The effects of diet and orlistat on body weight and lipid profiles in high risk Chinese patients with coronary artery disease,obesity and hypercholesterolemia

Background  Orlistat is a gastrointestinal lipase inhibitor approved for use in obesity. So far, no evidence has been reported on the use of orlistat in obese patients with coronary artery disease (CAD). Aim  To investigate the effect of orlistat on body weight and lipid profiles in obese patients with CAD and hypercholesterolemia. Methods  Thirty non-diabetic patients with CAD, body mass index (BMI) ≥25 kg/m² and low-density lipoprotein cholesterol (LDL-C) ≥2.6 and <4.1 mmol/L were put on diet for 12 weeks. Those still having a BMI ≥25 kg/m² received orlistat 120 mg thrice daily for another 24 weeks. Results  BMI was significantly reduced by 1.7% after 12 weeks of dietary treatment. The 24-week orlistat treatment resulted in further significant reduction in BMI (−2.8%) and LDL-C (−7.0%). Conclusion  Diet and orlistat treatment significantly reduced BMI and improved LDL-C in obese patients with CAD and hypercholesterolemia.     

Prediction of Abdominal Visceral Obesity From Body Mass Index, Waist Circumference and Waist-hip Ratio in Chinese Adults： Receiver Operating Characteristic Curves Analysis

Objective To evaluate the sensitivity and specificity of body mass index (BMI), waist circumference (WC) and waist-to-hip ratio (WHR) measurements in diagnosing abdominal visceral obesity. Methods BMI, WC, and WHR were assessed in 690 Chinese adults (305 men and 385 women) and compared with magnetic resonance imaging (MRI) measurements of abdominal visceral adipose tissue (VA). Receiver operating characteristic (ROC) curves were generated and used to determine the threshold point for each anthropometric parameter. Results 1) MRI showed that 61.7% of overweight/obese individuals (BMI≥25 kg/m2) and 14.2% of normal weight (BMI<25 kg/m2) individuals had abdominal visceral obesity (VA≥100 cm2). 2) VA was positively correlated with each anthropometric variable, of which WC showed the highest correlation (r=0.73-0.77, P<0.001). 3) The best cut-off points for assessing abdominal visceral obesity were as followed: BMI of 26 kg/m2, WC of 90 cm, and WHR of 0.93, with WC being the most sensitive and specific fact     

Central Obesity and Metabolic Risk Factors in Middle-aged Chinese

Objective Central obesity is considered to be a central component of metabolic syndrome. Waist circumference(WC) has been widely used as a simple indicator of central obesity. This study is aimed to evaluate the sensitivity of WC cut-off values for predicting metabolic risk factors in middle-aged Chinese. Methods The study involved 923 subjects aged 40-65 years. The metabolic risk factors were defined according to the Chinese Joint Committee for Developing Chinese Guidelines on Prevention and Treatment of Dyslipidemia in Adults. WC cut-off 85-90 cm and ≥90 cm were used as cut-off values of central pre-obesity and central obesity in males, respectively, while WC 80-85 cm and ≥85 cm were used as cut-off values of central pre-obesity and central obesity in females. Results First, WC values corresponding to body mass index(BMI) 24 kg/m2 and visceral fat area(VFA) 80 cm2 were 88.55 cm and 88.51 cm in males, and 81.46 cm and 82.51 cm in females respectively. Second, receiver operating characteristic curves showed that the optimal WC cut-off of value was 88.75 cm in males, higher than that in females(81.75 cm). Third, the subjects with higher WC values were more likely to have accumulating metabolic risk factors. The prevalence of metabolic risk factors increased linearly and significantly in relation to WC levels. Conclusion WC cut-off values of central pre-/central obesity are optimal to predict multiple metabolic risk factors.     

