-2.07), and a significant nonlinear relationship between BMI and SPA was observed (P-overall < 0.001, P-nonlinear = 0.042). Subgroup analysis indicated that among individuals under 80 years old, females, those with a high school education or lower, Caucasians, individuals with depressive symptoms, and those without functional limitations, grade 2/3 obesity was positively correlated with negative SPA.

Conclusion

Obesity in middle-aged and older adults is related to negative SPA. Healthcare professionals should pay attention to the potential psychological impacts of obesity during the aging process and develop more targeted prevention and intervention strategies to assist obese individuals in improving their mental health as they age.

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目的

自我感知老化(self-perceptions of aging, SPA)是中老年人心理健康领域的一个关键问题，其与肥胖的复杂关系仍未得到充分探讨。本研究分析肥胖对中老年人SPA的影响。

方法

基于美国健康与退休研究(HRS)的纵向随访数据，采用logistic回归分析身体质量指数（boby mass index, BMI）与SPA之间的关系，采用限制性立方样条(RCS)揭示二者潜在的非线性关联。

结果

调整基线年龄、性别、种族、教育程度、婚姻状况、慢性病数量、抑郁症状、功能限制和基线SPA水平后，2级/3级肥胖与消极SPA有关(OR=1.50，95%CI：1.08～2.07)，并且BMI和SPA之间存在显著的非线性关联(P-overall<0.001, P-nonlinear=0.042)。亚组分析结果显示，年龄小于80岁、女性、高中或以下文化程度、白种人、有抑郁症状、无功能限制的个体中2级/3级肥胖均与消极SPA存在正相关。

结论

中老年人肥胖与消极的SPA有关，医疗保健人员应重视肥胖对中老年人口老龄化过程中的潜在心理方面的影响，制定更具针对性的预防和干预策略来帮助特定人群中的肥胖者改善衰老过程中的心理健康状况。

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孔菲，E-mail:
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杨洪伟（1987—），女，硕士在读，主管护师，研究方向：疾病预防与护理

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杨洪伟（1987—），女，硕士在读，主管护师，研究方向：疾病预防与护理

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杨洪伟（1987—），女，硕士在读，主管护师，研究方向：疾病预防与护理

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General demographic data of participants ［n（%）］

, figureFileSmall=null, figureFileBig=null, tableContent=
变量正常体重/体重不足(n=583)超重(n=884)1级肥胖(n=670)2/3级肥胖(n=477)总计(n=2 614)P值
年龄（岁）
<6586 (14.8)149 (16.9)138 (20.6)136 (28.5)509 (19.5)<0.001
65～80317 (54.4)517 (58.5)435 (64.9)302 (63.3)1 571 (60.1)
≥80180 (30.9)218 (24.7)97 (14.5)39 (8.2)534 (20.4)
性别
男151 (25.9)353 (39.9)242 (36.1)136 (28.5)882 (33.7)<0.001
女432 (74.1)531 (60.1)428 (63.9)341 (71.5)1 732 (66.3)
教育程度
高中及以下313 (53.7)488 (55.2)385 (57.5)281 (58.9)1 467 (56.1)0.296
高中以上270 (46.3)396 (44.8)285 (42.5)196 (41.1)1 147 (43.9)
婚姻状况
已婚306 (52.5)534 (60.4)391 (58.4)273 (57.2)1 504 (57.5)0.016
分居9 (1.5)7 (0.8)8 (1.2)6 (1.3)30 (1.1)
离婚66 (11.3)114 (12.9)80 (11.9)77 (16.1)337 (12.9)
丧偶182 (31.2)204 (23.1)167 (24.9)103 (21.6)656 (25.1)
未婚20 (3.4)25 (2.8)24 (3.6)18 (3.8)87 (3.3)
慢性疾病数量
026 (4.5)28 (3.2)14 (2.1)5 (1.0)73 (2.8)<0.001
1109 (18.7)133 (15.0)73 (10.9)36 (7.5)351 (13.4)
2167 (28.6)228 (25.8)185 (27.6)104 (21.8)684 (26.2)
≥3281 (48.2)495 (56.0)398 (59.4)332 (69.6)1 506 (57.6)
抑郁症状
无249 (42.7)347 (39.3)254 (37.9)166 (34.8)1 016 (38.9)0.064
有334 (57.3)537 (60.7)416 (62.1)311 (65.2)1 598 (61.1)
种族
白种人508 (87.1)757 (85.6)548 (81.8)369 (77.4)2 182 (83.5)<0.001
黑种人50 (8.6)98 (11.1)99 (14.8)92 (19.3)339 (13.0)
其它种族a25 (4.3)29 (3.3)23 (3.4)16 (3.4)93 (3.6)
任何功能限制
无457 (78.4)693 (78.4)504 (75.2)298 (62.5)1 952 (74.7)<0.001
有126 (21.6)191 (21.6)166 (24.8)179 (37.5)662 (25.3)
基线SPA
积极209 (35.8)315 (35.6)245 (36.6)152 (31.9)921 (35.2)0.384
消级374 (64.2)569 (64.4)425 (63.4)325 (68.1)1 693 (64.8)
), ArticleFig(id=1241821866600502239, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241676524559061825, language=CN, label=表1, caption=

