目的 探讨肌少症性肥胖（SO）诊断标准的演进及其在中国老年人群中的本土化综合干预路径。方法 评述ESPEN/EASO最新共识，结合我国老年人代谢特征，系统分析“筛查-诊断-分期”流程及运动营养协同干预的临床效能。结果 SO诊断核心在于识别“隐性肥胖”，建议在AWGS2019标准基础上，叠加中国特异性腰围切点（男≥90 cm，女≥85 cm）或体脂率指标，并应用ALM/BMI校正肌肉质量。研究证实，以渐进式抗阻训练联合高蛋白营养（1.2~1.5 g·kg-1·d-1）为核心的协同模式，通过激活mTOR通路可显著逆转肌肉流失并改善胰岛素抵抗。融入八段锦等传统功法及乳清蛋白补充，能有效重塑中国患者“高碳水、低蛋白”的膳食习惯，提升依从性。结论 构建护士主导、社区依托的多学科管理模式，并借助远程健康工具实现闭环监测，是提升我国SO精准诊疗水平的关键路径。

      Objective To explore the evolution of diagnostic criteria for sarcopenic obesity（SO）and its localized comprehensive intervention pathways tailored to the metabolic characteristics of the Chinese elderly population．Methods The latest ESPEN/EASO consensus was reviewed．Combined with the metabolic profile of Chinese older adults，the “screening-diagnosis-staging” workflow and the clinical efficacy of synergistic exercise and nutrition interventions were systematically analyzed．Results The core of SO diagnosis lies in identifying “hidden obesity．”It is recommended to incorporate Chinese-specific waist circumference cut-offs（male≥90 cm，female≥85 cm）or body fat percentage into the AWGS2019 framework，utilizing ALM/BMI for muscle mass calibration．Evidence suggests that a synergistic model，centered on progressive resistance training（PRT）and high-protein nutrition（1.2~1.5 g·kg-1·d-1），can significantly reverse muscle loss and improve insulin resistance by activating the mTOR pathway．Integrating traditional Chinese exercises（e. g. ，Baduanjin）and whey protein supplementation effectively reshapes the “high-carbohydrate，low-protein” dietary habits of Chinese patients，thereby enhancing intervention adherence．Conclusions Establishing a nurse-led，community-based multidisciplinary management model，integrated with digital health tools for closed-loop monitoring，is a pivotal strategy for enhancing the precision of SO diagnosis and treatment in China．

       目的 探讨肥胖与肺功能参数的相关性。方法 将90例接受肺功能检查的患者依据体质指数（BMI）分为肥胖组（BMI≥25 kg/m²，n=50）和正常体质量组（18.5 kg/m²＜BMI≤24.9 kg/m²，n=40），比较两组各项肺功能参数的差异，包括肺通气功能的参数如［用力肺活量（FVC）、第1秒用力呼气容积（FEV₁）、1秒率（FEV₁/FVC）、最大呼气流量（PEF）］以及反映小气道功能的参数［50%最大呼气流量（MEF₅₀），25%最大呼气流量（MEF₂₅）］；比较肥胖组不同性别间上述肺功能参数的差异及其与腰围（WC）与BMI的相关性。结果 肥胖组FVC、FEV₁、FEV₁/FVC、MEF₅₀、MEF₂₅低于正常体质量组（P＜0.01）；肥胖组中男性FVC及FEV₁低于女性（P＜0.01）。相关分析结果显示，肥胖组中WC与BMI均与肺功能多个参数呈负相关趋势，其中WC的负相关趋势更突出，且与FVC呈负相关关系（P＜0.05）。结论 肥胖影响反映肺功能的多个参数，表现为肺通气功能和小气道功能多个指标水平降低，且肥胖男性更甚；在肥胖人群中，相较于BMI，WC与FVC的关系更密切。