Correlation between Waist Circumference and Carotid Intima-Media Thickness in Women from Shanghai, China

ObjectiveTo evaluate whether waist circumference (WC) ≥85 cm is related to asymptomatic preclinical atherosclerosis in women from Shanghai, China.MethodsA total of 2365 females aged ≥20 years recruited from 4 communities underwent physical examination and carotid artery scanning. Their carotid intima-media thickness (C-IMT) was measured.ResultsThe C-IMT was significantly higher in overweight or obese women with their BMI ≥25.0 kg/m² (P<0.01) and in those with their WC ≥85 cm than in those with their WC <85 cm (P<0.01). Spearman and partial correlation analysis showed that the C-IMT was significantly correlated with WC which was independent of menopausal status. The C-IMT significantly increased with the increasing WC and reached to a platform in about 85 cm. An increment tendency was found in the subgroup with its WC < 85 cm (P<0.01) while no significant tendency was found in the subgroup with its WC≥85 cm (P=0.07). Multiple stepwise regression analysis showed that the WC was an independent risk factor for C-IMT. In logistic regression model, the odd ratio of WC ≥80 cm, ≥80 cm and <85 cm and ≥85 cm for evaluating the risk of C-IMT elevation was 1.632, 1.501, and 1.878, respectively.ConclusionWC is significantly correlated with C-IMT in women from Shanghai, China, and WC≥85 cm may be used in identifying the risk of subclinical carotid atherosclerosis.     

不同肥胖标准在评估多囊卵巢综合征胰岛素抵抗中的价值

目的 分析不同肥胖标准:体质量指数（BMI）、腰围(WC)、内脏脂肪面积(VAA,CT测量)在评估多囊卵巢综合征（PCOS）患者胰岛素抵抗中的价值。方法 选择300例已确诊为PCOS的患者作为研究对象,以WC为标准分为:腹型肥胖（WC≥80 cm）210例,非腹型肥胖（WC＜80 cm）90例;以BMI为标准分为:整体肥胖（BMI≥25 kg/m2）97例,非整体肥胖(BMI＜25 kg/m2)203例;以VAA为标准分为:内脏型肥胖（VAA≥80 cm2)198例,非内脏型肥胖（VAA＜80 cm2)102例。分别检测其空腹血糖（FPG）、空腹胰岛素（FINS）,并计算稳态模型指数(HOMA-IR);分析3种（BMI、WC、VAA）标准下对PCOS患者肥胖的检出率、胰岛素抵抗的检出率、胰岛素抵抗的漏诊率。同时检测血性激素全套、甲状腺功能、血浆总皮质醇（PTC）。结果 ① 3种标准下,各组血性激素水平〔含促黄体生成素(LH)/卵泡刺激素(FSH)〕、甲状腺相关激素、皮质醇、空腹血糖组间差异均无统计学意义（P>0.05）,但体质量及FINS组间差异有统计学意义（P<0.05）。②3种标准下对PCOS患者的肥胖检出率分别为:整体肥胖率为32.33%（97/300）、腹型肥胖率为70.00%（210/300）、内脏型肥胖率为66.00%（198/300）,3者两两比较,BMI作为肥胖判断标准与WC、VAA作为肥胖判断标准相比,其肥胖检出率最低,差异均有统计学意义（P均＜0.05）,而VAA与WC相比,肥胖检出率差异无统计学意义（P>0.05）。③3种标准下胰岛素抵抗的检出率分别为:BMI 38.60%（83/215）、WC 85.11%（183/215）、VAA 69.77%（150/215）,WC的检出率最高,BMI的检出率最低,3种标准对胰岛素抵抗的检出率两两比较,差异均有统计学意义（P均＜0.05）。④3种标准下胰岛素抵抗的漏诊率分别为:BMI 61.40%（132/215）、WC 14.88%（32/215）、VAA 30.23%（65/215）,BMI漏诊率最高,WC漏诊率最低,两者差异有统计学意义（P<0.05）,VAA较WC漏诊率稍高,差异亦有统计学意义（P<0.05）。结论 在肥胖的检出率、降低胰岛素抵抗漏诊率方面,BMI存在明显不足,WC较BMI、VAA均具有明显优势,WC在评估肥胖型PCOS患者胰岛素抵抗方面可能更有临床价值。     