调查对象的一般人口学资料［n（%）］

, figureFileSmall=null, figureFileBig=null, tableContent=
变量正常体重/体重不足(n=583)超重(n=884)1级肥胖(n=670)2/3级肥胖(n=477)总计(n=2 614)P值
年龄（岁）
<6586 (14.8)149 (16.9)138 (20.6)136 (28.5)509 (19.5)<0.001
65～80317 (54.4)517 (58.5)435 (64.9)302 (63.3)1 571 (60.1)
≥80180 (30.9)218 (24.7)97 (14.5)39 (8.2)534 (20.4)
性别
男151 (25.9)353 (39.9)242 (36.1)136 (28.5)882 (33.7)<0.001
女432 (74.1)531 (60.1)428 (63.9)341 (71.5)1 732 (66.3)
教育程度
高中及以下313 (53.7)488 (55.2)385 (57.5)281 (58.9)1 467 (56.1)0.296
高中以上270 (46.3)396 (44.8)285 (42.5)196 (41.1)1 147 (43.9)
婚姻状况
已婚306 (52.5)534 (60.4)391 (58.4)273 (57.2)1 504 (57.5)0.016
分居9 (1.5)7 (0.8)8 (1.2)6 (1.3)30 (1.1)
离婚66 (11.3)114 (12.9)80 (11.9)77 (16.1)337 (12.9)
丧偶182 (31.2)204 (23.1)167 (24.9)103 (21.6)656 (25.1)
未婚20 (3.4)25 (2.8)24 (3.6)18 (3.8)87 (3.3)
慢性疾病数量
026 (4.5)28 (3.2)14 (2.1)5 (1.0)73 (2.8)<0.001
1109 (18.7)133 (15.0)73 (10.9)36 (7.5)351 (13.4)
2167 (28.6)228 (25.8)185 (27.6)104 (21.8)684 (26.2)
≥3281 (48.2)495 (56.0)398 (59.4)332 (69.6)1 506 (57.6)
抑郁症状
无249 (42.7)347 (39.3)254 (37.9)166 (34.8)1 016 (38.9)0.064
有334 (57.3)537 (60.7)416 (62.1)311 (65.2)1 598 (61.1)
种族
白种人508 (87.1)757 (85.6)548 (81.8)369 (77.4)2 182 (83.5)<0.001
黑种人50 (8.6)98 (11.1)99 (14.8)92 (19.3)339 (13.0)
其它种族a25 (4.3)29 (3.3)23 (3.4)16 (3.4)93 (3.6)
任何功能限制
无457 (78.4)693 (78.4)504 (75.2)298 (62.5)1 952 (74.7)<0.001
有126 (21.6)191 (21.6)166 (24.8)179 (37.5)662 (25.3)
基线SPA
积极209 (35.8)315 (35.6)245 (36.6)152 (31.9)921 (35.2)0.384
消级374 (64.2)569 (64.4)425 (63.4)325 (68.1)1 693 (64.8)
), ArticleFig(id=1241821866738914278, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241676524559061825, language=EN, label=Table 2, caption=

