天津市北辰区社区老年人腰围及向心性肥胖流行趋势分析

目的 分析2011-2013年天津市北辰区社区老年人腰围平均水平,超重、肥胖及向心性肥胖检出率的变化情况.方法 利用2011-2013年天津市北辰区果园新村街及双街镇≥60岁社区居民的体检资料进行统计分析.结果 该社区老年人3年间向心性肥胖的检出率最高,其次为超重及肥胖.超重的标化检出率呈逐年降低趋势(x2趋势=7.99,P =0.005);肥胖的标化检出率于2012年有所下降,于2013年呈大幅度提高(x2=186.39,P＜0.001);向心性肥胖的标化检出率呈逐年上升趋势(x2趋势=28.84,P＜0.001).2011-2013年男性腰围平均水平均高于女性,男性向心性肥胖的标化检出率均低于女性(均有P ＜0.05);3年间各年龄组人群的腰围平均水平均有所增长,60～岁年龄组增长幅度最大.各年龄组人群向心性肥胖的标化检出率随着年龄的增加呈现先升后降的趋势(均有P ＜0.05),于65～岁年龄组达到最大值.结论 3年间天津市北辰区社区老年人的腰围平均水平、肥胖以及向心性肥胖的检出率升高,因此应加强老年人群肥胖的防制工作,降低相关慢性疾病的发生率,提高老年人群的生活质量.     

贵阳市20～69岁人群腹型肥胖状况调查

目的 对2005年贵州省贵阳市城镇及乡村20～69岁居民有腹型肥胖状况进行检测分析.方法 采集贵阳市2005年20～69岁人群的腰围和臀围数据,计算腰臀比、腹型肥胖率、腰围及腰臀比均值.结果 贵阳市男性25～29岁、女性40～44岁年龄组腹型肥胖率增长幅度最大;男性60～64岁、女性65～69岁年龄组腹型肥胖率最高,达58.22%,86.36%;45～69岁女性腹型肥胖率显著高于男性(P<0.01).与贵州省贵阳市2000年相比,男女腰臀比均值及男性部分年龄组、女性各年龄组匀值明显增大(P<0.05,P<0.01);女性腰围比贵州省2000年增大3.01～6.65 cm(P<0.01),男性腰围低于2005年全国均值2.14～3.95 cm(P<0.01),女性腰围高于全国均值1.48～4.56cm(P<0.01).结论 贵阳市男女性25岁起应注意监控腰围及腰臀比,女性进入40岁后腹型肥胖人数比例相对偏高.     

11省市队列人群代谢综合征的流行病学研究

目的　探讨队列人群代谢综合征的流行病学特征。方法　在 1992年对 11省市队列人群 (35～ 6 4岁 ) 2 7739人进行基线危险因素的调查。计算队列人群代谢综合征患者各种因素的均值±标准差和标化患病率。结果　 (1) 11省市队列人群有代谢综合征者高腰围的百分率最高 ,男性为89 0 % ,女性为 85 1%。其他主要指标 (除高密度脂蛋白 )男性均高于女性 ;(2 )代谢综合征患病率为13 3% ,其中男性为 12 7% ,女性为 14 2 % ,且随年龄的增加而增长 ;(3)多元logistic分析结果表明 ,腰围和糖尿病家族史是男性代谢综合征患者的危险因素 ,女性为腰围和高血压家族史。高密度脂蛋白增高是代谢综合征的保护因素。结论　 11省市队列人群代谢综合征患病率较高 ,腰围增大是代谢综合征重要的危险因素。     

