青岛地区肥胖症流行特点的研究

THE EPIDEMIC CHARACTERISTICS OF OBESITY IN QINGDAO AREA

①目的明确青岛地区肥胖症的患病率及其影响因素.②方法采用分层整群抽样法,对青岛市市区和农村年龄20～74岁,居住5年及5年以上以家庭为单位的自然人群进行肥胖症流行特点抽样调查.③结果青岛地区肥胖和体质量超标的总患病率分别为9.01%和39.40%.市区、近郊和远郊肥胖患病率分别为14.16%、9.34%、3.56%,标化率分别为4.72%、2.53%、1.41%;体质量超标的患病率分别为57.98%、40.41%和19.29%,标化率分别为19.32%、10.97%、7.63%.162例肥胖者中并2型糖尿病(DM)和糖耐量减低(IGT)者占24.07%,并收缩期和舒张期高血压者分别占32.71%、39.15%.DM、IGT和高血压的患病率随体质量指数(BMI)升高而升高,BMI≥28者DM+IGT患病率与BMI<19组比较明显升高(χ2=7.50～10.15,P<0.05、0.01),BMI≥24者高血压患病率与<19组比较升高明显(χ2=6.24～18.40,P<0.05、0.01).DM+IGT和高血压的患病率随腰围/臀围比值(腰臀比)升高而升高,腰臀比≥0.8者DM+IGT和高血压的患病率与<0.7组比较明显升高(χ2=3.89～35.36,P<0.05、0.01).肥胖组和体质量超标组的年龄、腰臀比、收缩期高血压、舒张期高血压、服糖后2 h血糖均明显高于体质量正常组(t=9.27～15.40,P均<0.01),而肥胖组年龄、腰臀比、收缩压、舒张压也明显高于体质量超标组(t=2.24～5.02,P<0.05、0.01).以BMI为因变量多元逐步回归分析显示家庭饮食开支占总收入的比例、舒张压、脂肪的摄入频率、职业性体力活动选入回归方程.④结论青岛市市区和近郊区肥胖和体质量超标患病率高于远郊区,市区和近郊区应作为肥胖症防治的重点.肥胖尤其腹型肥胖与DM+IGT和高血压关系密切.从防治高血压和糖尿病的角度出发,结合青岛市BMI、腰臀比的分布特点,以BMI 24～27作为体质量超标、BMI≥28作为肥胖的诊断切入点较为合适;腰臀比≥0.8作为腹型肥胖的诊断切入点较为恰当.增龄、脂肪的摄入频率高、低体力活动、用于家庭饮食开支增多为发生肥胖症的危险因素.

Objective To investigate the prevalence and influencing factors of obesity in Qingdao area. Methods The residents who had lived in urban and rural districts of Qingdao for at least five years and aged from 20 to 74 years were surveyed by random sampling methods of dividing layers. Results The prevalence of obesity and overweight was 9.01% and 39.40%, respectively, in Qingdao. The obesity in urban, suburb, and outskirt districts was 14.16%, 9.34% and 3.56%, the standardized rate being 4.72%, 2.53% and 1.41%, respectively. The prevalence of overweight in these districts was 57.98%, 40.41% and 19.29%, the standardized rate being 19.32%, 10.97% and 7.63%, respectively. In 162 obesity subjects, the incidence of Type 2 diabetes mellitus (DM) and impaired glucose tolerance (IGT) was 24.07%, those with systolic hypertension, and diastolic hypertension accounted for 32.71% and 39.15%, respectively. The prevalence of DM+IGT and hypertension increased with the increase of body mass index(BMI). When BMI was 28 or above, the prevalence of DM+IGT increased obviously compared to the BMI<19 group (χ2=7.50-10.15;P<0.05,0.01). When BMI was 24 or above, the incidence of hypertension was significantly higher than that of the BMI<19 group (χ2=6.24-18.40;P<0.05,0.01). The prevalence of DM+IGT and hypertension increased with the increase of WHR(waist to hip ratio). When WHR was 0.8 or above, the incidence of DM+IGT and hypertension was markedly higher than that of the <0.7 group (χ2=3.89-35.36;P<0.05,0.01).The age, WHR, systolic pressure, diastolic pressure, blood glucose at 2 h after taking sugar, in obesity and overweight groups were obviously higher than those in the normal body weight group(t=9.27-15.40, P<0.01), and those in the obesity group were obviously higher than those in overweight group (t=2.24-5.02;P<0.05,0.01). The percentage of food expenses, diastolic pressure, fat intake, and physical activity were analyzed with multiple stepwise regression analysis. Conclusion The prevalence of obesity and overweight in urban and suburb districts was higher than that in outskirt. The focal point of prevention and treatment of obesity should be placed in the urban and suburb districts. Obesity, especially abdomen obesity, is closely correlated with DM+IGT and hypertension. People with BMI between 24 and 27 should be diagnosed as overweight, BMI≥28 as obesity, and WHR≥0.8 as abdomen obesity. Aging, high fat intake, inactivity and increasing expenses for food are risk factors causing obesity.