Supplementary Material for: Obesity in Older Adults and Associations with Cardiovascular Structure and Function

Introduction: Body mass index (BMI), despite being widely used as a marker of obesity, fails to fully capture cardiovascular risks as it is an insufficient biomarker of abdominal adiposity, unlike waist circumference (WC). We aim to characterize associations between BMI and WC with cardiovascular structure and function in older adults. Methods: Among an observational cohort study of community older adults, transthoracic echocardiography determined cardiovascular structure and function, while aerobic capacity was determined by peak oxygen uptake (VO2) metrics. The cut-offs for obesity were 27.5kg/m2 for BMI, and >90cm for males and >80cm for females for WC. Results: 970 older adults without cardiovascular disease [mean age 73±4 years, 432 (44%) males], 124 (12.8%) were obese by BMI definition while 347 (35.7%) were obese by WC definition. Inter-definitional agreement was fair (Cohen’s κ=0.345). Unlike BMI definition, participants defined as obese by WC were more likely to be women (65% vs 50%, p

引言：体质量指数（Body Mass Index，BMI）尽管被广泛用作肥胖的判定指标，但其无法完全反映心血管疾病风险——作为腹部脂肪堆积的生物标志物，其效能远不及腰围（Waist Circumference，WC）。本研究旨在探讨老年人群体质量指数（BMI）与腰围（WC）和心血管结构及功能之间的关联特征。
方法：本研究基于社区老年人群的观察性队列研究，采用经胸超声心动图（Transthoracic Echocardiography）检测心血管结构与功能，通过峰值摄氧量（Peak Oxygen Uptake，VO2）指标评估有氧代谢能力。肥胖的判定界值为：BMI≥27.5kg/m²，男性腰围＞90cm、女性腰围＞80cm。
结果：本研究共纳入970名无心血管疾病的老年受试者，平均年龄为73±4岁，其中男性432名（占比44%）；按BMI标准判定为肥胖者124名（占比12.8%），按WC标准判定为肥胖者347名（占比35.7%）。两种判定标准间的一致性一般（科恩kappa系数=0.345）。与BMI判定的肥胖人群不同，按WC标准判定为肥胖的受试者中女性占比更高（65% vs 50%，p