      Objective To investigate the correlation between obesity and pulmonary function parameters．Methods Ninety patients undergoing pulmonary function testing were categorized into an obese group（BMI≥25 kg/m²，n=50）and a normal-weight group（18.5 kg/m²＜ BMI≤24.9 kg/m²，n=40）．Differences in pulmonary function parameters were compared between groups，including ventilatory parameters（forced vital capacity［FVC］，forced expiratory volume in 1 second［FEV₁］，FEV₁/FVC ratio，peak expiratory flow［PEF］） and parameters reflecting small airway function（maximum expiratory flow at 50% of forced expiratory volume［MEF₅₀］，and 25% maximum expiratory flow［MEF₂₅］）．Differences in these pulmonary function parameters between genders within the obese group and their correlations with waist circumference（WC）and BMI were also assessed．Results FVC，FEV₁，FEV₁/FVC，MEF₅₀，and MEF₂₅ were significantly lower in the obese group compared to the normal-weight group（P＜0.01）．Among obese subjects，male FVC and FEV₁ were significantly lower than female values（P＜0.01）．Correlation analysis revealed negative correlations of WC and BMI with multiple pulmonary function parameters in the obese group，with WC exhibiting a more pronounced negative correlation and a significant negative relationship with FVC（P＜0.05）．Conclusions Obesity impacts multiple parameters reflecting lung function，manifesting as reduced levels of several indicators of pulmonary ventilation and small airway function，with male obese individuals exhibiting greater impairment．Within the obese population，WC correlates more closely with FVC than BMI．

目的 研究高尿酸（UA）和肥胖的交互作用对非酒精性脂肪肝病（NAFLD）患病率的影响。方法 采用病例对照的研究法,选取2021年1月至2021年12月兰州市某医院健康体检中心进行常规健康体检的504人为研究对象,按照诊断标准分为NAFLD组187人和非NAFLD 组317人。采用Logistic 回归模型、相乘、相加交互模型探讨非酒精性脂肪肝病患病风险的影响因素及因素间的交互作用。结果 多因素条件Logistic回归分析可知,肥胖（OR=4.87,95%CI：3.01~7.89）,糖尿病患者（OR=3.40,95%CI：1.51~7.68）,幽门螺杆菌（Hp）携带者（OR=1.62,95%CI：1.03~2.57）,高尿酸血症的NAFLD患病风险增加,分别是正常者、非糖尿病患者、非Hp携带者,非高尿酸血症的4.87倍,3.40倍,1.62倍,2.28倍,在调整混杂因素后交互作用结果显示,高尿酸血症和肥胖对NAFLD患病率有相乘交互作用（OR=0.30,95%CI：0.10~0.88,P=0.029）、但无相加交互作用（相对超额危险度比=3.15、归因比=0.24、协同指数=1.34）。结论 BMI、糖尿病、Hp是NAFLD患病的独立危险因素,其中高尿酸血症和超重与肥胖对NAFLD患病有相乘交互作用,无相加交互作用。

Objective To explore the influence of the interaction of high uric acid（UA）and obesity on the prevalence of non-alcoholic fatty liver disease（NAFLD）．Methods Using a case-control study method,504 people who underwent routine health checkups at the health checkup centre of a hospital in Lanzhou City from January 2021 to December 2021 were enrolled in the study,and 187 people were included in the NAFLD group and 317 people in the non-NAFLD group according to the diagnostic criteria．Logistic regression models,multiplicative and additive interaction models were used to investigate the factors affecting the risk factors of NAFLD and the interaction between the factors．Results Multifactorial conditional logistic regression analysis showed that the risk of NAFLD was increased in obese（OR=4.87,95% CI：3.01-7.89）,diabetic patients（OR=3.40,95% CI：1.51-7.68）,Helicobacter pylori（Hp）carriers（OR=1.62,95% CI：1.03-2.57）;the increased risk of NAFLD prevalence in hyperuricaemia patients was 4.87,3.40,1.62,and 2.28 times higher than that of normal,non-diabetic,non-Hp carriers,and non-hyperuricemic individuals,respectively．And the adjusted interaction showed a multiplicative interaction of hyperuricaemia and obesity on the prevalence of NAFLD after controlling for the confounders（OR=0.30,95% CI：0.10-0.88,P=0.029）,but no additive interaction （relative excess risk due to interaction=3.15,attributable proportion due to interaction=0.24,and synergy index=1.34） interactions．Conclusions BMI,diabetes mellitus,and Hp were independent risk factors for the prevalence of NAFLD,with hyperuricaemia and overweight and obesity having multiplicative interaction and no additive interaction．

