2013—2014年甘肃省成年人中心性肥胖流行特征
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摘要
目的分析甘肃地区18岁及以上成年人腰围水平及中心性肥胖流行情况。方法采用多阶段分层整群随机抽样方法,于2013年9月—2014年8月在甘肃省13个监测点抽取7800名18岁及以上常住居民,问卷调查获取人口学特征、个人生活方式等信息,通过体检获取体质指数、腰围等。最终分析了7607名成年人腰围水平和中心性肥胖的流行现状,描述中心性肥胖及中心性肥胖前期在不同性别、年龄、文化程度、收入及职业人群的分布特征。结果调查对象平均年龄为51.9岁,其中男性3216名(42.3%),女性4391名(57.7%)。甘肃省成年男女性腰围分别为(84.7±10.3)cm和(81.3±9.5)cm;随年龄增长,女性腰围呈增长趋势,由18～44岁组78.6 cm增至60岁以上组83.5 cm;随文化程度的提高,男性腰围逐渐升高,由文盲/半文盲组82.7 cm增至大专及以上组87.6 cm(P<0.001),女性腰围逐渐下降,由文盲/半文盲组81.9 cm降至大专及以上组77.6 cm(P<0.001);家庭人均年收入越高,男性腰围越高,由<5000元组83.0 cm增至≥18 000元组85.9 cm;职业人群中男性以企事业单位职工腰围最大(88.9 cm),女性则以企事业单位职工腰围最小(79.0 cm)。中心性肥胖率为32.6%(标化率28.8%),男女性分别为30.9%(标化率28.8%)和33.9%(标化率28.8%)。中心性肥胖前期率为18.1%(标化率17.6%),男女性分别为16.2%(标化率16.0%)和19.5%(标化率18.5%)。随年龄增长,女性中心性肥胖率呈上升趋势,由18～44岁组22.6%增至60岁以上组45.3%。随文化程度升高,男性中心性肥胖率呈上升趋势,由文盲/半文盲组23.0%上升至大专及以上组42.5%(P<0.001);女性中心性肥胖率则逐渐下降,由文盲/半文盲组36.1%降至大专及以上组20.1%(P<0.05)。随家庭人均年收入增长,男性中心性肥胖上升,由<5000元组23.8%上升至≥18 000元组的35.5%。职业人群中,企事业单位男性职工中心性肥胖率最高,为48.5%(P<0.001),女性中企事业单位职工最低,为25.8%(P<0.001)。在超重和肥胖的人群中,男性腰围分别为(88.3±7.4)cm和(98.8±8.3)cm,女性腰围分别为(84.4±6.7)cm和(94.5±8.1)cm;男性中心性肥胖率分别为43.3%,和87.7%,女性分别为47.3%和93.9%。在非超重/肥胖人群中,仍有6.0%的男性和9.8%的女性为中心性肥胖。结论甘肃地区中心性肥胖在成年人群广泛流行,男女性腰围均值已接近或超过中国中心性肥胖前期切点水平,中心性肥胖率高于全国平均水平,成年人中肥胖主要是中心性肥胖。
OBJECTIVE To analyze waist circumference level and the prevalence of central obesity among adults aged 18 years and above in Gansu Province.METHODS The data from Chinese adult chronic diseases and their risk factors monitoring in 2013 was obtained by multi-stage stratified cluster random sampling method. The waist circumference level and epidemiologic characteristics of central obesity of 7607 adults aged 18 years and above in Gansu Province were analyzed. RESULTS The waist circumference was(84.7±10.3)cm and(81.3±9.5)cm for adult men and women in Gansu Province, respectively. With the increase of age, waist circumference level of women showed a gradual increase trend from 78.6 cm in the group of 18-44 years to 83.5 cm in the group above 60 years; with improvement of education level, the average waist circumference of men gradually increased from 82.7 cm in illiterate/semi-literate group to 87.6 cm in group of junior college and above(P<0.001), but the value of women gradually reduced from 81.9 cm in illiterate/semi-literate group to 77.6 cm in group of junior college and above group(P<0.001); the higher the average annual income of family, the higher the waist circumference of the men from 83.0 cm in the group below 5000 yuan to 85.9 cm in the group above 18 000 yuan; among the occupational group, the highest waist circumference(88.9 cm) was the men engaged in enterprises and institutions and in contrast the women were the lowest in this occupation(79.0 cm). The prevalence of central obesity was 32.6%(standardized rate 28.8%) and men(33.9%)(standardized rate 28.8%) was higher than women(30.9%)(standardize rate 28.8%). The pre-obesity rate was 18.1%(standardized rate 17.6%), and that of women and men was 19.5%(standardized rate 18.5%) and 16.2%(standardized rate 16.0%), respectively. With the age increase, the central obesity rate of women showed a gradually increasing trend from 22.6% in the group of 18-44 years to 45.3% in the group above 60 years. With the increase of education level, the prevalence of central obesity showed increasing trend from 23.0% in illiterate/semi-literate group to 42.5% in group of college and above in men(P<0.001), but the prevalence of women gradually reduced from 36.1% in illiterate/semi-literate group to 20.1% in group of college and above group(P<0.001); with the increase in per capita annual income of the family, the prevalence of male central obesity increased from 23.8% in the group below 5000 yuan to 35.5% in the group above 18 000 yuan; among the professional groups, men predisposed central obesity(48.5%, P<0.001) and women had lowest prevalence(25.8%, P<0.001) in enterprises and institutions. Among the groups of overweight and obesity, the waist circumference was(88.3±7.4) cm and(98.8±8.3) cm in men, respectively, while the waist was(84.4±6.7)cm and(94.5±8.1)cm in women, respectively; the prevalence of central obesity was 43.3% and 87.7% in men and 