2010年我国正常体重成人中心型肥胖流行状况分析

目的了解我国体重正常人群中心型肥胖的流行状况及分布特点。方法利用中国慢病监测(2010)项目询问调查及身体测量获得的数据,分析我国18岁及以上成人正常体重人群中心型肥胖的流行状况,描述城乡、不同地区、不同性别及年龄、不同收入人群的分布及差异。分析体重正常人群中心型肥胖与心血管疾病危险因素聚集的关系。使用SAS 9.3软件Surveymeans过程计算加权率及95%置信区间,使用Sur-veylogistic过程计算危险因素聚集情况,计算比值比(OR)及95%置信区间,统计学检验以P<0.05为差异有统计学意义。结果共分析49 320人的资料,其中男性22 832人,女性26 488人,经加权调整后分别占49.7%和50.3%。我国成人体重正常人群中,按照腰围、腰围身高比划分的中心型肥胖的比例分别为14.8%和20.8%,均为女性(17.2%和24.3%)高于男性(12.5%和17.2%),随着年龄的增大,中心型肥胖的比例依次增大,18～29岁最低,分别为9.4%和9.3%;≥70岁组最高,分别为25.7%和46.1%。不同受教育程度体重正常的人群中,小学及以下受教育程度的中心型肥胖率最高,分别为17.2%和29.2%,呈现出随着受教育程度的升高的趋势。城市地区(15.7%,19.0%)与农村地区(14.4%,21.7%)差别不大。在调整了年龄、性别、受教育程度、城乡、地区等因素的影响后,正常体重人群中的中心型肥胖者心脑血管疾病危险因素聚集的比例是非中心性肥胖者的1.95倍。结论在体重正常的人群中近五分之一中心型肥胖并伴有心脑血管疾病危险因素聚集的风险升高。建议在进行肥胖干预时,不应片面强调控制体重,应结合腰围、腰围身高比、身体脂肪构成等评价中心型肥胖的指标。

Prevalence of central obesity among adults with normal body weight in 2010

Objective To understand the prevalence of central obesity among adults who had normal body weight. Methods The prevalence of central obesity was assessed based on the data obtained from Chinese Chronic Disease Surveillance project in which a questionnaire survey was conducted and body waist circumference （WC） and waist-to-height ratio （WHtR） were measured among adults aged 18 years and above with normal body weight The correlation between central obesity and clustering of cardiovascular risk factors was analyzed as well. SAS 9.3 software survey means was used for data statistical analysis. Results Data of a total 49 320 adults were collected and analyzed including 22 832 men and 26 488 women which accounted for 49.7% and 50.3% after weighting being adjusted. The prevalence of central obesity among normal body weight chinese adults were 14.8% or 20.8% assessed by WC or WHtR, which were both higher in women than men （17.2% vs 12.5% and 24.3% vs 17.2%）, and also increased with age. The prevalence was the lowest of 9.4% or 9.3% among those aged 18-29 years and the highest of 25.7% or 46.1% in those aged 70 and above. Meanwhile, the prevalence varied greatly among adults with different education level, the highest were found among participants who had the lowest education of primary school （17.2% vs 29.2%）. There was no significant difference of prevalence between adults from rural and urban area （15.7% vs 14.4%, 19.0% vs 21.7%） . After adjustment of age, gender, education level and geographic location, the risk of suffering cardiovascular diseases was 1.95 times higher among adults with central obesity compared to those without obesity. Conclusions Central obesity is associated with a higher risk of heart disease. Nearly one fifth of central obesity adults with normal body weight face high risk of cardiovascular diseases. Therefore, it is more important to focus on such indicators as WC, WHtR or body fat percentage than only to control body weight when taking intervention for obesity.