Body mass index and active range of motion exercise treatment after intra-articular injection in adhesive capsulitis

BackgroundAdhesive capsulitis is commonly associated with medical diseases such as diabetes mellitus, hyperthyroidism, and obesity. Intra-articular injection has been used to speed recovery and relieve pain associated with frozen shoulder. In this study, we evaluated and compared the effects of an intra-articular injection of corticosteroid and lidocaine in the treatment of primary adhesive capsulitis in overweight and normal-weight patients.MethodsThis is a prospective clinical study of patients with adhesive capsulitis, in which the main treatment strategy was an intra-articular injection of corticosteroid (3 mL) and lidocaine (3 mL). Active range of motion exercise was initiated immediately after the injection and performed four times daily. The evaluation included the recording of a detailed medical and orthopedic history, and the assessment of pain and function by determining the Constant score at baseline (before injection) and every 2 weeks thereafter. Patients were classified as normal weight (body mass index [BMI] < 25 kg/m²) or overweight (BMI ≥ 25 kg/m²). The Constant scores of all patients were compared at 8 weeks after injection.ResultsAfter clinical examinations and radiographic and ultrasonographic studies, 79 patients were treated for adhesive capsulitis between 2010 and 2012. In the normal-weight group, the mean Constant score increased from 35.4 to 74.6 after 8 weeks, whereas in the overweight group, the mean Constant score increased from 32.0 to 47.2. There was a significant difference in the mean Constant score between the normal-weight and overweight groups at 8 weeks.ConclusionActive range of motion exercise after an intra-articular injection of corticosteroid and lidocaine improved pain and functional outcome at 8 weeks in normal-weight (BMI < 25 kg/m²) patients with primary adhesive capsulitis. Manipulation under anesthesia may be considered a priority in overweight patients.     

腹型肥胖内脏脂肪定量检测的评估及其临床意义

目的 分析临床常用体脂检测方法与内脏脂肪型肥胖(VFO)诊断切点的相关性,及其在判断腹型肥胖类型中的价值.方法 4301例研究对象,其中659例接受了CT、生物电阻抗(体脂仪)和B超3项检查.以CT检查确定的腹内脂肪面积(VA)≥100 cm2作为判断VFO的诊断标准,应用受试者工作特征(ROC)曲线分别分析简易体脂参数(腰围、体重指数、腰臀比),体脂仪参数(全身脂肪含量、全身脂肪重量),超声测值(腹壁脂肪厚度、腹内脂肪厚度)判断VFO的切点及其敏感性和特异性.结果 (1)腰围、脂肪重量、体重指数、腹内脂肪厚度、全身脂肪含量、腰臀比诊断VFO均有较高准确性(ROC曲线下面积为0.718～0.837),其中腰围判断VFO的诊断效率最好.(2)判断VFO的最佳切点及其敏感性和特异性在男性和女性分别是:腰围为89.5、85.5 cm;体重指数为25、26 kg/m2;腰臀比为0.97、0.95;全身脂肪含量为29%、38%;全身脂肪重量为18.6、20.4 kg;腹内脂肪厚度为38.5、34.7 mm.结论 简易体脂参数、体脂仪、超声可用于临床定量评估内脏脂肪变化.在确定腰围的前提下,结合超声或体脂仪参数可进一步判断腹型肥胖的类型.     

Repeated measures of body mass index and waist circumference in the assessment of mortality risk in patients with myocardial infarction

Abstract

Aims: Weight loss is recommended for myocardial infarction (MI) patients with overweight or obesity. It has, however, been suggested that obese patients have better prognosis than normal-weight patients have, but also that central obesity is harmful. The aim of this study was to examine associations between repeated measures of body mass index (BMI) and waist circumference (WC), and all-cause mortality.