宁波市35～74岁城市居民腹部肥胖流行特征分析

目的了解宁波市城区35～74岁人群腹部肥胖的流行特点及相关因素,为开展肥胖的干预工作提供依据。方法采用多阶段随机抽样的方法对宁波市城区8个社区35～74岁的居民进行流行病学调查。结果共调查35～74岁居民7903人,腰围均值（79.2±9.8）cm,男性高于女性（t=20.66,P〈0.01）;男、女性腰围均随年龄的上升而上升,呈线性相关关系,且差异均有统计学意义;腹部肥胖的标化发生率为38.2%,男、女性分别为36.3%和39.6%,男性低于女性（u=2.84,P〈0.01）;随着年龄的增加,男、女性腹部肥胖的发生率呈现上升趋势,趋势χ2检验差异均有统计学意义。非条件Logistic回归分析结果表明：男性、文化程度为大学或大学以上、年龄55～74岁、常吃富含油脂的食品及饮酒者的腹部肥胖发生率高;女性及经常参加体育锻炼者的腹部肥胖发生率低。结论腹部肥胖由多种因素引起,应当采取综合性干预措施控制腹部肥胖的发生。     

中国九省区1993—2006年成年人腰围分布的变化及中心性肥胖流行趋势分析

目的 分析1993-2006年中国9省区20～65岁的成年居民腰围分布的变化及中心性肥胖的流行趋势.方法 以1993、1997、2000、2004和2006年"中国健康与营养调查"资料中20～65岁健康成年人作为研究对象,应用Stata软件分析成年人腰围分布的变化,并使用LMS方法分别拟合男性和女性各调查年份P15、P50和P85百分位数曲线;以2002年由卫生部疾病控制司颁布实施的<中国成年人超重和肥胖症预防控制指南>中男性腰围≥85 cm、女性腰围≥80 cm作为判断成年人中心性肥胖的标准,应用SAS软件分析成年人腰围分布和中心性肥胖率的城乡差别及腰围与BMI的相关性.结果 1993-2006年中国20～65岁成年男性腰围均值从77.1 cm增加至82.9 cm,中心性肥胖率从17.9%增加至42.5%,平均增长速度为1.9%;女性腰围均值从75.8 cm增加至78.9 cm,中心性肥胖率从28.8%增加至46.9%,平均增长速度为1.4%.男性和40岁以上农村女性是腰围和中心性肥胖率增长最快的人群.由于农村女性腰围和中心性肥胖率的增长均高于城市女性,到2006年女性腰围和中心性肥胖率的城乡差异消失.BMI处于正常范围的成年人中心性肥胖率呈现增加的趋势,2006年BMI正常的男性中有21.6%、女性中有27.4%处于中心性肥胖状态. 结论 1993-2006年中国20～65岁成年居民腰围呈现逐年增大的趋势;随着腰围的增大,中心性肥胖率也呈现逐年增加,男性腰围及中心性肥胖率的增长幅度高于女性;只有控制成年人腰围和中心性肥胖率过快增长,才能有效地控制与肥胖相关的慢性非传染性疾病患病率的增加.     

江汉平原某农村居民肥胖超重流行现状及影响因素

目的了解江汉平原某农村>35岁居民肥胖超重流行现状与影响因素。方法采用整群抽样方法,抽取江汉平原某农村1 692名≥35岁常住居民进行现场调查。结果 >35岁居民超重、肥胖和中心性肥胖的年龄标化患病率分别为26.52%、7.73%和24.06%,其中男性分别为23.82%、7.36%和20.49%,女性分别为28.41%、7.99%和26.57%。在不同年龄组中,男性超重肥胖患病率最高为35～44岁年龄段,而女性患病率最高的年龄段为45～64岁。超重肥胖患病率随着居民膳食消费水平的增高而呈上升趋势;超重肥胖人群中高血压和糖尿病的患病率分别为23.21%和4.01%。结论江汉平原某农村中老年人群超重肥胖现状不容乐观,需加大对重点人群的健康教育与综合防治干预措施力度。     

