成年人肥胖及其影响因素的纵向研究

Longitudinal Study of Adults Obesity and Its Influencing Factors

目的：了解江苏省成年人肥胖的流行特征及其相关影响因素，为科学指导防治肥胖和减少慢性病的危险因素提供理论依据。方法：以江苏省20～69岁的成年人为研究对象，采用分层整群抽样的方法，收集2000—2010年的肥胖数据，采用SAS软件分析资料。结果：1946—1950年出生队列到1976—1980年出生队列的肥胖率在2000-2010年间逐渐上升（P〈O．05）。而1931—1935年出生队列到1941—1945年出生队列等3个人群的肥胖率并没有明显增加（P〉0．05）。25岁以上各年龄组随着年龄的增加，发生肥胖的危险性逐渐增大。25岁以上各组的OR值与20～25岁基准组相比均有统计学差异（P〈0．05）。与1995—1999年相比，各观察时期的作用并不明显（P〉0．05）。趋势面分析显示，江苏省成年人肥胖率整体呈现出西高东低、北高南低的地理分布趋势。多因素Logistic逐步回归分析显示，性别（OR=0．49，95％CI为0．44～0．54）、学历（0．81，0．74～0．88）、慢性病（1．68，1．52～1．86）、小区公用健身设施（0．87，0．79～0．96）、上班距离（1．19，1．08～1．32）、生活压力感（0．84，0．78～0．91）、睡眠时间（0．79，0．68～0．91）、闲暇时静坐习惯（1．17，1．07～1．30）和体质等级（0．37，0．34～0．39）是肥胖的相关影响因素。结论：随着年龄的增加，发生肥胖的危险性逐渐增大；2000年以来的时代变迁对肥胖的影响并不明显；不同年代出生的人发生肥胖的危险性是有差异的。多种危险因素与肥胖相关，应尽快采取干预手段，加强健康教育，提高居民体力活动水平和提倡合理膳食是预防肥胖的重要措施。

Objective：To describe the epidemiological characteristics and relative impact factors of adults with obesity in Jiangsu province, and to provide a theoretical basis for the scientific guid ance of treating obesity and reducing the risk factors. Methods.. With Jiangsu province 20469 adults as the research object, using the stratified cluster sampling method to collect obese data in 2000--2010 and using SAS software to analyze the data. Results： Obesity prevalence of 1946--1950 birth cohort to 1976--1980 birth cohort gradually increased （P〈0. 05） from 2000 to 2010. Obesity prevalence from 1931--1935 birth cohort to 1941--1945 birth cohort was not significantly increased （P〈0.05）. With increasing age in each age group of over 25 years old, the risk of obesity increased gradually. Compared with baseline groups of 20- 25 years old, OR values of age groups of over 25 were statistical differences （P〈0. 05）. Com- pared with the period of 1995--1999, the other periods had a slight influence on the obesity prevalence （P〈0.05）. Trend surface analysis showed the overall prevalence of adult obesity in Jiangsu province was a gradual decreasing trend of the geographical distribution from west to east, from north to south. The results of Logistic regression analysis showed that major risk factors influencing obesity were gender （OR= 0.49,95 % CI：0.44 -0.54）, education （0.81, 0. 74-0. 88）, chronic disease （ 1. 68, 1. 52-1. 86）, district public health facilities （0. 87, 0. 79-0. 96） ,distance to work （1. 19,1. 08-1. 32）,a sense of life stress （0. 84,0.78-0. 91）, sleep time （0.79,0.68 - 0.91 ）, leisure- time sitting habits （ 1. 17,1.07 -1.30） and physical fitness levels （0.37,0.34-0.39）. Conclusion With increasing age, the risk of obesity increased gradually; era changes on the impact of obesity is not significantly different since the 2000 % obesity risks of those born in the different time are different. Many factors were re lated to adult obesity. Intervention should be taken to change this situation as soon as possible. Strengthening health education, improving the level of physical activity and advocating a rea-sonable diet should be important measures to prevent obesity.