Methods and results: A total of 14,224?MI patients aged <75 years in Sweden between the years 2004 and 2013 had measurements of risk factors at hospital discharge. The patients’ BMI and WC were recorded in secondary prevention clinics two months and one year after hospital discharge. We collected mortality data up to 8.3 years after the last visit. There were 721 deaths. We used anthropometric measures at the two-month visit and the change from the two-month to the one-year visit. With adjustments for risk factors and the other anthropometric measure the hazard ratio (HR) per standard deviation in a Cox proportional hazard regression model for mortality was 0.64 (95% confidence interval [CI] 0.56–0.74) for BMI and 1.55 (95% CI 1.34–1.79) for WC, and 1.43 (95% CI 1.17–1.74) for a BMI decrease from month two to one year of more than 0.6?kg/m². Low BMI and high WC were associated with the highest mortality.

Conclusion: High WC is harmful regardless of BMI in MI patients. Reduced BMI during the first year after MI is, however, associated with higher mortality, potentially being an indicator of deteriorated health.     

Relationship of Body Mass Index, Waist Circumference and Cardiovascular Risk Factors in Chinese Adult

Objective To compare the relative risk of waist circumference （WC） and/or BMI on cardiovascular risk factors. Methods A cross-sectional data of 41 087 adults （19 567 male and 21 520 female） from the 2002 China National Nutrition and Health Survey were examined. According to the obesity definition of WGOC （BMI, 24 kg/m^2 and 28 kg/m^2; WC, male 85 cm and 95 cm for male, 80 cm and 90 cm for female）, the study population were divided into 9 groups. The prevalence and odds ratio （ORs） of cardiovascular disease （CVD） risk factors （hypertension, high fasting plasma glucose and dyslipidemia） were compared among these 9 groups. Stepwise linear regression analyses were used to compare the likelihood of BMI and/or WC on CVD risk factors. Results Both the indexes levels and the odds ratios of CVD risk factors were significantly increased （decreased for HDL-C levels） along with the increase of WC and/or BMI, even when the effect of age, sex, income, education, sedentary activity and dietary factors were adjusted. The variances （R2） in CVD risk factors explained by WC only and BMI only were quite similar, but a little bit larger when WC and BMI were combined. The standard fl was higher of BMI when predicting systolic BP and was higher of WC when predicting TG, TC and HDL. Conclusions BMI and WC had independent effects on CVD risk factors and combination of BMI and WC would be more predictive. Findings from the present study provided substantive evidence for the WGOC recommendation of a combined use of BMI and WC classifications.     

Body Mass Index and Body Fat Percentage in Assessment of Obesity Prevalence in Saudi Adults

Objective To assess the obesity prevalence in Saudi adults according to the international standards of body mass index (BMI) and body fat percentage (BF%). Methods Five hundred and thirty healthy Saudi adults aged 18-72 years (mean 36.91±15.22 years) were enrolled in this study. Their body composition was assessed by bioelectrical impendence analysis with a commercially available body composition analyzer. Standard BMI and BF% values were used to define obesity. Results The prevalence of underweight, normal underweight, overweight and obesity in Saudi adults according to the BMI criteria (<18.5 kg/m 2 , 18.5-24.4 kg/m 2 , 25-29.9 kg/m 2 , 30 kg/m 2 and above, respectively) was 2.5%, 30.2%, 33.6%, and 33.8%, respectively, whereas the obesity prevalence was 60% (n=318) in Saudi adults according to the BF% criteria (25% for males and 30% for females), which was significantly higher than that according to BMI criteria. However, it was 50.6% (n=268) when the BMI cutoff point was 27.5 kg/m 2 , proposed by WHO for the Asian population. Kappa analysis showed that the obesity prevalence defined by BMI and BF% was higher in females than in males (k=0.530 vs k=0.418, P<0.0001). The sensitivity and specificity of BMI (30 kg/m 2 and 27.5 kg/m 2 ) were 54.1% and 96.7% and 76.4% and 88.2%, respectively, for obesity. A lower BMI cutoff point (26.60 kg/m 2 ) was proposed in this study, which gave the maximum sensitivity (84.3%) and specificity (85.4%), with a moderate kappa agreement (k=0.686). Moreover, the obesity prevalence at this cutoff point (56.4%) was significantly higher than that recommended by WHO. Conclusion The specificity of BMI for obesity is high and its sensitivity is low in both sexes. Its sensitivity can be increased by changing BMI cutoff to a lower value. The choice of BF% reference is of great influence for the assessment of obesity prevalence according to the BMI.     