47.3% and 93.9% in women between overweight and obese groups. However, the rate of central obesity in the groups without overweight/obesity(BMI<24.0) was only 6.0% in men and 9.8% in women. CONCLUSION The central obesity is widely prevalence in adults of Gansu Province, and the averaged waist circumference level in men and women is close to or more than the cut-off point predicating pre-central obesity and the prevalence for this type of obesity is higher than that of the national level which indicates that using cut-off point of waist circumference. The subjects with obesity are more likely susceptible to central obesity.
OBJECTIVE To analyze waist circumference level and the prevalence of central obesity among adults aged 18 years and above in Gansu Province.METHODS The data from Chinese adult chronic diseases and their risk factors monitoring in 2013 was obtained by multi-stage stratified cluster random sampling method. The waist circumference level and epidemiologic characteristics of central obesity of 7607 adults aged 18 years and above in Gansu Province were analyzed. RESULTS The waist circumference was(84.7±10.3)cm and(81.3±9.5)cm for adult men and women in Gansu Province, respectively. With the increase of age, waist circumference level of women showed a gradual increase trend from 78.6 cm in the group of 18-44 years to 83.5 cm in the group above 60 years; with improvement of education level, the average waist circumference of men gradually increased from 82.7 cm in illiterate/semi-literate group to 87.6 cm in group of junior college and above(P<0.001), but the value of women gradually reduced from 81.9 cm in illiterate/semi-literate group to 77.6 cm in group of junior college and above group(P<0.001); the higher the average annual income of family, the higher the waist circumference of the men from 83.0 cm in the group below 5000 yuan to 85.9 cm in the group above 18 000 yuan; among the occupational group, the highest waist circumference(88.9 cm) was the men engaged in enterprises and institutions and in contrast the women were the lowest in this occupation(79.0 cm). The prevalence of central obesity was 32.6%(standardized rate 28.8%) and men(33.9%)(standardized rate 28.8%) was higher than women(30.9%)(standardize rate 28.8%). The pre-obesity rate was 18.1%(standardized rate 17.6%), and that of women and men was 19.5%(standardized rate 18.5%) and 16.2%(standardized rate 16.0%), respectively. With the age increase, the central obesity rate of women showed a gradually increasing trend from 22.6% in the group of 18-44 years to 45.3% in the group above 60 years. With the increase of education level, the prevalence of central obesity showed increasing trend from 23.0% in illiterate/semi-literate group to 42.5% in group of college and above in men(P<0.001), but the prevalence of women gradually reduced from 36.1% in illiterate/semi-literate group to 20.1% in group of college and above group(P<0.001); with the increase in per capita annual income of the family, the prevalence of male central obesity increased from 23.8% in the group below 5000 yuan to 35.5% in the group above 18 000 yuan; among the professional groups, men predisposed central obesity(48.5%, P<0.001) and women had lowest prevalence(25.8%, P<0.001) in enterprises and institutions. Among the groups of overweight and obesity, the waist circumference was(88.3±7.4) cm and(98.8±8.3) cm in men, respectively, while the waist was(84.4±6.7)cm and(94.5±8.1)cm in women, respectively; the prevalence of central obesity was 43.3% and 87.7% in men and 47.3% and 93.9% in women between overweight and obese groups. However, the rate of central obesity in the groups without overweight/obesity(BMI<24.0) was only 6.0% in men and 9.8% in women. CONCLUSION The central obesity is widely prevalence in adults of Gansu Province, and the averaged waist circumference level in men and women is close to or more than the cut-off point predicating pre-central obesity and the prevalence for this type of obesity is higher than that of the national level which indicates that using cut-off point of waist circumference. The subjects with obesity are more likely susceptible to central obesity.
