JAMA Network Open:中国疾控中心施小明团队:高龄老人体质指数与日常生活自理能力失能风险的关系

2018-09-18 吕跃斌 科研圈

该原创性论著文章基于客观方法测量体质指数(BMI)与国际通用方法测量日常生活自理能力(ADL),利用16 022名80岁及以上高龄老人70 606人年随访样本信息,分析发现中国高龄老人较高的BMI与较低的ADL失能风险存在关联关系,研究提示高龄老人BMI推荐标准需要重新审视,在高龄老人的体重管理和ADL失能风险控制方面应更多关注低体重而非超重或肥胖。

2018年9月7日,JAMA Network Open刊登了中国疾病预防控制中心环境与健康相关产品安全所施小明研究团队的最新研究成果“Association of body mass index with disability in activities of daily living among Chinese adults 80 years of age or older”。该原创性论著文章基于客观方法测量体质指数(BMI)与国际通用方法测量日常生活自理能力(ADL),利用16 022名80岁及以上高龄老人70 606人年随访样本信息,分析发现中国高龄老人较高的BMI与较低的ADL失能风险存在关联关系,研究提示高龄老人BMI推荐标准需要重新审视,在高龄老人的体重管理和ADL失能风险控制方面应更多关注低体重而非超重或肥胖。

随着高血压、中风、2型糖尿病等患病率在全世界范围内的逐年增加,肥胖已成为一个日益严峻的公共卫生问题。该研究通过纵向研究探讨了中国高龄老人(80岁以上)BMI与其ADL中失能风险之间的关系,发现在高龄老人预防ADL失能中,需更加注意体重过低不是超重或肥胖的问题。

BMI与成年人身体机能受损及死亡率均呈U型关系,但这种关系随着年龄增长而逐步减弱。80岁以上高龄老人是中国人群中数量增长最快的群体,探究在这一年龄组BMI与日常生活能力中残疾风险是否存在关联极具现实意义。

本文使用惩罚样条Cox模型、Cox比例风险模型,并控制相关混杂因素。利用中国23个省份,16 022名高龄老人探讨中国高龄老人BMI与ADL失能的相关性。

BMI与ADL失能呈线性相关,BMI每增加1 kg/m2,ADL失能风险降低4.5%。将BMI按照中国肥胖问题工作组颁布的指南分级时,与BMI正常组(BMI:18.5~24.0)相比,体重过低组(BMI<18.5)的ADL失能风险显著增加,危险比为1.34(95%CI:1.28-1.41);而超重或肥胖组(BMI≥24.0)的ADL失能风险明显降低(危险比0.84;95%CI:0.78-0.91;P<0.001)。

图1 不同分位数BMI中国高龄老人ADL残疾的发生率
(图片来源:JAMA Network Open)

中高龄老年人群ADL失能的发生率整体显示出随BMI分位数升高而降低的趋势。整个队列人群发生率为11.5例/100人-年,第一分位组高达14.3例/100人-年,而第五分位组为8.4例/100人-年。



图2 Cox比例风险回归模型中BMI与ADL失能的相关性
(图片来源:JAMA Network Open)

通过惩罚样条Cox回归模型分析ADL残疾发生风险与BMI的潜在曲线关系,结果显示二者整体上线性关系(P<.001),ADL失能发生风险随BMI升高而显著降低。



图3 80岁以上成年人BMI与ADL残疾的关系
(图片来源:JAMA Network Open)

控制基本信息、生活方式、基础疾病等混杂因素后,按中国指南肥胖分级以及BMI分位数分组进行COX回归分析均显示BMI低伴随着ADL残疾的发生风险显著升高。

公共卫生及临床实践意义:

施小明研究团队在此项以社区为基础的中国高龄老人前瞻性大型队列研究中发现对于80岁或以上的老年人,BMI较高组ADL失能风险较低。因此,为了预防ADL失能,在80岁及以上的老年人中应该更加关注体重过低,而不是超重或肥胖的问题。研究结果进一步支持了世界卫生组织或中国肥胖工作组有关超重和肥胖的指南并不适用于高龄老人的观点。随着预期寿命的增加以及超重、肥胖人群数量的增加,在未来的研究中,重新评估BMI在80岁或以上老年人群的疾病人口负担中的作用是极为重要的。同时,在公共卫生政策制定时可能需要根据80岁以上高龄老人的特殊性为其制定特定的体重管理指南,从而更好地开展高龄老人肥胖相关疾病的防控工作,降低失能风险,提高生活质量,促进健康长寿。

