17~45岁肥胖门诊患者的6分钟步行试验距离参考方程研究

doi:10.12114/j.issn.1007-9572.2023.0846

摘要/Abstract

摘要： 背景目前6分钟步行试验（6MWT）已经被广泛用于评估肥胖人群的运动能力，并为制订干预措施提供了参考依据。国外已有研究提出了其他人群的6MWT距离参考方程，但中国17~45岁且BMI≥30 kg/m2肥胖受试者的6MWT距离参考方程研究较少。目的为17~45岁门诊肥胖受试者制订6MWT距离参考方程，并评估其影响因素。方法根据美国胸科学会指南，前瞻性选取2022年6月—2023年9月于江苏省苏北人民医院内分泌科肥胖门诊部就诊的143名年龄17~45岁且BMI≥30 kg/m2的成年人（71名男性和72名女性），进行人体测量和6MWT。采用逐步多元回归模型建立6MWT距离参考方程，将新建立的6MWT距离参考方程与现有的预测方程进行比较。结果 143名受试者的平均6MWT距离为（506.1±49.8）m，其中男性平均6MWT距离为（515.7±50.1）m，大于女性的平均6MWT距离（496.6±47.9）m（P<0.05）。在年龄段17~23岁、24~30岁、31~37岁以及38~45岁中，男性与女性6MWT距离比较，差异均有统计学意义（P<0.05）。男性受试者的体质量、BMI、最大心率（HRmax）、心率差（ΔHR）、腰围、舒张压差（ΔDBP）、Borg量表评分差（ΔBorg）与6MWT距离相关（P<0.05），女性受试者的体质量、BMI、腰围与6MWT距离相关（P<0.05）。以步进的方法将潜在的影响因素纳入多元线性回归方程中，最终建立6MWT距离参考公式：男性y=494.463+1.414×ΔHR-3.903×BMI+0.874×HRmax，R2=0.429，女性y=670.448+0.299×ΔHR-4.342×BMI-0.195×HRmax，R2=0.312。结论 17~45岁门诊肥胖受试者中，男性的平均6MWT距离长于女性，且在不同年龄段均有显著差异。男性的体质量、BMI、HRmax、ΔHR、腰围、ΔDBP、ΔBorg与6MWT距离相关，女性的体质量、BMI、腰围、ΔSBP与6MWT距离相关。通过多元线性回归分析，为男性和女性分别建立了预测6MWT距离的参考方程，这些公式可能为评估个体的体能水平提供有价值的参考。

关键词: 肥胖症, 步行试验, 距离方程, 17~45岁, 6分钟步行试验, 影响因素分析

Abstract:

Background

The 6-minute walk test (6MWT) is extensively used to assess the exercise capacity of obese populations and offers a reference for devising intervention measures. While reference equations for the 6MWT distance for various populations have been proposed internationally, there is a scarcity of studies on reference equations for the 6MWT distance among Chinese obese subjects aged 17 to 45 years with a BMI ≥ 30 kg/m².

Objective

To develop reference equations for the 6MWT distance for outpatient obese subjects aged 17 to 45 years and to assess its influencing factors.

Methods

Following the American Thoracic Society guidelines, from June 2022 to September 2023, 143 adults aged 17 to 45 years with a BMI ≥30 kg/m² (71 males and 72 females) who visitied the Department of Endocrinology, Northern Jiangsu People's Hospital, were prospectively selected for anthropometric measurements and the 6MWT. A stepwise multiple regression model was employed to establish reference equations for the 6MWT distance, and the newly developed equations were compared with existing prediction equations.

Results

The average 6MWT distance for the 143 subjects was (506.1±49.8) m, with males averaging (515.7±50.14) m, which was greater than the females' average of (496.6±47.9) m (P<0.05). Across age groups 17-23, 24-30, 31-37, and 38-45 years, differences in 6MWT distances between males and females were statistically significant (P<0.05). In males, weight, BMI, HR_max, resting heart rate difference (ΔHR), waist circumference, diastolic blood pressure difference (ΔDBP), and Borg scale score difference (ΔBorg) were related to 6MWT distance (P<0.05), whereas in females, weight, BMI, and waist circumference were related to 6MWT distance (P<0.05). Incorporating potential influencing factors into a stepwise multiple linear regression equation, the final reference formulas were established as follows: for males, y=494.463+1.414×ΔHR-3.903×BMI+0.874×HR_max, R²=0.429; for females, y=670.448+0.299×ΔHR-4.342×BMI-0.195×HR_max, R²=0.312.