引文
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[3] BRAGG F,TANG K,GUO Y,et al.Associations of general and central adiposity with incident diabetes in Chinese men and women[J].Diabetes Care,2018,41(3):494-502.
[4] WHO Expert Consulation.Appropriate body-mass index for Asian populations and its implications for policy and intervention strategies[J].Lancet,2004,363(9403):157-163.
[5] 王丽敏,张梅,李镒冲,等.2013年中国慢性病及其危险因素监测总体方案[J].中华预防医学杂志,2018,52(2):191-194.
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[9] DALE C E,FATEMIFAR G,PALMER T M,et al.Causal associations of adiposity and body fat distribution with coronary heart disease,stroke subtypes,and type 2 diabetes mellitus:a mendelian randomization analysis[J].Circulation,2017,135(24):2373-2388.
[10] ZHAI Y,FANG H Y,YU W T,et al.Changes in waist circumference and abdominal obesity among chinese adults over a ten-year period[J].Biomed Environ Sci,2017,30(5):315-322.
[11] NI G H,ZHANG J,ZHENG F T.Status and trends of Chinese obesity epidemic [J].Food Nutr China,2013,19(10):70-74.
[12] SWINBURN B A,CATERSON I,SEIDELL J C,et al.Nutrition and the prevention of excess weight and obesity[J].Public Health Nutr,2004,7(1A):123-146.
[13] FORD E S,MAYNARD L M,LI C.Trends in mean waist circumference and abdominal obesity among US adults,1999-2012[J].JAMA,2014,312(11):1151-1153.
[14] 中国疾病预防控制中心,中国疾病预防控制中心慢性非传染性疾病预防控制中心.中国慢性病及其危险因素监测报告-2013[M].北京:军事医学出版社,2016.
[15] 翟屹,房红芸,于文涛,等,2010—2012年中国成年人腰围水平与中心型肥胖流行特征[J].中华预防医学杂志,2017,51(6):506-512.
[16] GE P,DONG C,REN Χ,et al.The high prevalence of low HDL-cholesterol levels and dyslipidemia in rural populations in Northwestern China[J].PLoS One,2015,10(12):e0144104.
[17] 罗水英,杨虹,蒙晓宇,等.2010年广西成人中心型肥胖流行现状及腰围分布特征分析[J].中国健康教育,2014,30(5):401-403.
[18] LEENERS B,GEARY N,TOBLER P N,et al.Ovarian hormones and obesity[J].Human Reprod Update,2017,3(23):300-321.
[19] NEWTON S,BRAITHWAITE D,AKINYEMIJU T F.Socio-economic status over the life course and obesity:systematic review and meta-analysis [J].PLoS One,2017,12(5):e0177151.
[20] HEO J,BECK A N,LIN S F,et al.Cohort-based income gradients in obesity among U.S.adults[J].Am J Hum Biol,2017,30(5):1-12.
[21] QOBADI M,PAYTON M.Racial disparities in obesity prevalence in mississippi:role of socio-demographic characteristics and physical activity[J].Int J Environ Res Public Health,2017,14(3):258.
[22] MCLAREN L.Socioeconomic status and obesity [J].Epidemiol Rev,2007,29:29-48.