Secular Changes on the Distribution of Body Mass Index among Chinese Children and Adolescents, 1985-2010

ObjectiveTo analyze the change in Body Mass Index (BMI) distribution among Chinese children and adolescents for the development of more effective intervention for childhood obesity.MethodsData on the national students' constitution and health survey between 1985 and 2010 was used for this study. Subjects were students aged 7-18 randomly selected from 30 provinces in China. BMI for-age curves were developed by LMS method, and the trend of BMI distribution was determined by comparing the upper BMI percentiles and analyzing the skew shift of distribution between 1985 and 2010.ResultsAn overall positive swift trend of BMI between 1985 and 2010 was observed among the Chinese school-age children and adolescents. The average median of the BMI increased from 16.8 and 17.0 kg/m² to 18.2 and 17.9 kg/m² in 25 years, with increments 0.56 and 0.36 kg/m² per decade for males and females, respectively. The more obvious increments were found at the high BMI. The total increments of BMI in this period were 4.03 and 2.20 kg/m² at the 85th, 6.14 and 3.57 kg/m² at the 95th, and 6.99 and 4.27 kg/m² at the 97th percentiles, for males and females, respectively.ConclusionObvious increments were observed at high BMI of the Chinese children and adolescents. More effective interventions should be taken for control and prevention of obesity and its health consequence for these subgroups. It is necessary to establish a risk-complex system consisting of the identification of BMI scope, the screen of the disease risk factors and the assessment of excessive adiposity.     

Association between age at arrival,duration of migration,and overweight/obesity in Chinese rural-to-urban migrants: the Yi migrant study

Background:Urbanization in China is rapidly proceeding, but rural-to-urban migration and its association with overweight and obesity is not well studied. This study aimed to explore the age at arrival, duration of migration, and the corresponding association with overweight/obesity in Yi migrants in China.Methods:A cross-sectional study was conducted in rural and urban areas in 2015 in Sichuan province, China. Demographic characteristics, lifestyle factors, and anthropometry were collected. General linear regression models were used to assess the effect of duration of migration (1–10, 11–20, 21–30, and >30 years) on body mass index (BMI). Multi-variable logistic regression was used to examine the association between duration of migration and overweight/obesity (BMI ≥ 25 kg/m²).Results:A total of 3056 Yi people (1894 Yi farmers and 1162 Yi migrants) aged 20 to 80 years were enrolled. After adjusting for age, sex, and other potential confounders, Yi migrants had 1.71 kg/m² (95% confidence interval [CI]: 1.36–2.06) higher BMI and a 2.13-fold (95% CI: 1.71–2.65) higher risk of overweight/obesity than Yi farmers. In Yi migrants, stratified by age at arrival, no significant association between duration of migration and overweight/obesity was observed in those who were 0 to 20 years old at arrival. In comparison, in migrants >20 years old at arrival, compared with the reference group (1–10 years), long-term migration (>30 years) was found to be associated with overweight/obesity after adjustment (odds ratio: 1.85, 95% CI: 1.04–3.29).Conclusions:Yi migrants were observed to have greater risk of overweight/obesity than Yi farmers. In Yi migrants, the risk of overweight/obesity increased according to the duration of migration, especially in those who were older upon their arrival.     