Association between obesity and self-perceptions of aging

, figureFileSmall=null, figureFileBig=null, tableContent=
变量模型 1a模型 2b
OR值(95%CI)P值OR值(95%CI)P值
BMI
正常体重/体重不足1.001.00
超重1.00(0.80, 1.25)>0.9000.92(0.71, 1.20)0.500
1级肥胖1.02(0.81, 1.29)0.9000.99(0.75, 1.31)>0.900
2/3级肥胖1.55(1.19, 2.04)0.0011.50(1.08, 2.07)0.015
), ArticleFig(id=1241821866860549097, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241676524559061825, language=CN, label=表2, caption=

肥胖和SPA之间的关系

, figureFileSmall=null, figureFileBig=null, tableContent=
变量模型 1a模型 2b
OR值(95%CI)P值OR值(95%CI)P值
BMI
正常体重/体重不足1.001.00
超重1.00(0.80, 1.25)>0.9000.92(0.71, 1.20)0.500
1级肥胖1.02(0.81, 1.29)0.9000.99(0.75, 1.31)>0.900
2/3级肥胖1.55(1.19, 2.04)0.0011.50(1.08, 2.07)0.015
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中老年人肥胖与自我感知老化的关系分析
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杨洪伟 1 , 赵京芳 1 , 仲亚茹 1 , 周敏 2 , 孔菲 2
现代预防医学 | 健康与社会行为 2024,51(21): 3980-3985
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现代预防医学 | 健康与社会行为 2024, 51(21): 3980-3985
中老年人肥胖与自我感知老化的关系分析
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杨洪伟1, 赵京芳1, 仲亚茹1, 周敏2, 孔菲2
作者信息
  • 1.山东第一医科大学附属省立医院消化内科二病区，山东 济南 250021
  • 2.山东第一医科大学附属省立医院消化内科一病区，山东 济南 250021

    • 杨洪伟（1987—），女，硕士在读，主管护师，研究方向：疾病预防与护理

通讯作者:

孔菲，E-mail:
Analysis of the relationship between obesity and self-perceptions of aging in middle-aged and older adults
Hong-wei YANG1, Jing-fang ZHAO1, Ya-ru ZHONG1, Min ZHOU2, Fei KONG2
Affiliations
  • Department of Gastroenterology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan,Shandong 250021, China
出版时间: 2024-11-10 doi: 10.20043/j.cnki.MPM.202407128
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摘要
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目的

自我感知老化(self-perceptions of aging, SPA)是中老年人心理健康领域的一个关键问题，其与肥胖的复杂关系仍未得到充分探讨。本研究分析肥胖对中老年人SPA的影响。

方法

基于美国健康与退休研究(HRS)的纵向随访数据，采用logistic回归分析身体质量指数（boby mass index, BMI）与SPA之间的关系，采用限制性立方样条(RCS)揭示二者潜在的非线性关联。

结果

调整基线年龄、性别、种族、教育程度、婚姻状况、慢性病数量、抑郁症状、功能限制和基线SPA水平后，2级/3级肥胖与消极SPA有关(OR=1.50，95%CI：1.08～2.07)，并且BMI和SPA之间存在显著的非线性关联(P-overall<0.001, P-nonlinear=0.042)。亚组分析结果显示，年龄小于80岁、女性、高中或以下文化程度、白种人、有抑郁症状、无功能限制的个体中2级/3级肥胖均与消极SPA存在正相关。

结论

中老年人肥胖与消极的SPA有关，医疗保健人员应重视肥胖对中老年人口老龄化过程中的潜在心理方面的影响，制定更具针对性的预防和干预策略来帮助特定人群中的肥胖者改善衰老过程中的心理健康状况。

肥胖  /  体重指数  /  SPA  /  老年人
Objective

Self-perceptions of aging (SPA) are a critical issue in the mental health of middle-aged and older adults, yet the complex relationship with obesity remains insufficiently explored. This study analyzes the impact of obesity on SPA among this demographic.

