生活方式对中国35～74岁成年人中心型肥胖发病率的影响

The effects of lifestyle factors on the incidence of central obesity in Chinese adults aged 35-74 years

目的 调查我国成年人中心型肥胖的发病率及其分布特征,并探讨生活方式对中心型肥胖发病的影响.方法 2007-2008年,对1998年和2000年建立的两个队列中27 020名35 ～ 74岁成年人进行随访,收集腰围及生活方式等相关指标;以男性腰围≥90 cm、女性腰围≥85 cm和≥80 cm作为中心型肥胖的诊断标准,计算中心型肥胖的发病率;采用多因素logistic回归模型,调整基线相关变量（性别、年龄、南北方、城乡及生活方式等）后,计算生活方式对中心型肥胖发病的相对危险度（RR）.结果 我国35 ～ 74岁成年男性中心型肥胖（腰围≥90 cm）标化年发病率为2.19％,65岁前,发病率随年龄的升高而逐渐降低;使用腰围≥85 cm和≥80 cm标准,女性中心型肥胖标化年发病率分别为2.64％和4.06％,更年期后（55 ～ 74岁）发病率明显升高.多因素调整后,高中及以上学历者中心型肥胖（男性腰围≥90 cm、女性腰围≥85 cm）发病的相对风险较低[RR =0.84（95％ CI：0.74 ～0.96）];中心型肥胖发病风险随着家庭人均月收入的升高而升高;与中-重度体力工作者相比,非在岗者（从事家务劳动和退休者）的发病风险较高[RR=1.17 （95％ CI：1.01 ～ 1.36）];饮酒[RR=1.15（95％CI：1.01 ～ 1.32）]、饮花茶[RR=1.49（95％CI：1.28 ～ 1.72）]可以增加中心型肥胖的发病风险,而喝牛奶[RR =0.85（95％ CI：0.74 ～0.97）]、饮红茶[RR =0.74（95％ CI：0.58～0.95）]可以降低其发病风险.结论 改善生活方式是预防中心型肥胖最有效的途径,应在全社会中提倡健康生活方式,摒弃不良习惯,以遏制中心型肥胖的流行.

Objective To understand the incidence of central obesity and its characteristics,and explore the effects of lifestyle factors on incidence of central obesity in Chinese adults aged 35-74 years.Methods A total of 27 020 Chinese adults aged 35 to 74 years were enrolled in a prospective follow-up study （the study cohort was built from 1998 to 2000,respectively） during 2007 and 2008.Central obesity was defined as waist circumference ≥ 90 cm in men,≥ 85 cm and ≥ 80 cm in women,respectively.Multivariate logistic regression was used to estimate relative risks （RR） of central obesity for lifestyle factors after adjusting factors including genders,age,southern and geographic region,urbanization,lifestyles,and so on.Results Among Chinese adults aged 35-74 years,the standardized annual incidence of central obesity （waist≥90 cm） was 2.19％ for men and this rate decreased gradually with age among people younger than 65 vears old.The incidence of central obesity was 2.64％ （waist≥85 cm） and 4.06％ （waist≥80 cm） for women,respectively,and this rate increased obviously among people aged 55 to 74 years.Participants with ≥ 12 years＇ education（RR =0.84,95％ CI：0.74-0.96） had a lower risk of central obesity （waist≥90 cm for men,waist≥85 cm for women）.And this risk increased as the monthly household per capita income increased.Compared with the reference group,people involved in housework or retirees（RR =1.17 ;95％ CI：1.01-1.36）,drinking alcohol（RR =1.15,95％ CI：1.01-1.32） or scented tea（RR =1.49,95％ CI：1.28-1.72） had a higher risk of developing central obesity,while drinking milk （RR =0.85,95％ CI：0.74-0.97） or black tea（RR =0.74,95％ CI：0.58-0.95）,had a lower risk of developing central obesity.Conclusion A healthy lifestyle plays a key role in the prevention and control of central obesity in Chinese adults,and a healthy wav of lifestyle should be promoted in the whole society to decelerate the epidemic of the central obesity.