中老年男性肥胖流行特征及其与慢性病的关系

李泓澜; 徐飚; 郑苇; 徐望红; 高静; 舒晓鸥; 项永兵

Abstract

李泓澜,徐飚,郑苇,徐望红,高静,舒晓鸥,项永兵.中老年男性肥胖流行特征及其与慢性病的关系[J].Chinese journal of Epidemiology,2010,31(4):370-374

中老年男性肥胖流行特征及其与慢性病的关系

Epidemiological characteristics of obesity and its relation to chronic diseases among middle aged and elderly men

Received:October 10, 2009

DOI：10.3760/cma.j.issn.0254-6450.2010.04.003

KeyWord: 肥胖|体重指数|腰围臀围比|慢性病

English Key Word: Obesity|Body mass index|Waist to hip ratio|Chronic disease

FundProject:

Author Name	Affiliation	E-mail
Li Honglan	Cancer Institute of Shanghai Jiatong University, Shanghai Cancer Institute, Shanghai 200032, China
Xu Biao	School of Public Health, Fudan University
Zhang Wei	Division of Epidemiology, Vanderbilt University Medical Center, USA
Xu Wanghong	School of Public Health, Fudan University
Gao Jing	Cancer Institute of Shanghai Jiatong University, Shanghai Cancer Institute, Shanghai 200032, China
Shu Xiaoou	Division of Epidemiology, Vanderbilt University Medical Center, USA
Xiang Yongbing	Cancer Institute of Shanghai Jiatong University, Shanghai Cancer Institute, Shanghai 200032, China	ybxiang@online.sh.cn

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Abstract:

目的了解上海市中老年男性肥胖的流行现状及其与慢性病的关系。方法利用上海市男性健康队列研究的基线调查资料。研究对象为上海市某区8个街道40～74岁的中老年男性, 2002-2006年期间共调查61500人。采用体重指数(BMI)和腰嗣臀围比(WHR)作为肥胖的测量指标。利用非条件logistic回归模型分析肥胖和各种慢性病之间的关系。结果被访者超重、肥胖和向心性肥胖的标化患病率分别为36.8%、7.7%和49.7%。在所有被访者中, 66.7%患有一种及以上慢性疾病。高血压标化患病率(26.5%)居首位。分别调整WHR和BMI, 高血压、冠心病、胆结石、泌尿道结石、中风的患病率随BMI和WHR的增高而上升。与正常BMI组相比, 肥胖组患5种疾病的OR值为1.16～3.13; WHR最大组与最小组相比, 5种疾病的OR值为1.20～1.69。趋势检验P值均<0.05。糖尿病与WHR呈正相关, WHR最大组的患病率是最小组2.40倍(95%CI:2.14～2.70), 而糖尿病与BMI无关。慢性阻塞性肺病的患病率随BMI增高而下降, 肥胖组与正常BMI组相比。OR=O.87(95%CI:0.77～0．98); 而WHR结果则相反, WHR最大组的OR值为最小组的1.26倍(95%CI:1.14～1.40)。结论高血压、胆结石、泌尿道结石、心脑血管疾病在肥胖男性中患病率较高。糖尿病患病率与向心性肥胖呈正相关。

English Abstract:

Objective To investigate the epidemiological characteristics of obesity and how they related to chronic diseases among middle aged and elderly men in urban Shahghai. Methods A cross-sectional analysis was conducted using data from a baseline survey from an on-going cohort study of 6l500 men between 40-74 of age in urban Shanghai. Study subjects were recruited from 8 communities of an urban district in Shanghai during 2002 to 2006. General obesity was measured by body mass index(BMI≥28) and, central obesity by waist to hip ratio(WHR≥0.9). Unconditional logistic regression model was used to estimate the odds ratio and 95% confidence interval of chronic diseases associated with obesity after adjustment for potential confounding factors. Results The aged-adjusted prevalence rates of overweight, overall obesity and central obesity were 36.8%, 7.7% and 49.7% respectively. In this population. 66.7% subjects had ever been diagnosed with one or more kinds of chronic diseases, in which hypertension ranked first with an age-adjusted prevalence rate of 26.5%. After mutual adjustment for WHR and BMI. obesity(BMI≥28) appeared to be associated with increased prevalence rates of hypertension. coronary heart disease, gallstone, urinary tract calculus and stroke comparing to men having normal BMI(18.5≤BMI<24) with ORs ranged from 1.16 to 3.13. However, to the lowest quartile, the ORs associated with the highest WHR were between 1.20 and 1.69 for these 5 diseases. AlI P values for trend trend were less than 0.05. WHR was positively associated with diabetes, with OR as 2.40(95%CI:2.14-2.70)for the highest quartile comparing to the lowest quartile. BMI was unrelated to the diabetes prevalence. Prevalence of chronic obstructive pulmonary disease decreased with increasing BMI, but increased with WHR．The corresponding OR was 0.87(95%CI/:0.77-0.98) for the obese men compared to those with normal BMI while 1.26(95%CI:1.14-1.40) for the subjects with the highest WHR comparing to those with the lowest WHR. Conclusion The prevalence rates of hypertension, gallstone, urinary tract calculus, cardiovascular and cerebrovascular diseases were higher in obesity men. Central obesity seemed to be related to high prevalence of diabetes.

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