山东地区肥胖症流行特点的研究

EPIDEMIOLOGIC CHARACTERISTICS OF OBESITY IN SHANDONG PROVINCE

①目的 探讨山东地区肥胖症流行特点。②方法 采用分层整群抽样法 ,对山东地区居住≥ 5年2 0～ 74岁不同城市和农村的自然人群进行调查。③结果 山东地区人群体质量指数 (BMI)的分布近似正态分布 ,其BMI的均数为 2 3.16± 4 .0 2 ,其 95 %正常值范围为 15 .2 8～ 31.0 4。按照WHO标准 ,山东地区人群体质量超标准率 (超标率 )和肥胖患病率分别为 7.32 %、18.79% ,城市肥胖和超标率由高到低依次为青岛市、济南市、招远市、五莲县 ,前三者明显高于后者 (χ2 =5 .5 6～ 2 6 .2 7,P <0 .0 5、0 .0 1)。男女肥胖率和超标率随年龄的增长均逐步增高 ,30～ 39岁年龄组男性高于女性 (χ2 =4 .2 5、8.92 ,P <0 .0 5、0 .0 1) ;6 0岁以上年龄组男性肥胖的患病率低于女性 (χ2 =5 .91,P <0 .0 5 )。 2型糖尿病 (DM )、糖耐量减低 (IGT)、高血压的患病率随BMI的变化而变化 ,Logistic回归分析显示BMI2 5 .0～ 2 8.9时 ,DM、IGT患病的危险性与BMI呈中度相关 ;BMI≥ 2 9.0时 ,上述疾病患病的危险性与BMI呈高度相关 ;BMI 2 4 .0～ 2 7.9时 ,高血压患病的危险性与BMI呈中度相关 ,BMI≥ 2 8.0时 ,高血压患病的危险性与BMI呈高度相关。男性腰围≥ 90cm、腰围 /臀围比值≥ 0 .90、女性腰围≥ 80cm、腰围 /臀围比值≥ 0 .85?

Objective To study the epidemic characteristics of obesity in Shandong province. Methods The residents aged from 20 to 74 years and had been living in the urban or rural areas of Shandong for at least five years were investigated with stratified random sampling methods. Results The body mass index (BMI) of Shandong people was normally distributed, the mean being 23.16±4.02. The 95% normal value range was 15.28-31.04. The obesity and overweight rate was 7.32% and 18.79%, respectively, in Shandong, according to the criteria of WHO. In the order of obesity and overweight prevalence, the areas were Qingdao, Ji′nan, Zhaoyuan, and Wulian. The prevalence rates of the first three areas were significantly higher than that of Wulian(χ2=5.56-26.27,P<0.05,0.01).The prevalence of obesity and overweight increased with age. The rate in 30-39-year-old male group was higher than that of female group(χ2=4.25,8.92, P<0.05,0.01), but it was lower in male group above 60 years old than that of female group(χ2=5.91,P<0.05). The prevalence of diabetes mellitus(DM), impaired glucose tolerance(IGT) and hypertension increased obviously with BMI. Logistic regression analysis showed that DM and IGT was moderately correlated with BMI of 25.0-28.9, but highly correlated with BMI of ≥29.0. The risk of hypertension(HT) was moderate if BMI was 24.0-27.9, but high when it was ≥28.0. The prevalence of DM, IGT and HT increased obviously when the waist circumference ≥90 cm in males and ≥80 cm in females, and when the waist to hip ratio was ≥0.90 in males and ≥0.85 in females. The age, waist to hip ratio, HT, and blood glucose at two hours of the subjects in the obesity and overweight group were higher than those of the normal controls(t=9.27-15.40,P<0.01). The serum uric acid, cholesterol, triglyceride, and insulin sensitive index in the obesity group were obviously different from those of the non-obesity group(t=3.25-15.02,P<0.05,0.01). Aging, high fat intake, physical inactivity and menopause were risk factors for obesity and overweight Conclusion The prevalence rate of obesity and overweight in urban districts is higher than that of rural areas, and increases with age. The incidence of DM, IGT, and HT increases with BMI. For the prevention HT, IGT and DM, overweight may be diagnosed with BMI between 24.0 and 28.0, and if BMI is more than 28.0, obesity may be diagnosed. Abdominal obesity should be considered with waist circumference(male ≥90, female ≥80)and waist to hip ratio(male ≥0.90, female ≥0.85). More attention should be paid to the people who live in the cities and relatively developed rural districts to prevent and control obesity.