Methods

Utilizing longitudinal follow-up data from the Health and Retirement Study (HRS) in the United States, logistic regression was employed to examine the relationship between Body Mass Index (BMI) and SPA, while restricted cubic splines (RCS) were used to reveal potential nonlinear associations.

Results

After adjusting for baseline age, gender, race, education level, marital status, number of chronic diseases, depressive symptoms, functional limitations, and baseline SPA levels, grade 2/3 obesity was associated with negative SPA (OR=1.50, 95%CI: 1.08-2.07), and a significant nonlinear relationship between BMI and SPA was observed (P-overall < 0.001, P-nonlinear = 0.042). Subgroup analysis indicated that among individuals under 80 years old, females, those with a high school education or lower, Caucasians, individuals with depressive symptoms, and those without functional limitations, grade 2/3 obesity was positively correlated with negative SPA.

Conclusion

Obesity in middle-aged and older adults is related to negative SPA. Healthcare professionals should pay attention to the potential psychological impacts of obesity during the aging process and develop more targeted prevention and intervention strategies to assist obese individuals in improving their mental health as they age.

Obesity  /  Body mass index  /  Self-perceptions of aging  /  Older adults
杨洪伟, 赵京芳, 仲亚茹, 周敏, 孔菲. 中老年人肥胖与自我感知老化的关系分析. 现代预防医学, 2024 , 51 (21) : 3980 -3985 . DOI: 10.20043/j.cnki.MPM.202407128
Hong-wei YANG, Jing-fang ZHAO, Ya-ru ZHONG, Min ZHOU, Fei KONG. Analysis of the relationship between obesity and self-perceptions of aging in middle-aged and older adults[J]. Modern Preventive Medicine, 2024 , 51 (21) : 3980 -3985 . DOI: 10.20043/j.cnki.MPM.202407128
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自我感知老化（self-perceptions of aging, SPA）是个体对自身衰老历程的主观评价，反映了个人对衰老过程的信念和期望[1]，包括对不断变化的角色以及身体和精神随时间变化的接受程度。积极的SPA不仅与寿命延长相关，而且还意味着强大的心理储备[2]。相反，消极的SPA与老年人更高的疾病负担、功能健康下降、幸福感下降和社会孤立增加有关[3-4]。既往研究表明，SPA对老年人生活质量、健康结果和死亡率具有预测能力，使其成为促进健康老龄化干预的关键目标[5-6]。