不同类型肥胖与心血管疾病危险因素关联的比较

目的 比较不同类型肥胖与心血管疾病(CVD)危险因素的关联,为预防和控制心血管疾病提供科学依据.方法 利用"2002年中国居民营养与健康状况调查"资料,按照<中国成人超重和肥胖症预防控制指南>中判定肥胖的界值点[体重指数(BMI):24kg/m2和28 kg/m2;腰围:男性85 cm和95 cm,女性80 cm和90 cm]判定肥胖类型,比较不同类型肥胖人群与罹患CVD危险因素的关联;用logistic回归和多元线性回归分析BMI和腰围与CVD危险因素的关系.结果 与体重和腰围均在正常范围的人群(OR=1)相比,正常体重并高腰围Ⅰ(男性85～95 cm,女性80～90 cm)的人群、超重但腰围正常的人群罹患CVD危险因素的风险为1～2倍,超重并高腰围Ⅰ、肥胖但腰围正常的人群为2～3倍,超重并高腰围Ⅱ(男性≥95 cm,女性≥90 cm)、肥胖并高腰围Ⅰ或Ⅱ(男性≥85 cm,女性≥80 cm)的人群为≥3倍;同一腰围组中,随着BMI增加罹患CVD危险因素的风险也呈逐渐增加趋势;BMI和腰围同时解释CVD危险因素变异的1.7%～9.4%,大于BMI或腰围单独解释的比例(1.5%～9.0%);BMI对于收缩压的标化回归系数为0.129,略大于腰围(0.123),腰围对甘油三酯、总胆固醇和高密度脂蛋白胆同醇标化回归系数的绝对值大于BMI.结论 BMI和腰围与CVD危险因素独立相关,建议评估疾病危险时同时使用BMI和腰围两项指标.     

上海市35-74岁成人代谢综合征腰围切点的研究

［目的］ 探寻上海市35-74 岁人群中代谢综合征（metabolic syndrome,MS）相关肥胖程度的腰围切点。 ［方法］采用多阶段随机抽样方法,在上海市35~74 岁居民中进行横断面调查,共调查7 414 名个体。分析男性和女性不同腰围水平与MS 其他因素的关系,以获得检出2 个及以上危险因素敏感性和特异性均较好的腰围切点。 ［结果］ 随腰围增大,MS 危险因素聚集的比值比（OR）也随之升高,检出2 个及以上MS 危险因素的特异度和阳性预测值逐渐增高,而敏感度和阴性预测值逐渐下降。当男性腰围≥ 85 cm、女性腰围≥ 80 cm,检出2 个及以上MS 危险因素的敏感度为68.33%（男性）、70.17%（女性）,特异度为58.48%（男性）、58.36%（女性）,受试者工作特征曲线（ROC）距离最短,分别为男性0.522 1、女性0.512 2。 ［结论］ 当男性腰围≥ 85 cm、女性腰围≥ 80 cm时,能较好反映MS 危险因素的聚集,为本研究人群代谢综合征肥胖的腰围切点。     

中国11省市35～64岁人群应用不同代谢综合征诊断标准的比较

目的比较美国国家胆固醇教育计划成人治疗方案第三次报告(NCEP-ATPⅢ)、国际糖尿病联盟(IDF)和中华医学会糖尿病学分会(CDS)建议的代谢综合征(MS)诊断标准在中国35～64岁人群中应用的差异。方法1992年对中国11省市35～64岁人群共29 564人进行了心血管病危险因素基线调查,1996—1999年又入选了35～64岁男女两性共3129人,分别应用三种标准计算该人群MS的患病率,分析不同标准时MS异常组分及危险因素聚集的检出情况,比较三种标准在中国人群中应用的一致性和差异。结果(1)应用ATPⅢ、IDF和CDS标准计算中国人群MS的年龄标化患病率分别为18.7%、14.6%和9.0%。(2)ATPⅢ诊断MS中有77.8%的人有中心性肥胖,22.2%无中心性肥胖;IDF诊断为非MS者中还有4.6%的人有3个及以上危险因素聚集;CDS诊断为非MS者中还有11.2%的人有3个及以上危险因素聚集。(3)ATPⅢ和IDF诊断标准在中国人群中应用的一致性较好,男女两性的Kappa值分别为0.795和0.899;CDS诊断标准与另两种诊断标准的一致性不高。(4)男性腰围切点为85 cm,女性腰围切点为80 cm时,预测危险因素聚集的ROC曲线距离分别为0.40和0.34,其在所选择的切点中ROC曲线距离相对最短。结论在三种MS诊断标准中,ATPⅢ诊断中国人群MS的患病率及检出危险因素聚集的比例最高;适宜中国人群的最佳腰围切点为男性85 cm、女性80 cm。     