施小明研究团队今年还在BMJ杂志以及两次在中科院一区期刊Journal of the American Medical Directors Association(JAMDA,影响因子5.325)发表有关体质指数和血压与高龄老人健康的关系研究,研究结果均提示对这一年龄段的人群应审慎地、个体化地开展体重管理和血压管理。这一系列原创性研究成果对高龄老人疾病防控和健康促进具有重要指导意义,为相关公共卫生政策的制定提供重要参考依据

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createdName=xlysu, createdTime=Thu Sep 20 12:38:00 CST 2018, time=2018-09-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1457216, encodeId=5b23145e2161a, content=<a href='/topic/show?id=e936266e7a4' target=_blank style='color:#2F92EE;'>#体质指数#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=49, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=26677, encryptionId=e936266e7a4, topicName=体质指数)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=41e05859443, createdName=tigerlr100, createdTime=Thu Sep 20 12:38:00 CST 2018, time=2018-09-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1530243, encodeId=667b1530243c8, content=<a href='/topic/show?id=5b3d21912a7' target=_blank style='color:#2F92EE;'>#中国疾控中心#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=38, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=21912, encryptionId=5b3d21912a7, topicName=中国疾控中心)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=fbd912073499, createdName=tcm103hq, createdTime=Thu Sep 20 12:38:00 CST 2018, time=2018-09-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=345579, encodeId=c9313455e9bf, content=不错的文章值得拥有哦哦, beContent=null, objectType=article, channel=null, level=null, likeNumber=71, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=eff51996281, createdName=1e1b8538m79(暂无匿称), createdTime=Tue Sep 18 23:02:13 CST 2018, time=2018-09-18, status=1, ipAttribution=)]
  4. 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createdBy=6c32257, createdName=DEXTER3139, createdTime=Sat Dec 08 16:38:00 CST 2018, time=2018-12-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1820379, encodeId=cfe718203e9ff, content=<a href='/topic/show?id=c87f10089032' target=_blank style='color:#2F92EE;'>#风险的关系#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=33, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=100890, encryptionId=c87f10089032, topicName=风险的关系)], attachment=null, authenticateStatus=null, createdAvatar=http://login.medsci.cn/upload/avatar/cc81592b507031e3cfd8d4c57911d98b/62c22832a9474aea1ca90ca058aebc03.jpg, createdBy=bed5446, createdName=limedical1974, createdTime=Mon Dec 03 08:38:00 CST 2018, time=2018-12-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1727594, encodeId=c3751e2759484, content=<a href='/topic/show?id=986913980dd' target=_blank style='color:#2F92EE;'>#PE#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=13980, encryptionId=986913980dd, topicName=PE)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=a12645, createdName=智智灵药, createdTime=Sat Aug 24 06:38:00 CST 2019, time=2019-08-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1734061, encodeId=e12d1e340610d, content=<a href='/topic/show?id=d4f412668a4' target=_blank style='color:#2F92EE;'>#NET#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=35, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=12668, encryptionId=d4f412668a4, topicName=NET)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=7ea033781210, createdName=canlab, createdTime=Tue Sep 03 17:38:00 CST 2019, time=2019-09-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1405327, encodeId=c529140532ee4, content=<a href='/topic/show?id=3f67e0632c0' target=_blank style='color:#2F92EE;'>#疾控中心#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=37, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=70632, encryptionId=3f67e0632c0, topicName=疾控中心)], attachment=null, authenticateStatus=null, createdAvatar=http://thirdqq.qlogo.cn/qqapp/1103841572/0AD7956C8522FF8EF9A242DC5569528A/100, createdBy=d51a2536255, createdName=zutt, createdTime=Thu Sep 20 12:38:00 CST 2018, time=2018-09-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1416079, encodeId=d39314160e924, content=<a href='/topic/show?id=99fb1028231b' target=_blank style='color:#2F92EE;'>#高龄#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=102823, encryptionId=99fb1028231b, topicName=高龄)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=307c3130149, createdName=xlysu, createdTime=Thu Sep 20 12:38:00 CST 2018, time=2018-09-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1457216, encodeId=5b23145e2161a, content=<a href='/topic/show?id=e936266e7a4' target=_blank style='color:#2F92EE;'>#体质指数#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=49, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=26677, encryptionId=e936266e7a4, topicName=体质指数)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=41e05859443, createdName=tigerlr100, createdTime=Thu