Prevalence and Root Cause Analysis of Adiposity-based Chronic Disease in Older Adults Aged 65 Years and Older

Abstract

Background The American Association of Clinical Endocrinologists and the American Society of Endocrinology have proposed an adiposity-based chronic disease (ABCD) model for evaluating obesity, and there has been very few studies of ABCD in China, and the efficacy of its application is unclear. Objective To understand the prevalence of ABCD and its root cause in the Chinese elderly population aged 65 years and above using ABCD, a new obesity evaluation index. Methods Five thousand five hundred and sixty-two elderly people aged 65 years and above who participated in medical checkups at 28 community health centers in Pingshan District, Shenzhen City, Guangdong Province, from January to December 2021 were selected to obtain the basic characteristics of the study subjects through questionnaires, physical examinations, and laboratory tests, and to stage the sample population according to the diagnostic criteria of the ABCD model, and calculate the prevalence rates of ABCD and the individual stage, and multifactorial Logistic regression analysis was used to explore the relationship between ABCD staging and different cardiometabolic risk factor risks. Results The prevalence of ABCD in this study was 71.0%, and the prevalence of stage 0, 1, and 2 were 4.8% (267/5 562) , 32.5% (1 808/5 562) , and 33.7% (1 874/5 562) , respectively. The results of multifactorial Logistic regression analysis showed that, using ABCD normal as the reference group, diabetes mellitus, hypertension, high triacylglycerol, low HDL-C, high LDL-C, and cigarette smoking, in addition to high total cholesterol and alcohol consumption, were associated with the stage of ABCD (P<0.05) ; The risk of developing hypertension, high triacylglycerol, low HDL-C, and high LDL-C in ABCD stage 1 was 2.393, 1.515, 1.940, 1.688, and 1.376 times higher than that of the normal population, respectively; The risk of diabetes, hypertension, high triacylglycerol, low HDL-C, and high LDL-C in ABCD stage 2 was 2.918, 4.231, 9.282, 4.128, 2.970, and 1.672 times higher than that of the normal population, respectively. Smoking was a protective factor for ABCD stage 1 and 2, with OR (95%CI) of 0.577 (0.480-0.693) and 0.752 (0.633-0.893) , respectively. Conclusion In this study, there were male-female differences in the prevalence of ABCD in the elderly aged 65 years and older, and the prevalence was associated with cardiometabolic risk factors such as hypertension, diabetes, and smoking, and the ABCD model has been well applied in the Chinese elderly population.

Keywords

• obesity|abcd|adipose tissue|chronic disease|senior citizen|epidemiologic studies|root cause analysis