1993-2011年中国9省区成年人腰围分布变化趋势

目的分析1993-2011年中国9省区18～65岁成年居民腰围分布变化及中心型肥胖流行趋势。方法以"中国健康与营养调查"1993-2011年7轮调查资料中18～65岁成人为研究对象,以国标WS/T 428-2013为标准,采用偏度均值变异系数(LMS)法揭示腰围分布变化趋势。结果 1993-2011年间中国9省区18～65岁成人腰围分布峰值下降,曲线右移。腰围百分位数曲线第15、50、85百分位均显示增高趋势,高百分位增高更明显。腰围均值男性从76.5cm增至84.0 cm,女性从75.3 cm增至80.6 cm。中心型肥胖率男性从8.4%增至30.4%,女性从15.2%增至28.1%,平均增长速度分别为1.2%、0.7%。各不同BMI水平人群均有中心型肥胖发生,且呈增加趋势。其中超重者约有1/3～2/3者为中心型肥胖,4/5以上腰围超标。体重正常者,中心型肥胖率男性从2.6%增加到9.1%,女性从5.0%增加到14.3%,到2011年约有1/3成人存在腰围超标。结论过去二十余年,中国9省区18～65岁成人腰围水平和中心型肥胖率呈增加趋势,腰围高百分位处增幅更大。不同BMI水平人群均存在中心型肥胖且呈增加趋势。应采取有力措施抑制腰围过快增长。     

Cut-off points for anthropometric indices of adiposity: differential classification in a large population of young women

Anthropometric indices of adiposity include BMI, waist circumference and waist:height ratio. In the recruitment phase of a prospective cohort study carried out between 1998 and 2002 we studied a population sample of 11 786 white Caucasian non-pregnant women in Southampton, UK aged 20-34 years, and explored the extent to which proposed cut-off points for the three indices identified the same or different women and how these indices related to adiposity. Height, weight and waist circumference were measured and fat mass was estimated from skinfold thicknesses; fat mass index was calculated as fat mass/height1.65. Of the subjects, 4869 (42 %) women were overweight (BMI > or = 25 kg/m2) and 1849 (16 %) were obese (BMI > or = 30 kg/m2). A total of 890 (8 %) subjects were not overweight but had a waist circumference > or = 80 cm and 748 (6 %) subjects were overweight but had a waist circumference < 80 cm (6 %). Of the women, 50 % had a BMI > or = 25 kg/m2 or a waist circumference > or = 80 cm or a waist:height ratio > or = 0.5. Of the variation in fat mass index, 85 % was explained by BMI, 76 % by waist circumference and 75 % by waist:height ratio. Our findings demonstrate that many women are differentially classified depending on which index of adiposity is used. As each index captures different aspects of size in terms of adiposity, there is the need to determine how the three indices relate to function and how they can be of use in defining risk of ill health in women.     