Sep 20 12:38:00 CST 2018, time=2018-09-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1530243, encodeId=667b1530243c8, content=<a href='/topic/show?id=5b3d21912a7' target=_blank style='color:#2F92EE;'>#中国疾控中心#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=38, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=21912, encryptionId=5b3d21912a7, topicName=中国疾控中心)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=fbd912073499, createdName=tcm103hq, createdTime=Thu Sep 20 12:38:00 CST 2018, time=2018-09-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=345579, encodeId=c9313455e9bf, content=不错的文章值得拥有哦哦, beContent=null, objectType=article, channel=null, level=null, likeNumber=71, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=eff51996281, createdName=1e1b8538m79(暂无匿称), createdTime=Tue Sep 18 23:02:13 CST 2018, time=2018-09-18, status=1, ipAttribution=)]
    2019-08-24 智智灵药
  5. 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href='/topic/show?id=3f67e0632c0' target=_blank style='color:#2F92EE;'>#疾控中心#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=37, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=70632, encryptionId=3f67e0632c0, topicName=疾控中心)], attachment=null, authenticateStatus=null, createdAvatar=http://thirdqq.qlogo.cn/qqapp/1103841572/0AD7956C8522FF8EF9A242DC5569528A/100, createdBy=d51a2536255, createdName=zutt, createdTime=Thu Sep 20 12:38:00 CST 2018, time=2018-09-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1416079, encodeId=d39314160e924, content=<a href='/topic/show?id=99fb1028231b' target=_blank style='color:#2F92EE;'>#高龄#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=102823, encryptionId=99fb1028231b, topicName=高龄)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=307c3130149, createdName=xlysu, createdTime=Thu Sep 20 12:38:00 CST 2018, time=2018-09-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1457216, encodeId=5b23145e2161a, content=<a href='/topic/show?id=e936266e7a4' target=_blank style='color:#2F92EE;'>#体质指数#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=49, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=26677, encryptionId=e936266e7a4, topicName=体质指数)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=41e05859443, createdName=tigerlr100, createdTime=Thu Sep 20 12:38:00 CST 2018, time=2018-09-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1530243, encodeId=667b1530243c8, content=<a href='/topic/show?id=5b3d21912a7' target=_blank style='color:#2F92EE;'>#中国疾控中心#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=38, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=21912, encryptionId=5b3d21912a7, topicName=中国疾控中心)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=fbd912073499, createdName=tcm103hq, createdTime=Thu Sep 20 12:38:00 CST 2018, time=2018-09-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=345579, encodeId=c9313455e9bf, content=不错的文章值得拥有哦哦, beContent=null, objectType=article, channel=null, level=null, likeNumber=71, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=eff51996281, createdName=1e1b8538m79(暂无匿称), createdTime=Tue Sep 18 23:02:13 CST 2018, time=2018-09-18, status=1, ipAttribution=)]
    2019-09-03 canlab
  6. 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href='/topic/show?id=3f67e0632c0' target=_blank style='color:#2F92EE;'>#疾控中心#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=37, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=70632, encryptionId=3f67e0632c0, topicName=疾控中心)], attachment=null, authenticateStatus=null, createdAvatar=http://thirdqq.qlogo.cn/qqapp/1103841572/0AD7956C8522FF8EF9A242DC5569528A/100, createdBy=d51a2536255, createdName=zutt, createdTime=Thu Sep 20 12:38:00 CST 2018, time=2018-09-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1416079, encodeId=d39314160e924, content=<a href='/topic/show?id=99fb1028231b' target=_blank style='color:#2F92EE;'>#高龄#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=102823, encryptionId=99fb1028231b, topicName=高龄)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=307c3130149, createdName=xlysu, createdTime=Thu Sep 20 12:38:00 CST 2018, time=2018-09-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1457216, encodeId=5b23145e2161a, content=<a href='/topic/show?id=e936266e7a4' target=_blank style='color:#2F92EE;'>#体质指数#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=49, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=26677, encryptionId=e936266e7a4, topicName=体质指数)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=41e05859443, createdName=tigerlr100, createdTime=Thu Sep 20 12:38:00 CST 2018, time=2018-09-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1530243, encodeId=667b1530243c8, content=<a