上海18739名职业人员不同类型肥胖特征及其与慢性病指标的关系

目的研究上海市职业人群不同类型肥胖流行特征,分析其与血糖、血脂、肝肾功能等慢性病指标间的关系,为职业人群的健康管理提供依据。方法选取2020年在华东疗养院诊疗中心参加健康体检的18739名上海市职业人员为研究对象,收集一般基础资料、健康体检资料,按照全身型肥胖和中心型肥胖的判断标准对研究对象的肥胖类型进行区分,采用二元logistic回归分析验证超重、肥胖的影响因素及其与慢性病指标的相关性。结果18739名职业人群中,根据体质量指数(BMI),超重(含肥胖)检出率为51.25%,其中肥胖检出率为13.27%;中心型肥胖检出率为42.70%。随着BMI的增加,中心型肥胖占比也升高。随着年龄的增大,超重肥胖的风险也随之增大,其中50~60岁年龄组风险最大(OR=2.031,P<0.01);女性发生超重肥胖的风险较男性低(OR=0.216,P<0.01);吸烟(OR=1.128,P<0.01)、饮酒(OR=1.300,P<0.01)者发生超重、肥胖的风险高于不吸烟、饮酒者;分别相比公务员、脑力劳动者、每天静坐<2 h者,农民(OR=3.424,P<0.01)、轻体力劳动者(OR=1.149,P<0.01)、每天静坐时间4~6 h(OR=1.114,P<0.01)和>6 h者(OR=1.158,P<0.01)发生超重肥胖的风险增加,而每天睡眠时长7~9 h者较睡眠时长<5 h者发生超重肥胖风险显著降低(OR=0.799,P<0.01)。各类慢性病指标异常的检出率随着BMI的增加而升高(P<0.01);中心型肥胖组的各指标异常检出率均高于正常组(P<0.01);相比正常人群,合并两种类型肥胖的人群发生高血压、高血糖、高总胆固醇、高甘油三酯、高低密度脂蛋白胆固醇、高尿酸的风险最高(OR=1.422~5.885,P<0.01)。结论上海市职业人群中超重、肥胖情况比较严峻,肥胖人群尤其是中心型肥胖人群面临较严重的健康风险,降低超重、肥胖率迫在眉睫。

Different obesity characteristics and their relationship with indicators of chronic diseases among 18 739 workers in Shanghai

  Objective  To understand the epidemiological characteristics of different types of obesity among workers in Shanghai, and to analyze their relationship between obesity with indicators of chronic diseases, such as blood glucose, blood lipids, liver and kidney function, so as to provide orientation for health management of this population.  Methods  Totally 18 739 workers in Shanghai who participated in physical examination in Huadong Sanatorium in 2020 were studied. The general data and physical examination data were collected. The obesity types were diagnosed according to the judgment criteria of systemic obesity and central obesity, and the influencing factors of overweight and obesity and their correlation with indicators of chronic disease were verified by binary logistic regression analysis.  Results  Among 18 739 persons, the overweight rate (including obesity) was 51.25% according to body mass index (BMI), while obesity rate was 13.27%; the proportion of central obesity was 42.70%, which was increased with higher BMI. The incidence of overweight and obesity increased with age, among whom the risk of 50 - 60 years old age group was the highest (OR = 2.031, P < 0.01);the risk of overweight and obesity in women was lower than that in men (OR = 0.216, P < 0.01);the persons with smoking and drinking had higher risk of overweight and obesity than non-smokers and non-drinkers (OR = 1.128-1.300, P < 0.01, respectively); compared with the civil servants, the mental workers, these who meditated less than 2 hours a day, the farmers (OR = 3.424, P < 0.01), manual workers with mild level (OR = 1.149, P < 0.01), those mediated 4 - 6 hours a day (OR = 1.114, P < 0.01) and more than 6 hours (OR = 1.158, P < 0.01), the risk of overweight and obesity was increased, while those who slept for 7 - 9 hours a day had a significantly lower risk of overweight and obesity than those who slept for less than 5 hours (OR = 0.799, P < 0.01). The abnormality of indicators of various chronic diseases increased with higher BMI (P < 0.01);the abnormality of all indicators of chronic diseases in the persons with central obesity was higher than that with normal body weight (P < 0.01);compared with persons with normal body weight, the obese had the highest risk of hypertension, hyperglycemia, high TC, high TG, high LDL-L and high UA (OR = 1.422 - 5.885, P < 0.01).  Conclusions  The incidences of overweight and obesity among the occupational population in Shanghai were relatively serious. The obese, especially central obese, faced the serious health risks. It is urgent to reduce overweight and obesity rates.