中老年人群中心性肥胖与多种慢性病的关联分析

  目的  了解江苏省中老年居民中心性肥胖与慢性阻塞性肺疾病（简称“慢阻肺”）患病的关系，为慢阻肺高危人群的早期发现及制定慢阻肺防控策略和措施提供参考依据。  方法  于2015年7 — 12月采用多阶段整群随机抽样方法在江苏省南京市雨花台区、江阴市、溧阳市、连云港市海州区、淮安市淮安区和扬中市6个监测点抽取3600名 ≥ 40岁中老年居民进行问卷调查、体格检查和肺功能检测。  结果  江苏省3365名 ≥ 40岁中老年居民中，中心性肥胖者1545人（45.9 %），非中心性肥胖者1 820人（54.1 %）；患慢阻肺者428例，慢阻肺患病率为12.7 %。在调整了性别、年龄、文化程度、职业、吸烟情况、二手烟暴露史、烹饪燃料暴露史、烹饪油烟暴露史、取暖燃料暴露史、职业粉尘或有害气体暴露史、体质指数和是否高血压等混杂因素后，多因素非条件logistic回归分析结果显示，江苏省中心性肥胖的中老年居民慢阻肺患病风险为非中心性肥胖中老年居民的1.41倍（OR = 1.41，95 % CI = 1.05～1.89）。分层分析结果显示，女性、≥ 60岁、小学及以下文化程度、职业为农林牧渔者、无取暖燃料暴露史、有职业粉尘或有害气体暴露史和非高血压的中心性肥胖中老年居民慢阻肺患病风险较高（均P < 0.05）。  结论  江苏省有中心性肥胖的中老年居民慢阻肺患病风险较高。

Global strategy for the diagnosis,management, and prevention of chronic obstructive lung disease 2017 report. GOLD executive summary

  Objective  To investigate the association between central obesity and chronic obstructive pulmonary disease (COPD) among middle-aged and elderly residents in Jiangsu province, and to provide references for early detection of COPD high-risk groups and the development of COPD prevention and control strategies and measures.  Methods  With multistage cluster random sampling, we recruited 3 600 permanent residents aged 40 years and above in 6 surveillance areas of Jiangsu province. Face-to-face questionnaire interview, physical examination and pulmonary function test were carried out among the selected residents during July – December 2015.  Results  Of the 3 365 residents with complete information, 1 545 (45.9%) were identified with central obesity and 428 (12.7%) were diagnosed with COPD. The results of unconditional multivariate logistic regression analysis revealed that the residents with central obesity were at a significantly increased risk of COPD (odds ratio = 1.41, 95% confidence interval: 1.05 – 1.89) compared to those without central obesity after adjusting for sex, age, education, smoking status, history of passive smoking exposure, history of biomass and lampblack for cooking exposure, history of biomass for heating exposure, history of occupational harmful gas or dust exposure, body mass index, and hypertension. Stratified analysis demonstrated that the residents being female, aged ≥ 60 years, with the education of elementary school and below, being farmer/forestry worker/stock farmer/fisherman, without the history of heating fuel exposure, ever exposed to occupational dust or harmful gas, and with central obesity but without hypertension had a significantly higher risk of COPD (all P < 0.05).  Conclusion  The risk of COPD is higher among the middle-aged and elderly residents with central obesity in Jiangsu province.