1991-2015年中国9省份18~64岁男性吸烟状况与肥胖风险的关系

赵健; 苏畅; 孙健; 范丹丹; 王惠君; 张兵

Abstract

赵健,苏畅,孙健,范丹丹,王惠君,张兵.1991-2015年中国9省份18~64岁男性吸烟状况与肥胖风险的关系[J].Chinese journal of Epidemiology,2021,42(11):1962-1968

1991-2015年中国9省份18~64岁男性吸烟状况与肥胖风险的关系

Relationship between smoking status and obesity risk in males aged 18-64 years in 9 provinces of China, 1991-2015

Received:January 06, 2021

DOI：10.3760/cma.j.cn112338-20210106-00009

KeyWord: 吸烟全身性肥胖中心性肥胖成年男性

English Key Word: Smoking status General obesity Abdominal obesity Male adult

FundProject:国家重点研发计划（2019YFC1605100）；中国健康与营养调查（R01-HD30880，DK056350，R01-HD38700）；国家财政项目“中国居民营养状况变迁的队列研究”（13103110700015005）

Author Name	Affiliation	E-mail
Zhao Jian	Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences, Beijing 100005, China
Su Chang	National Institute of Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing 100050, China	suchang@ninh.chinacdc.cn
Sun Jian	School of Public Health & Management, Ningxia Medical University, Yinchuan 750004, China
Fan Dandan	Chaoyang District Health Commission, Beijing 100026, China
Wang Huijun	National Institute of Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing 100050, China
Zhang Bing	National Institute of Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing 100050, China

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Abstract:

目的分析1991-2015年中国9省份18~64岁成年男性居民吸烟状况与肥胖患病风险的关系。方法利用"中国健康与营养调查"1991-2015年9轮调查资料，选取参加两轮及以上、有完整人口统计学特征、吸烟状况和体格测量数据的18~64岁成年男性居民作为研究对象，共计32 169名。依据研究对象是否吸烟以及吸烟者每日吸烟数量将研究对象分为不吸烟、轻度吸烟（1~14支/d）、中度吸烟（15~24支/d）和重度吸烟（≥ 25支/d）组。观察不同吸烟程度下研究对象的BMI、腰围、全身性肥胖和中心性肥胖的分布情况，利用两水平混合效应线性回归模型和logistic回归模型分析男性吸烟状况与肥胖患病风险的关系。结果不同吸烟程度下调查对象的BMI、腰围、全身性肥胖和中心性肥胖的患病率呈现逐年上升的趋势。在校正混杂因素后，轻、中和重度吸烟者BMI分别比不吸烟人群减少了0.19 kg/m²（95%CI：-0.27~-0.10）、0.40 kg/m²（95%CI：-0.49~-0.31）和0.36 kg/m²（95%CI：-0.53~-0.19）；腰围分别减少了0.49 cm （95%CI：-0.76~-0.21）、0.80 cm （95%CI：-1.08~-0.51）和0.79 cm （95%CI：-1.38~-0.36）。男性轻、中和重度吸烟者患全身性肥胖的风险分别是不吸烟者的0.70倍（OR=0.70，95%CI：0.62~0.79）、0.61倍（OR=0.61，95%CI：0.55~0.69）和0.78倍（OR=0.78，95%CI：0.65~0.96）；患中心性肥胖的风险分别是不吸烟者的0.78倍（OR=0.78，95%CI：0.73~0.84）、0.74倍（OR=0.74，95%CI：0.70~0.79）和0.84倍（OR=0.84，95%CI：0.76~0.95）。结论 1991-2015年间，男性不吸烟与吸烟（轻、中和重度）居民的BMI、腰围和肥胖患病率均呈现显著上升趋势。成年男性居民吸烟与肥胖患病风险呈显著性负向关联。

English Abstract:

Objective To investigate longitudinal association between smoking behavior and obesity risk in male adults in China from 1991 to 2015. Methods A total of 32 169 male adults aged 18-64 years who participated in two or more rounds of China Health and Nutrition Survey (CHNS, 1991-2015) and had complete information of demographic characteristics, smoking status and physical measurements were selected as the study subjects. According to whether the subjects smoked or not and the number of cigarettes smoked per day, the subjects were divided into four groups:nonsmoker, light smoker (1-14 cigarettes/d), moderate smoker (15-24 cigarettes/d) and heavy smoker (≥ 25 cigarettes/d). The distribution of body mass index (BMI), waist circumference (WC), general obesity and central obesity of subjects with different smoking status were observed. Two-level mixed effect linear regression model and logistic regression model were used to analyze the relationship between smoking status and obesity risk. Results Compared with nonsmokers, the BMI decreased by 0.19 kg/m² in light smokers (95%CI:-0.27--0.10), 0.40 kg/m²in moderate smokers (95%CI:-0.49--0.31), and 0.36 kg/m² in heavy smokers (95%CI:-0.53--0.19), respectively, and the WC decreased by 0.49 cm in light smokers (95%CI:-0.76--0.21), 0.80 cm in moderate smokers (95%CI:-1.08--0.51) and 0.79 cm in heavy smokers (95%CI:-1.38--0.36) in, respectively. Compared with nonsmokers, the odds ratio of the risk for general and abdominal obesity were 0.70 (95%CI:0.62-0.79) and 0.78 (95%CI:0.73-0.84) in light smokers, 0.61 (95%CI:0.55-0.69) and 0.74 (95%CI:0.70-0.79) in moderate smokers and 0.78 (95%CI:0.65-0.96) and 0.84 (95%CI:0.76-0.95) in heavy smokers, respectively. Conclusions From 1991 to 2015, the BMI, WC, prevalence of general and abdominal obesity in male adults showed a significant upward trends in both nonsmokers and smokers (light, moderate and heavy) in China, suggesting that smoking is negatively associated with the risk for obesity in male adults.

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