山东沿海超重和肥胖流行病学特征的5年变迁

Five-year changes in epidemiological characteristics of overweight and obesity in Shandong coastal inhabitants

目的了解2009年山东沿海地区20岁以上人群超重和肥胖的流行病学特征及其相关因素，并与2004年调研结果相比较，探讨其5年来的变迁。方法采用随机、分层、整群抽样方法，入户调查青岛、烟台、威海、13照、东营常住居民5060人超重和肥胖的流行病学情况。结果2009年超重、肥胖和腹型肥胖的标化率分别为33．5％、16．1％和40．0％，较2004年分别增加0．6％（P〈0．05）、2．9％（P〈0．01）和6．8％（P〈0．05）；其中男性超重、肥胖和腹型肥胖的标化率分别为37．9％、17．1％和44．6％，较2004年分别增加3．7％（P〈0.01）、3．7％（P〈0.01）和10．2％（P〈0.01）；2009年女性腹型肥胖患病率为38．6％，较2004年增加6．6％（P〈0.01）。此外，肥胖患病率随年龄增长而升高，50～69岁达高峰，70岁以后有所下降。男性肥胖呈现明显年轻化趋势，绝经后女性肥胖患病率明显升高。2009年各组的平均年龄、体重指数、腰围、甘油三酯、总胆固醇、血糖、血尿酸水平均较2004年有所升高（P〈0.01）。Logistic回归分析显示年龄、高血压、血脂紊乱、高尿酸血症、高血糖水平为肥胖的正相关因素，吸烟为负相关因素。肉类摄入量与男性肥胖有关，主食摄人量与女性肥胖密切相关。结论与2004年相比，2009年超重和肥胖患病率明显升高，中青年男性及绝经后女性尤为显著，应作为未来肥胖防治的重点；增龄、高血压、高血糖、高尿酸、血脂紊乱及饮食结构不合理与肥胖的发生密切相关。虽吸烟可减轻体重．但不主张通过吸烟控制体重。

Objective To investigate the characteristics and relevant factors of overweight and obesity in adults of the Shandong coastal area in 2009, as well as to estimate the epidemiological trends by comparing with results found in 2004. Methods A random and stratified cluster sampling of adults aged 20 years or older was conducted, and 5 060 inhabitants in the cities of Qingdao, Yantai, Weihai, Rizhao, and Dongying were included. Results The standardized prevalence rates of overweight, obesity, and abdominal obesity were 33.5% , 16. 1% , and 40.0% respectively in 2009, with respective increase of 0.6% （ P〈0.05 ） , 2.9% （ P〈0.01 ） , and 6.8% （ P〈0.05 ） compared with those in 2004 ; the rates for male were 37.9% , 17. 1% , and 44.6% respectively in 2009, with increase of 3.7% （ P〈0.01 ） , 3.7% （ P〈0.01 ） , and 10.2% （ P〈0.01 ） respectively compared with those in 2004 ; the prevalence of abdominal obesity for female was 38.6% , with an increase of 6.6% （ P〈0.01 ） compared with that in 2004. The prevalence of obesity increased consistently with age, reached a peak within 50-69 years old. There was a trend of developing obesity in younger, males, while obesity became more common in postmenopausal women. In contrast with the findings in 2004, the average age, body mass index, waist circumference, triglyceride, total cholesterol, uric acid, and blood glucose levels increased significantly （ P〈0.01 ） in 2009. Logistic regression analysis showed that aging, dyslipidemia, hypertension, hyperglycemia, hyperuricemia were positively related with obesity, and smoking was negatively related with it. Consumption of meat was related to male obesity, while carbohydrate consumption was related to female obesity. Conclusions A remarkable increase in the prevalence of obesity was found in 2009 compared with 2004, especially for the young and middle-aged men and postmenopausal women. Aging, hypertension, hyperglycemia, hyperuricemia, dyslipidaemia, and incorrect components of diet contributed to obesity. Although smoking is a negative factor for body weight, it is not suggested.