Effects of physical activity,body mass index,waist-to-hip ratio and waist circumference on total mortality risk in the Swedish National March Cohort

The health benefits of physical activity (PA) have been well documented. However, there is less research investigating whether or not these health benefits might differ among males and females or among subjects characterized by different levels of body mass index (BMI), waist-to-hip ratio (WHR), and waist circumference (WC). Baseline total PA, BMI, WHR and waist circumference were measured in 14,585 men and 26,144 women who participated in the Swedish National March. Their effects on all-cause mortality were analyzed with a follow-up time of almost 10 years. Sedentary men with a BMI ≥ 30 had a 98% (95% CI: 30–201%) increased risk of mortality compared to normal weight men with a high level of total PA. The same trend was observed for sedentary men with high WHR or waist circumference, compared to lean and highly active men. Sedentary women with a waist circumference of 88 cm or more had almost doubled, i.e. 97% (95% CI: 35–189%) increased mortality risk compared to physically active women with a waist circumference below 80 cm. BMI in men, but waist circumference in women better forecast all-cause mortality. We found no substantial effect modification between different measures of adiposity and physical activity—physical inactivity and obesity seem to increase total mortality risk independently and additively.     

Change in women's body mass index and waist circumference, 1997 to 2002: the Nepean Study

OBJECTIVE: To investigate characteristics associated with body mass index (BMI) and waist circumference stability over a five-year period in women with school-age children. METHODS: Women with 7-8 year-old children from western Sydney, Australia, had anthropometric measures taken in 1996/97 (n=436) and five years later (n=327). Socio-demographic characteristics examined at baseline included age, socioeconomic status, smoking, and number of children. RESULTS: Over five years, less than half of the women maintained a stable BMI (38.8%) or waist circumference (31.5%), with the majority gaining in both indicators of adiposity. BMI and socio-demographic characteristics were not predictive of BMI or waist circumference stability or decrease. CONCLUSIONS AND IMPLICATIONS: Total and abdominal adiposity increased in these Australian women who have children. The results support the need to develop effective weight gain prevention initiatives.     

Trends in the nutritional status of the Spanish population: results from the Catalan nutrition monitoring system (1992-2003)

BACKGROUND: The purpose of this study was to evaluate the changes in the nutricional habits and nutricional status of the Catalan population over 10 years interval of the two Catalan Nutricional Surveys conducted in 1992-93 and 2002-03. METHODS: 2641 individuals in 1992-93 and 2060 individuals in 2002-03 aged 10 to 75 years participated in the surveys. Two 24 hour recall, a food frequency questionnaire, and a general questionnaire with information on physical activity, knowledge and opinions on nutrition and supplements use were administered. Weight (Kg), height (cm) and waist circumference (WC) (cm) were measured. A subsample of the population underwent a biochemical evaluation. Total cholesterol, HDL cholesterol, LDL cholesterol, tryglicerides and beta-carotene, alpha-tocopherol and retinol were measured. RESULTS: A decrease in the consumption of fruit, vegetables, potatoes, meat and fish and an increase in the consumption of dairy products and fast food (in young individuals) were reported. An increase in the mean value of Body Mass Index (BMI) was observed among males, and an increase in WC mean value was observed in males and females. BMI value decreased in females (except among the younger ones). The prevalence of obesity increased among males (from 9.9% to 16.6%), but not in females. Both total cholesterol and HDL cholesterol decreased. A decrease was observed in the percentage of population with sedentary habits during leisure time. CONCLUSIONS: There is a need for an effective nutrition policy promoting healthy nutrition in accordance with the ongoing dietary guidelines.     

2006年青岛市35岁以上人群腰围与糖耐量调查及3年后转归情况分析

[目的]了解35岁以上人群腰围与糖耐量情况,探讨影响糖耐量正常人群糖耐量转归的因素,为糖尿病预防提供科学依据。[方法]在青岛市城乡选取2006年糖耐量正常的684名35～74岁人群,测量其腰围值,3年后进行随访。[结果]2006年684名糖耐量正常者中,腹型肥胖罹患率为53.22%。3年后随访上述684人,IGR累积发病率为28.07%,其中腹型肥胖组为34.89%,腰围正常组为20.31%(P<0.01);DM累积发病率为3.51%,其中腹型肥胖者为4.67%,腰围正常组为2.19%(P>0.05)。684人中,2006年腰围为82.38±9.23cm,2009年腰围为85.29±9.45cm(P<0.01)。多因素非条件Logistic回归分析结果,影响糖耐量情况的因素有收缩压(SBP)、腰围(WC)、低密度脂蛋白胆固醇(LDL)、总胆固醇(TC)、尿酸(UA),OR值分别为1.011、1.047、0.643、1.584、1.003。[结论]腹型肥胖者较腰围正常者易发生IGR;收缩压高、腰围值高、低密度脂蛋白胆固醇含量低、总胆固醇含量高、尿酸高的人容易转归为IGR和/或DM。     