Optimal Waist Circumference Cut-off values for Identifying Metabolic Risk Factors in Middle-aged and Elderly Subjects in Shandong Province of China

Objective To study the optimal waist circumference （WC） cut-off values for identifying metabolic risk factors in middle-aged and elderly subjects in Shandong Province of China. Methods A total of 2 873 men and 5 559 women were included in this cross-sectional study. Metabolic syndrome （MetS） was diagnosed according to the definition of Chinese Diabetes Society in 2004. The relation between WC and MetS was analyzed by multivariate logistic regression analysis. The optimal WC cut-off values were identified using the area under the ROC curve and the different diagnostic criteria for central obesity were compared. Results The WC was the risk factor for MetS independent of BMI, blood glucose, blood lipid, and blood pressure. The optimal WC cut-off value was 83.8 cm and 91.1 cm for identifying MetS in women and men, respectively. Compared with 80 cm and 85 cm for women and men, 85 cm and 90 cm had a higher Youden index for identifying all metabolic risk factors and MetS in women and men. Conclusion The appropriate WC cut-off value is 85 cm and 90 cm for identifying central obesity and MetS in women and men in Shandong Province of China.     

Sensitivity and specificity of waist circumference as a single screening tool for identification of overweight and obesity among Malaysian adults

Generalised obesity and central obesity are risk factors for Type II diabetes mellitus and cardiovascular diseases. Waist circumference (WC) has been suggested as a single screening tool for identification of overweight or obese subjects in lieu of the body mass index (BMI) for weight management in public health program. Currently, the recommended waist circumference cut-off points of > or = 94cm for men and > or =80cm for women (waist action level 1) and > or = 102cm for men and > or = 88cm for women (waist action level 2) used for identification of overweight and obesity are based on studies in Caucasian populations. The objective of this study was to assess the sensitivity and specificity of the recommended waist action levels, and to determine optimal WC cut-off points for identification of overweight or obesity with central fat distribution based on BMI for Malaysian adults. Data from 32,773 subjects (14,982 men and 17,791 women) aged 18 and above who participated in the Third National Health Morbidity Survey in 2006 were analysed. Sensitivity and specificity of WC at waist action level 1 were 48.3% and 97.5% for men; and 84.2% and 80.6% for women when compared to the cut-off points based on BMI > or = 25kg/m2. At waist action level 2, sensitivity and specificity were 52.4% and 98.0% for men, and 79.2% and 85.4% for women when compared with the cut-off points based on BMI (> or = 30 kg/m2). Receiver operating characteristic analyses showed that the appropriatescreening cut-off points for WC to identify subjects with overweight (> or = 25kg/m2) was 86.0cm (sensitivity=83.6%, specificity=82.5%) for men, and 79.1cm (sensitivity=85.0%, specificity=79.5%) for women. Waist circumference cut-off points to identify obese subjects (BMI > or = 30 kg/m2) was 93.2cm (sensitivity=86.5%, specificity=85.7%) for men and 85.2cm (sensitivity=77.9%, specificity=78.0%) for women. Our findings demonstrated that the current recommended waist circumference cut-off points have low sensitivity for identification of overweight and obesity in men. We suggest that these newly identified cut-off points be considered.     

Association between measures of obesity and colorectal adenoma

Background  Few studies have used body mass index (BMI), waist-to-hip ratio (WHR) and waist circumference (WC) at the same time to investigate the association between obesity and colorectal adenoma. This study examined the strength of association between colorectal adenoma and obesity using not only BMI, but also WHR and WC.

Methods  Subjects of this study included 1322 asymptomatic patients who underwent colonoscopy for cancer screening from January 2006 to June 2008. Anthropometric measurements, blood test results, and a self-administered questionnaire from each subject were analyzed.

Results  Four hundred and fourteen adenoma cases were identified in 1322 subjects. Using univariate analysis, the prevalence of adenoma was associated with BMI and WHR and was higher among the abdominal obesity group using WC guidelines of the Korean Society for the Study of Obesity, but not using WC guidelines of the International Diabetes Federation. In multiple Logistic regression analysis, general obesity (BMI ≥25 kg/m²) increased the risk of colorectal adenoma (odds ratio (OR), 1.43; 95% confidence interval (CI), 1.05–1.94). Also, abdominal obesity by the WC cutoffs and the highest WHR percentile group (WHR ≥0.95) were significantly associated with adenoma. Among three measures of obesity, however, only BMI had a persistent association with adenoma after adjusting reciprocally for BMI, WC, and WHR (OR, 1.30; 95% CI, 1.02–1.80; and 1.49; 1.06–2.10, adjusted for WC and WHR, respectively).