href='/topic/show?id=5b3d21912a7' target=_blank style='color:#2F92EE;'>#中国疾控中心#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=38, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=21912, encryptionId=5b3d21912a7, topicName=中国疾控中心)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=fbd912073499, createdName=tcm103hq, createdTime=Thu Sep 20 12:38:00 CST 2018, time=2018-09-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=345579, encodeId=c9313455e9bf, content=不错的文章值得拥有哦哦, beContent=null, objectType=article, channel=null, level=null, likeNumber=71, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=eff51996281, createdName=1e1b8538m79(暂无匿称), createdTime=Tue Sep 18 23:02:13 CST 2018, time=2018-09-18, status=1, ipAttribution=)]
    2018-09-20 zutt
  7. [GetPortalCommentsPageByObjectIdResponse(id=1798388, encodeId=92d91e983883b, content=<a href='/topic/show?id=ab566916623' target=_blank style='color:#2F92EE;'>#生活自理能力#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=69166, encryptionId=ab566916623, topicName=生活自理能力)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=524d95, createdName=zhaozhouchifen, createdTime=Tue Aug 13 19:38:00 CST 2019, time=2019-08-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2048293, encodeId=1ef22048293f5, content=<a href='/topic/show?id=f8062191152' target=_blank style='color:#2F92EE;'>#中国疾控#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=33, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=21911, encryptionId=f8062191152, topicName=中国疾控)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=6c32257, createdName=DEXTER3139, createdTime=Sat Dec 08 16:38:00 CST 2018, time=2018-12-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1820379, encodeId=cfe718203e9ff, content=<a href='/topic/show?id=c87f10089032' target=_blank style='color:#2F92EE;'>#风险的关系#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=33, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=100890, encryptionId=c87f10089032, topicName=风险的关系)], attachment=null, authenticateStatus=null, createdAvatar=http://login.medsci.cn/upload/avatar/cc81592b507031e3cfd8d4c57911d98b/62c22832a9474aea1ca90ca058aebc03.jpg, createdBy=bed5446, createdName=limedical1974, createdTime=Mon Dec 03 08:38:00 CST 2018, time=2018-12-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1727594, encodeId=c3751e2759484, content=<a href='/topic/show?id=986913980dd' target=_blank style='color:#2F92EE;'>#PE#</a>, beContent=null, objectType=article, 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href='/topic/show?id=3f67e0632c0' target=_blank style='color:#2F92EE;'>#疾控中心#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=37, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=70632, encryptionId=3f67e0632c0, topicName=疾控中心)], attachment=null, authenticateStatus=null, createdAvatar=http://thirdqq.qlogo.cn/qqapp/1103841572/0AD7956C8522FF8EF9A242DC5569528A/100, createdBy=d51a2536255, createdName=zutt, createdTime=Thu Sep 20 12:38:00 CST 2018, time=2018-09-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1416079, encodeId=d39314160e924, content=<a href='/topic/show?id=99fb1028231b' target=_blank style='color:#2F92EE;'>#高龄#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=102823, encryptionId=99fb1028231b, topicName=高龄)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=307c3130149, createdName=xlysu, createdTime=Thu Sep 20 12:38:00 CST 2018, time=2018-09-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1457216, encodeId=5b23145e2161a, content=<a href='/topic/show?id=e936266e7a4' target=_blank style='color:#2F92EE;'>#体质指数#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=49, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=26677, encryptionId=e936266e7a4, topicName=体质指数)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=41e05859443, createdName=tigerlr100, createdTime=Thu Sep 20 12:38:00 CST 2018, time=2018-09-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1530243, encodeId=667b1530243c8, content=<a href='/topic/show?id=5b3d21912a7' target=_blank style='color:#2F92EE;'>#中国疾控中心#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=38, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=21912, encryptionId=5b3d21912a7, topicName=中国疾控中心)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=fbd912073499, createdName=tcm103hq, createdTime=Thu Sep 20 12:38:00 CST 2018, time=2018-09-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=345579, encodeId=c9313455e9bf, content=不错的文章值得拥有哦哦, beContent=null, objectType=article, channel=null, level=null, likeNumber=71, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=eff51996281, createdName=1e1b8538m79(暂无匿称), createdTime=Tue Sep 18 23:02:13 CST 2018, time=2018-09-18, status=1, ipAttribution=)]