Conclusion

In outpatient obese patients aged 17 to 45 years, males had a longer average 6MWT distance than females, with significant differences across different age groups. Factors such as weight, BMI, HR_max, ΔHR, wait cirumference ΔDBP, and ΔBorg were associated with 6MWT distance in males, while weight, BMI, waist cirumference and ΔSBP were related to 6MWT distance in females. Through multiple linear regression analysis, reference equations predicting 6MWT distance were established for males and females, providing valuable references for assessing individual physical fitness levels.

Key words: Obesity, Walk test, Distance equation, 17~45 years old, 6-minute walk test, Root cause analysis

张家鸣,王欣宇,王道荣,等. 17~45岁肥胖门诊患者的6分钟步行试验距离参考方程研究[J]. 中国全科医学, 2025, 28(03): 330-334. DOI: 10.12114/j.issn.1007-9572.2023.0846.
ZHANG Jiaming,WANG Xinyu,WANG Daorong, et al. Reference Equations for the 6-Minute Walk Test Distance in Outpatient Obese Patients Aged 17 to 45 Years[J]. Chinese General Practice, 2025, 28(03): 330-334. DOI: 10.12114/j.issn.1007-9572.2023.0846.

图/表 4

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项目	男性（n=71）	女性（n=72）	t值	P值
年龄（岁）	28.1±9.7	26.3±8.2	1.14	0.257
身高（cm）	172.4±7.9	166.6±5.2	5.14	<0.001
体质量（kg）	108.7±21.2	97.3±18.2	3.45	0.001
BMI（kg/m²）	36.3±5.3	35.3±6.0	0.99	0.320
腰围（cm）	110.7±15.0	100.6±14.3	4.08	<0.001
HR_max（次/min）	139.9±13.9	147.1±14.5	-3.05	0.003
ΔHR（次/min）	28.7±10.6	27.9±10.7	0.43	0.667
ΔBorg（分）	4.1±1.6	4.7±2.1	-2.78	0.006
ΔSBP（mmHg）	16.3±6.4	19.5±6.0	-3.09	0.002
ΔDBP（mmHg）	7.37±4.5	10.4±4.7	0.44	<0.001
6MWT距离（m）	515.7±50.1	496.6±47.9	2.33	0.021

项目	男性（n=71）	女性（n=72）	t值	P值
年龄（岁）	28.1±9.7	26.3±8.2	1.14	0.257
身高（cm）	172.4±7.9	166.6±5.2	5.14	<0.001
体质量（kg）	108.7±21.2	97.3±18.2	3.45	0.001
BMI（kg/m²）	36.3±5.3	35.3±6.0	0.99	0.320
腰围（cm）	110.7±15.0	100.6±14.3	4.08	<0.001
HR_max（次/min）	139.9±13.9	147.1±14.5	-3.05	0.003
ΔHR（次/min）	28.7±10.6	27.9±10.7	0.43	0.667
ΔBorg（分）	4.1±1.6	4.7±2.1	-2.78	0.006
ΔSBP（mmHg）	16.3±6.4	19.5±6.0	-3.09	0.002
ΔDBP（mmHg）	7.37±4.5	10.4±4.7	0.44	<0.001
6MWT距离（m）	515.7±50.1	496.6±47.9	2.33	0.021

性别	17~23岁		24~30岁		31~37岁		38~45岁
性别	人数	6MWT距离	人数	6MWD	人数	6MWD	人数	6MWT距离
男性	25	521.8±59.2	23	498.0±44.9	13	532.6±36.6	10	519.2±46.5
女性	26	486.7±38.9	34	503.2±52.4	5	515.8±63.8	7	487.7±444.7
t值		2.51		-0.39		0.71		1.39
P值		<0.001		<0.001		<0.001		<0.001

性别	17~23岁		24~30岁		31~37岁		38~45岁
性别	人数	6MWT距离	人数	6MWD	人数	6MWD	人数	6MWT距离
男性	25	521.8±59.2	23	498.0±44.9	13	532.6±36.6	10	519.2±46.5
女性	26	486.7±38.9	34	503.2±52.4	5	515.8±63.8	7	487.7±444.7
t值		2.51		-0.39		0.71		1.39
P值		<0.001		<0.001		<0.001		<0.001

项目	男性（n=71）		女性（n=72）
项目	r_s值	P值	r_s值	P值
年龄	0.070	0.562	0.037	0.756
身高	-0.071	0.558	-0.032	0.791
体质量	-0.422	<0.001	-0.610	<0.001
BMI	-0.492	<0.001	-0.577	<0.001
ΔHR	0.518	<0.001	0.193	0.105
腰围	-0.336	0.004	-0.452	<0.001
HR_max	0.382	0.001	-0.182	0.126
ΔSBP	0.221	0.064	-0.090	0.451
ΔDBP	0.255	0.032	-0.141	0.236
ΔBorg	0.280	0.018	0.116	0.330