Conclusion  The data suggest that general obesity is associated with an increased risk of colorectal adenoma.

     

延边地区朝鲜族和汉族青少年不同指标肥胖与血压的相关性

[目的]分析延边地区朝鲜族和汉族青少年不同指标肥胖与血压的相关性.[方法]选取2008—2009年间延边地区安图县1 206名高中生体格检查资料,年龄在17～18岁之间.通过体格检查准确测量身高、体质量、腰围(WC)及血压.采用体质量指数(BMI,kg/m2)、WC及腰围与身高比值(WHtR)作为不同指标肥胖:以BMI≥P90界值为整体型肥胖;分别以WC≥P90界值及WHtR≥0.46为腹型肥胖.[结果]朝鲜族WC,WHtR及收缩压(SBP)、舒张压(DBP)的平均水平均明显高于汉族,相比较差异均具有统计学意义(P<0.01).朝鲜族和汉族不同指标肥胖组的SBP及DBP的平均水平均高于正常组,相比较差异有统计学意义(P<0.05).偏相关分析结果显示,BMI,WC及WHtR与SBP及DBP均呈正相关(P<0.01).[结论]不同指标肥胖与血压存在明显的正相关关系.     

Changes in Waist Circumference and Abdominal Obesity among Chinese Adults over a Ten-year Period

Objective The aim of this study was to describe changes in waist circumference (WC) and prevalence of abdominal obesity over a period of 10 years among Chinese adults in different socio-economic status (SES).Methods Data derived from the China Nutrition and Health Surveillance during 2002 and 2010-2012.We calculated the mean WC and the prevalence of abdominal obesity by gender, place of residence, SES indicators (education, income, and marital status), and body mass index (BMI) categoriesand used pooled t-tests to assess the differences between the two time periods.Results 26.0% of men and 25.3% of women had abdominal obesity in 2010-2012. The age-adjusted mean WC increased by 2.7 cm among men and 2.1 cm among women; the age-adjusted prevalence of abdominal obesity increased by 7.7% among men and 5.3% among women. The rising trends were observed in all subgroups except for a negative growth in high-income women. People living in rural areas with low education and income and with a BMI of 18.5 to 23.9 kg/m2 had a greater absolute and relative increase in WC. People living in rural areas with low income had a greater relative increase in abdominal obesity.Conclusion The mean WC and prevalence of abdominal obesity among Chinese adults have increased during the past 10 years. Gender differences were noted using various SES indicators.     

腹型肥胖和全身型肥胖与中医体质类型的关系

[目的] 探求腹型肥胖和全身型肥胖与中医体质的关系,为调整偏颇体质、防治肥胖提供依据。[方法] 采用横断面现场调查法收集江西、安徽两家医院983例健康体检人群数据。中医体质调查采用标准化中医体质量表,应用判别分析法判定体质类型。采用Logistic回归分析探索腹型肥胖、全身型肥胖与中医体质类型的关系。[结果] 未调整混杂因素的模型1和调整混杂因素的模型2均显示痰湿质发生腹型肥胖（OR₁=2.92,95%CI=1.76~4.86,P<0.01;OR₂=2.74,95%CI=1.63~4.60,P<0.01）和全身型肥胖（OR₁=2.22,95%CI=1.36~3.61,P<0.01;OR₂=1.89,95%CI=1.14~3.14,P<0.05）的危险度显着增高,而阳虚质发生全身型肥胖（OR₁=0.36,95%CI=0.20~0.67,P<0.01;OR₂=0.38,95%CI=0.21~0.70,P<0.01）的危险度显着降低。[结论] 痰湿质是发生腹型肥胖和全身型肥胖的主要体质类型。     