SPA受社会互动、刻板印象、个人经历、社会结构及文化价值观等多重复杂因素影响，并关联于年龄、性别、教育等因素[7-10]。生物心理社会模型强调身心健康的交互性[11]，各种健康指标，如自评健康、慢性病负担也显著影响SPA[12-13]。肥胖，作为加速老化的潜在因素，可能通过身体机能、代谢及炎症等多途径影响SPA。身体质量指数(body mass index, BMI)作为肥胖的客观健康评价指标，与衰老过程中的心理健康密切相关[14]，因此，BMI可作为老年人心理健康结果的预测指标。
在当前老龄化社会背景下，深入探究肥胖与SPA关系，能增进对肥胖健康效应的理解，指导精准健康管理策略的制定。本研究旨在分析中老年群体肥胖与SPA的关联性，以期为老年健康管理的创新提供科学依据与方向。
1　资料与方法
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1.1　研究人群
本研究采用美国健康与退休研究（Health and Retirement Study，HRS）的数据，选取2012和2014年的参与者，排除标准：（1）在随后的4年（2016或2018年）中未再次完成SPA测试；（2）基线时缺乏身体质量指数（boby mass index, BMI）信息或BMI超过50；（3）基线年龄小于50岁或缺少协变量。
1.2　肥胖的测量
肥胖通过BMI反映。根据世界卫生组织定义的不同肥胖分级标准将个体分为：体重不足（BMI：<18.5 kg/m2）、正常体重（BMI：18.5～25 kg/m2）、超重（BMI：25～30 kg/m2）、1级肥胖（BMI：30～35 kg/m2）、2级肥胖（BMI：35～40 kg/m2）和3级肥胖（BMI：≥40 kg/m2）[15]。本研究中，将BMI分为四组分析：正常体重/体重不足（BMI：<25 kg/m2）、超重（BMI：25～30 kg/m2）、1级肥胖（BMI：30～35 kg/m2）和2/3级肥胖（BMI：≥35 kg/m2）。这种分类方式基于现有数据分布，有助于进行更稳健的分析。
1.3　SPA的测量
通过一个包含8个条目的量表进行SPA的评估[16]。使用6分李克特量表对同意程度进行评分，对正面陈述进行了反向编码，较高的分数表示更消极的SPA。根据既往研究的实践，我们将自我衰老感知分为两组：积极SPA(评分低于普通人群均值24.3分)和消极SPA（评分高于均值）[17]。该量表显示出良好的可靠性，Cronbach α值为0.70[18]。
1.4　协变量
协变量包括年龄、性别、种族、教育程度、婚姻状况、慢性疾病数量、抑郁症状、功能受限和基线SPA。其中，慢性疾病数量通过自我报告8种医生诊断的疾病来确定[19]；抑郁症状的评估涉及受访者是否经历过持续的抑郁感、缺乏精力、睡眠不安、孤独感、悲伤感、难以开始活动、幸福感或生活乐趣[19]；功能限制是基于自我报告在日常生活活动中遇到的困难来确定的[20]。
1.5　统计分析
使用频数和百分比描述研究对象的基线特征，通过χ2检验评估组间差异。采用logistic回归分析评估肥胖与SPA的关系。模型1未进行调整，模型2对协变量进行调整。通过亚组分析进一步探讨不同协变量组中肥胖与SPA之间的关系。此外，限制性立方样条（RCS）被用来评估BMI与SPA之间的非线性关联。基于赤池信息准则（AIC）最优性原则选择三个节点进行曲线拟合。最后通过2014和2016年的数据进行敏感性分析，以验证结果的稳健性。所有统计分析均使用R软件（4.3.1版本）进行，检验水准α=0.05。
2　结果
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2.1　研究对象的基本特征
2 614名对象的平均年龄为72.4岁，66.3%为女性，BMI的结果需要文字描述。不同年龄、性别、婚姻、种族、慢性疾病数量和有功能限制的BMI分组之间存在差异。见表1。
2.2　SPA情况
基线调查时有921（35.2%）名参与者报告了积极的SPA，而1 693（64.8%）名参与者报告了消极的SPA。
2.3　肥胖与SPA的关联
以正常体重/体重不足组为参照组，模型1显示2/3级肥胖与消极SPA相关(OR=1.55，95%CI：1.19～2.04)，在调整协变量后，相关关系仍然成立(OR=1.50，95%CI：1.08～2.07)。见表2。
2.4　亚组分析
65岁以下、65～80岁、女性、高中或以下学历、白种人、有抑郁症状者以及没有功能限制者的2/3级肥胖与消极SPA呈显著正相关。见图1、2。
2.5　肥胖与SPA的非线性关联
在调整所有协变量后，体人群中肥胖与SPA之间存在显著的非线性关联(P-overall<0.001, P-nonlinear = 0.042)。图3展示了这种非线性趋势，揭示了存在一个明显的阈值效应。
2.6　敏感性分析
在未调整模型中，2/3级肥胖与消极的SPA相关（OR=1.49，95%CI：1.11～2.01）。在调整了年龄、性别、种族、教育、婚姻状况、抑郁症状和基线SPA后，这种关系仍然存在（OR=1.43，95%CI：1.01～2.02）。
3　讨论