Waist circumference and weight following smoking cessation in a general population: the Inter99 study

OBJECTIVE: Central obesity is an independent risk factor of mortality. Change in waist circumference after smoking cessation has not been previously reported in a population-based prospective study of both sexes. METHODS: Population-based study, Inter99, 1999-2001 in Copenhagen, Denmark. 2408 daily smokers completed questionnaires and had their waist circumference and weight measured. Of these, 221 biochemically verified non-smokers and 1122 continuous smokers attended 1-year follow-up and had their waist circumference and weight measured. RESULTS: The mean increase in waist circumference was 3.88 cm (+/-5.4 cm) and 42% of the quitters had increased their waist circumference by > or = 5 cm. Quitters with high baseline tobacco consumption (OR 1.05, 95% CI=1.0-1.1) and quitters with self-reported reduced physical activity (OR 3.4, 95% CI=1.5-7.7) were more likely to have substantially increased waist circumference. The mean weight gain in quitters was 4.22 kg (+/-4.3 kg) and 41% had gained at least 5 kg. Female quitters gained more weight and had a higher increase in waist circumference than men. Abstinence from smoking was the most important predictor of substantial weight gain and substantial increase in waist circumference. CONCLUSIONS: Smoking cessation resulted in substantial increase in weight and central fat, which might attenuate some of the beneficial effects of smoking cessation. Quitters who reduced their physical activity and persons with high baseline tobacco consumption were more likely to have had a substantial increase in abdominal fat. Abstinence from smoking was the most important predictor of short-term weight gain and increase in waist circumference. It is a challenge for future smoking cessation interventions to achieve a combination of high quit rates and weight-control.     

Prospective study of abdominal adiposity and gallstone disease in US men

BACKGROUND: Obesity is an established risk factor for gallstones, but whether abdominal adiposity contributes independently to the risk, particularly in men, remains unclear. OBJECTIVE: The purpose of the study was to examine the associations of abdominal circumference and waist-to-hip ratio, as measures of abdominal adiposity, with the risk of symptomatic gallstone disease in men. DESIGN: We prospectively studied measures of abdominal obesity in relation to the incidence of symptomatic gallstone disease in a cohort of 29 847 men who were free of prior gallstone disease and who provided complete data on waist and hip circumferences. Data on weight, height, and waist and hip circumferences were collected in 1986 and in 1987 through self-administered questionnaires. As part of the Health Professionals Follow-Up Study, men reported newly diagnosed symptomatic gallstone disease on questionnaires mailed to them every 2 y. RESULTS: We documented 1117 new cases of symptomatic gallstone disease during 264 185 person-years of follow-up. After adjustment for body mass index and other known or suspected risk factors for gallstones, men with a height-adjusted waist circumference > or = 102.6 cm (40.4 in) had a relative risk of 2.29 (95% CI: 1.69, 3.11; P for trend < 0.001) compared with men with a height-adjusted waist circumference < 86.4 cm (34 in). Men with a waist-to-hip ratio > or = 0.99 had a multivariate relative risk of 1.78 (1.38, 2.28; P for trend < 0.001) compared with men with a waist-to-hip ratio < 0.89. CONCLUSIONS: Our data suggest the presence of a significant association between abdominal adiposity and the incidence of symptomatic gallstone disease. As measures of abdominal adiposity, abdominal circumference and waist-to-hip ratio predict the risk of developing gallstones independently of body mass index.