发展中国家中等收入人群的童年期社会经济地位与中年肥胖的关联

 目的 在中国泰州的中等收入人群中探索童年期社会经济地位(socioeconomic status,SES)与肥胖的关联。方法 本研究的数据来自泰州健康人群跟踪调查(Taizhou Longitudinal Study,TZL)第Ⅲ期基线调查中35～64岁中年人的基线数据。普通型肥胖定义为BMI≥28.0 kg/m2,中心型肥胖定义为男性腰围(waist circumference,WC)≥90 cm、女性WC≥80 cm。以20世纪中期中国家庭三大件(自行车、手表和缝纫机)数量来定义SES水平:0件、1或2件、3件分别代表SES低、中、高水平。比较不同SES组间的差异,并用Logistic回归分析童年期SES与肥胖的关联。 结果 男性中普通型肥胖的比例为13.5%,中心型肥胖的比例为30.9%;女性中普通型肥胖的比例为13.6%,中心型肥胖的比例为53.7%。男性SES水平与BMI和WC成正相关。相对于童年期家庭三大件数量为0件的人,拥有3件的人中年期普通型肥胖的风险(OR=1.79,95%CI:1.40～2.28)和中心型肥胖的风险均增加(OR=1.48,95%CI:1.12～1.80),在调节了年龄、婚姻状况、教育程度、家庭收入、吸烟饮酒状况和体力活动等混杂因素后,关联仍然显著。女性SES水平与BMI和WC成负相关。相对于童年期家庭三大件数量为0件的人,拥有3件的人中年期普通型肥胖(OR=0.72,95%CI:0.58～0.90)和中心型肥胖的风险(OR=0.45,95% CI:0.38～0.54)都降低。在调节了混杂因素后,与中心型肥胖的关联依然显著。结论 在发展中国家中等收入人群中,童年期SES与肥胖的关联存在性别差异,即高SES增加男性肥胖的风险,而降低女性肥胖的风险。在社会经济由发展中阶段向发达阶段转变的同时,童年期SES与肥胖的关联也从正相关向负相关转变,这种转变较早发生在女性身上。     

腹内脂肪面积切点与代谢综合征临床检出率的关系

目的探讨估测代谢综合征（MS）的腹内脂肪面积（VA）的切点,以及VA与代谢综合征检出率的关系。方法应用螺旋CT检测了564例代谢综合征、糖尿病和高血压病病人的腹内脂肪面积;分别应用ROC工作曲线和四分位法分析估测代谢综合征及其组分的VA临界点和该临界点所对应的简易体脂参数包括,体重指数（BMI）、腹围（WC）和腰臀比（WHR）,以及不同VA面积下的代谢综合征的检出率。结果（1）女性病人出现血脂紊乱、腹型肥胖和代谢综合征时VA集中在70～72cm。之间,而男性病人出现以上代谢紊乱时VA多在91～107cm^2之间,未找到高血糖和高血压相应的VA切点。（2）罹患代谢紊乱时,女性腹围在82～84cm之间,BMI在24～25kg／m^2之间;男性腹围在89cm左右,BMI在25kg／m^2左右。（3）男性VA在70cm^2、71～101cm^2、102～133cm^2、≥134cm^2时代谢综合征检出率分别为16．9％、49．4％、72．7％和87．5％,VA≥70cm^2时代谢综合征检出率显著增高（P〈0．01）;女性VA在〈55cm^2、55～84cm^2、85～104cm^2、≥105cm^2时代谢综合征检出率分别为7．7％、44．0％、67．2％和87．5％,VA≥55cm^2时代谢综合征检出率显著增高（P〈0．01）。结论代谢综合征病人腹内脂肪的堆积有性别差异;在临界超重或超重阶段,即已出现腹内脂肪堆积及各种代谢紊乱的聚集;随着腹内脂肪含量的增加,代谢综合征的临床检出率显著升高。