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近年来，肥胖因其与各种慢性疾病如2型糖尿病、心血管疾病和心衰有关而引起了全球的关注[21]。既往研究表明体重指数较高的人更容易出现抑郁等消极心理问题[22]，本研究发现，2/3级肥胖是中老年人群消极SPA的重要风险因素。分析其原因：首先，在肥胖与心理健康之间的生物途径中，脂肪细胞中细胞因子产生导致的神经炎症加剧占据了重要地位。肥胖患者表现出下丘脑-垂体-肾上腺（HPA）轴的不平衡，导致皮质醇水平持续升高[23]。其次，白色脂肪组织产生促炎细胞因子，触发免疫激活和整体炎症的增强。这些过程最终导致下游效应，如色氨酸水平降低，最终影响血清素水平并影响情绪[24]。另外，肥胖在社会中受到高度污名化，导致歧视、社会排斥和边缘化[25-26]。体重较重的人容易产生大量负面的自我认知，包括低自尊、自我厌恶、缺乏归属感以及认为自己是社会负担的感知[27]，这些情感负担可能增加了高BMI群体中出现消极SPA的风险。然而，也存在一些不同的观点，有研究表明，肥胖可能对中老年人有潜在的保护作用，老年人较高的BMI与健康衰老相关[28]，因此，在评估肥胖与健康之间的关系时，应从多方面进行考量。
65岁以下、65～80岁人群肥胖与消极SPA之间存在正相关，提示在低龄老年人中，心理健康问题与肥胖的关联更为突出[24]。女性肥胖与消极SPA呈正相关，社会文化因素可能使女性更加容易受到身体形象观念的影响，从而增加了肥胖对心理健康的不良影响[29]。由于社会所赋予女性的审美定位和期望，女性也倾向于感知到更多的容貌焦虑[30]。高中或以下学历的人群肥胖与消极SPA相关，而高中以上人群中没有观察到肥胖对SPA的影响，这可能是因为拥有更多知识储备的老年人能够更客观地看待肥胖，并采取积极的应对策略。尽管既往调查显示黑种人比白种人面临更高的肥胖风险，但这些人群通常更注重整体健康参数，如骨密度、体蛋白和瘦体重，而不是BMI[31]，这可能减弱了BMI和SPA之间的关联。在有抑郁症状的个体中，肥胖与消极SPA之间的关联更为显著，这表明抑郁症状可能加剧了肥胖对心理健康的不良影响，进一步强调了心理健康干预的紧迫性。在没有功能限制的个体中，我们同样发现了肥胖与消极SPA之间的显著正相关，这一结果突显了即便在身体功能相对健全的人群中，肥胖依然对SPA产生负面影响。医疗保健提供者应特别关注SPA与肥胖密切相关的人群，提高他们对肥胖的认识，并鼓励他们及时寻求帮助，涉及初级保健和心理健康专业人员的协作护理模式可能有所帮助。
我们的研究存在局限性。一方面，缺乏客观的SPA评估，可能存在一定程度的选择性偏差；另一方面，BMI没有考虑个体层面的脂肪分布、肌肉质量或骨密度等因素，需多维度的数据来全面验证中老年人肥胖与SPA的关系。
综上，中老年人肥胖与消极SPA有关，医疗保健人员应重视肥胖对中老年人口老龄化过程中的潜在心理方面的影响，制定更具针对性的预防和干预策略来帮助特定人群中的肥胖者改善衰老过程中的心理健康状况。
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2024年第51卷第21期
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doi: 10.20043/j.cnki.MPM.202407128
  • 接收时间：2024-07-10
  • 首发时间：2026-03-20
  • 出版时间：2024-11-10
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    1.山东第一医科大学附属省立医院消化内科二病区，山东 济南 250021
    2.山东第一医科大学附属省立医院消化内科一病区，山东 济南 250021

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2种不同金属材料的力学参数
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Family		 属数
Number of
genus		 种数
Number of
species		 占总种数比例
Percentage of
total species (%)		 属
Genus		 种数
Number of
species		 占总种数比例
Percentage of total
species (%)
鹅膏菌科Amanitaceae 2 11 5.26 鹅膏菌属 Amanita 10 4.78
小菇科 Mycenaceae 2 12 5.74 丝盖伞属 Inocybe 5 2.39
多孔菌科 Polyporaceae 8 14 6.70 蜡蘑属 Laccaria 5 2.39
红菇科 Russulaceae 3 23 11.00 小皮伞属 Marasmius 6 2.87
小菇属 Mycena 11 5.26
光柄菇属 Pluteus 5 2.39
红菇属 Russula 17 8.13
栓菌属 Trametes 5 2.39
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