目的 比较早产胎膜早破(PPROM)≥34周的肥胖孕妇与非肥胖孕妇的早产儿住院结局。方法 回顾性分析2016年1月—2020年12月在本院出生并入住新生儿科的所有出生胎龄≥34周的PPROM早产儿。根据孕妇分娩时体质量指数(BMI),分为肥胖组(BMI≥30 kg/m²)和非肥胖组(BMI＜30 kg/m²),比较2组间的一般情况、妊娠结局及所生晚期早产儿的住院结局,组间比较采用两独立样本t检验及χ²检验。结果 与非肥胖孕妇相比,肥胖孕妇的晚期早产儿分娩后呼吸道并发症发病率高,主要表现为新生儿呼吸窘迫综合征,辅助通气、吸氧和表面活性物质的使用、败血症、感染性肺炎发病率高,母亲妊娠期糖尿病发病率增高,差异均具有统计学意义(P＜0.05),其余新生儿高胆红素血症、新生儿坏死性小肠结肠炎、脑室内出血、早产儿支气管肺发育不良等并发症比较无统计学意义(P＞0.05)。结论 PPROM≥34周的肥胖孕妇与非肥胖孕妇相比,所生晚期早产儿呼吸道并发症和败血症等不良结局的发生率增加。

Objective To compare the hospitalization outcomes of 34 weeks or over preterm infants with preterm premature rupture of membranes (PPROM) in obese and non-obese pregnant women. Methods A retrospective analysis of PPROM preterm infants born in our hospital and admitted to the neonatology department from January 2016 to December 2020 with a gestational age of 34 weeks or over was carried out. According to the pregnant women's body mass index (BMI) at delivery, they were divided into obese group (BMI≥30 kg/m²) and non-obese group (BMI<30 kg/m²). The general conditions, pregnancy outcomes and late premature infants hospitalization outcomes between the two groups were compared using two independent samples t test and χ² test. Results Compared with non-obese pregnant women, the incidence of respiratory complications after delivery in late preterm infants of obese pregnant women was higher, mainly manifested as high incidence of neonatal respiratory distress syndrome, assisted ventilation, oxygen inhalation and the use of surfactants, sepsis, and pneumonia, also maternal gestational diabetes incidence was increased, and the differences were statistically significant (P<0.05); other complications of neonatal hyperbilirubinemia, necrotizing enterocolitis, intraventricular hemorrhage, bronchopulmonary dysplasia were not statistically significant (P>0.05). Conclusions Compared with non-obese pregnant women with 34 weeks or over PPROM, obese pregnant women had an increased incidence of adverse outcomes in late preterm infants such as respiratory complications and sepsis.

目的 观察平胃散联合耳穴治疗单纯性肥胖的临床疗效及其对血清神经肽Y(Neuropeptide Y,NPY)和瘦素(Leptin,LP)水平的影响。方法 64例单纯性肥胖患者,采用数字表法随机分为治疗组33例和对照组31例。治疗组予口服平胃散免煎颗粒配合耳穴治疗,对照组予口服奥利司他胶囊治疗,疗程4周。观察治疗前后体质量、体质量指数(bodymass index,BMI)、体脂百分比(Fat%,F%)、腰臀比(Waist Hip Ratio,WHR)、NPY、LP的变化。结果 治疗后,治疗组和对照组体质量、BMI、F%、WHR、相关疾病的危险度均下降(P＜0.001)。比较治疗前后体质量、BMI、F%、WHR差值,治疗组下降均比对照组明显(P＜0.01、P＜0.001)。治疗组临床疗效优于对照组(P＜0.05)。治疗组和对照组血清NPY、LP水平均下降(P＜0.001),且治疗组较对照组下降(P＜0.001)。结论 平胃散联合耳穴有较好的减肥作用,其机制可能是通过降低血清中NPY、LP含量。

Objective Clinical observation of Pingwei Powder combined with auricular point therapy in treating simple obesity and the effect on serum NPY and leptin Levels. Methods 64 cases of simple obesity patients were randomized into treatment group(33 cases) and control group(31 cases). The treatment group was given Pingwei Powder combined with auricular point therapy.The control group was given Orlistat capsules. After being treated for 4 weeks, body weight, bodymass index(BMI), fat% (F%), waist hip ratio (WHR),neuropeptide y (NPY) and leptin(LP) were determined. Results After post-treatment in treatment group and control group, body weight, BMI, F%, WHR, the risk of related diseases all decreased (P＜0.001), The body weight, BMI, F%, WHR before and after treatment were lower than those in the control group(P＜0.01, P＜0.001). The clinical efficacy of the treatment group was better than that of the control group(P＜0.05). Serum NPY and LP levels in treatment group and control group were decreased (P＜0.001), and that the treatment group were lower than of the control group (P＜0.001). Conclusion Pingwei Powder combined with auricular point therapy have better in weight loss, which is possibly by way of reducing serum NPY, LP Levels.