[23] 王醴湘,吕筠,郭彧,等.中国慢性病前瞻性研究:10个项目地区成年人超重/肥胖现况分析[J].中华流行病学杂志,2015,36(11):1190-1194.
[2] MACIAS N,QUEZADA A D,FLORES M,et al.Accuracy of body fat percent and adiposity indicators cut of values to detect metabolic risk factors in a sample of Mexican adults [J].BMC Public Health,2014,14:341.
[3] BRAGG F,TANG K,GUO Y,et al.Associations of general and central adiposity with incident diabetes in Chinese men and women[J].Diabetes Care,2018,41(3):494-502.
[4] WHO Expert Consulation.Appropriate body-mass index for Asian populations and its implications for policy and intervention strategies[J].Lancet,2004,363(9403):157-163.
[5] 王丽敏,张梅,李镒冲,等.2013年中国慢性病及其危险因素监测总体方案[J].中华预防医学杂志,2018,52(2):191-194.
[6] 中华人民共和国卫生和计划生育委员会.成人体重判定:WS/T 428—2013[S].北京:中国标准出版社,2013.
[7] 中华人民共和国卫生部疾病预防控制司.中国成人超重和肥胖症预防控制指南[M].北京:人民卫生出版社,2006.
[8] YUSUF S,HAWKEN S,OUNPUU S,et al.Obesity and the risk of myocardial infarction in 27,000 participants from 52 countries:a case-control study[J].Lancet,2005,366(9497):1640-1649.
[9] DALE C E,FATEMIFAR G,PALMER T M,et al.Causal associations of adiposity and body fat distribution with coronary heart disease,stroke subtypes,and type 2 diabetes mellitus:a mendelian randomization analysis[J].Circulation,2017,135(24):2373-2388.
[10] ZHAI Y,FANG H Y,YU W T,et al.Changes in waist circumference and abdominal obesity among chinese adults over a ten-year period[J].Biomed Environ Sci,2017,30(5):315-322.
[11] NI G H,ZHANG J,ZHENG F T.Status and trends of Chinese obesity epidemic [J].Food Nutr China,2013,19(10):70-74.
[12] SWINBURN B A,CATERSON I,SEIDELL J C,et al.Nutrition and the prevention of excess weight and obesity[J].Public Health Nutr,2004,7(1A):123-146.
[13] FORD E S,MAYNARD L M,LI C.Trends in mean waist circumference and abdominal obesity among US adults,1999-2012[J].JAMA,2014,312(11):1151-1153.
[14] 中国疾病预防控制中心,中国疾病预防控制中心慢性非传染性疾病预防控制中心.中国慢性病及其危险因素监测报告-2013[M].北京:军事医学出版社,2016.
[15] 翟屹,房红芸,于文涛,等,2010—2012年中国成年人腰围水平与中心型肥胖流行特征[J].中华预防医学杂志,2017,51(6):506-512.
[16] GE P,DONG C,REN Χ,et al.The high prevalence of low HDL-cholesterol levels and dyslipidemia in rural populations in Northwestern China[J].PLoS One,2015,10(12):e0144104.
[17] 罗水英,杨虹,蒙晓宇,等.2010年广西成人中心型肥胖流行现状及腰围分布特征分析[J].中国健康教育,2014,30(5):401-403.
[18] LEENERS B,GEARY N,TOBLER P N,et al.Ovarian hormones and obesity[J].Human Reprod Update,2017,3(23):300-321.
[19] NEWTON S,BRAITHWAITE D,AKINYEMIJU T F.Socio-economic status over the life course and obesity:systematic review and meta-analysis [J].PLoS One,2017,12(5):e0177151.
[20] HEO J,BECK A N,LIN S F,et al.Cohort-based income gradients in obesity among U.S.adults[J].Am J Hum Biol,2017,30(5):1-12.
[21] QOBADI M,PAYTON M.Racial disparities in obesity prevalence in mississippi:role of socio-demographic characteristics and physical activity[J].Int J Environ Res Public Health,2017,14(3):258.
[22] MCLAREN L.Socioeconomic status and obesity [J].Epidemiol Rev,2007,29:29-48.
[23] 王醴湘,吕筠,郭彧,等.中国慢性病前瞻性研究:10个项目地区成年人超重/肥胖现况分析[J].中华流行病学杂志,2015,36(11):1190-1194.