    2018-09-20 xlysu
  8. [GetPortalCommentsPageByObjectIdResponse(id=1798388, encodeId=92d91e983883b, content=<a href='/topic/show?id=ab566916623' target=_blank style='color:#2F92EE;'>#生活自理能力#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=69166, encryptionId=ab566916623, topicName=生活自理能力)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=524d95, createdName=zhaozhouchifen, createdTime=Tue Aug 13 19:38:00 CST 2019, time=2019-08-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2048293, encodeId=1ef22048293f5, content=<a href='/topic/show?id=f8062191152' target=_blank style='color:#2F92EE;'>#中国疾控#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=33, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=21911, encryptionId=f8062191152, topicName=中国疾控)], attachment=null, authenticateStatus=null, createdAvatar=, 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encryptionId=5b3d21912a7, topicName=中国疾控中心)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=fbd912073499, createdName=tcm103hq, createdTime=Thu Sep 20 12:38:00 CST 2018, time=2018-09-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=345579, encodeId=c9313455e9bf, content=不错的文章值得拥有哦哦, beContent=null, objectType=article, channel=null, level=null, likeNumber=71, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=eff51996281, createdName=1e1b8538m79(暂无匿称), createdTime=Tue Sep 18 23:02:13 CST 2018, time=2018-09-18, status=1, ipAttribution=)]
  9. [GetPortalCommentsPageByObjectIdResponse(id=1798388, encodeId=92d91e983883b, content=<a href='/topic/show?id=ab566916623' target=_blank style='color:#2F92EE;'>#生活自理能力#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=69166, encryptionId=ab566916623, topicName=生活自理能力)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=524d95, createdName=zhaozhouchifen, createdTime=Tue Aug 13 19:38:00 CST 2019, time=2019-08-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2048293, encodeId=1ef22048293f5, content=<a href='/topic/show?id=f8062191152' target=_blank style='color:#2F92EE;'>#中国疾控#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=33, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=21911, encryptionId=f8062191152, topicName=中国疾控)], attachment=null, authenticateStatus=null, createdAvatar=, 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  10. [GetPortalCommentsPageByObjectIdResponse(id=1798388, encodeId=92d91e983883b, content=<a href='/topic/show?id=ab566916623' target=_blank style='color:#2F92EE;'>#生活自理能力#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=69166, encryptionId=ab566916623, topicName=生活自理能力)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=524d95, createdName=zhaozhouchifen, createdTime=Tue Aug 13 19:38:00 CST 2019, time=2019-08-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2048293, encodeId=1ef22048293f5, content=<a href='/topic/show?id=f8062191152' target=_blank style='color:#2F92EE;'>#中国疾控#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=33, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=21911, encryptionId=f8062191152, topicName=中国疾控)], attachment=null, authenticateStatus=null, createdAvatar=, 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createdName=xlysu, createdTime=Thu Sep 20 12:38:00 CST 2018, time=2018-09-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1457216, encodeId=5b23145e2161a, content=<a href='/topic/show?id=e936266e7a4' target=_blank style='color:#2F92EE;'>#体质指数#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=49, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=26677, encryptionId=e936266e7a4, topicName=体质指数)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=41e05859443, createdName=tigerlr100, createdTime=Thu Sep 20 12:38:00 CST 2018, time=2018-09-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1530243, encodeId=667b1530243c8, content=<a href='/topic/show?id=5b3d21912a7' target=_blank style='color:#2F92EE;'>#中国疾控中心#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=38, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=21912, encryptionId=5b3d21912a7, topicName=中国疾控中心)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=fbd912073499, createdName=tcm103hq, createdTime=Thu Sep 20 12:38:00 CST 2018, time=2018-09-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=345579, encodeId=c9313455e9bf, content=不错的文章值得拥有哦哦, beContent=null, objectType=article, channel=null, level=null, likeNumber=71, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=eff51996281, createdName=1e1b8538m79(暂无匿称), createdTime=Tue Sep 18 23:02:13 CST 2018, time=2018-09-18, status=1, ipAttribution=)]
    2018-09-18 1e1b8538m79(暂无匿称)

    不错的文章值得拥有哦哦

    0

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