摘要
目的了解江苏省扬中市中老年居民不同肥胖类型与慢性病共病患病的关系,为优化肥胖诊断和慢性病共病的精准防控提供参考依据。方法于2017年11月—2021年6月采用多阶段分层整群抽样方法对在扬中市抽取的6899名40~69岁中老年居民进行问卷调查、体格检查和实验室检测,应用多元有序logistic回归模型分析扬中市中老年居民不同肥胖类型对慢性病共病患病的影响。结果最终纳入分析的扬中市6581名中老年居民中,患慢性病共病者3957例,慢性病共病患病率为60.1%。体质指数(BMI)超重、BMI肥胖、腰围(WC)中心性肥胖、腰臀比(WHR)中心性肥胖和腰高比(WHtR)中心性肥胖者比例分别为40.7%、12.1%、35.3%、79.6%和63.7%,BMI+WC、BMI+WHR和BMI+WHtR复合型肥胖者比例分别为10.5%、11.4%和11.8%。在控制了性别、年龄、文化程度、婚姻状况、家庭年收入、居住地、吸烟情况、饮酒情况、蔬菜摄入是否充足、水果摄入是否充足、体育锻炼情况、每日睡眠时间和慢性病家族史等混杂因素后,多元有序logistic回归分析结果显示,BMI超重(OR=1.736,95%CI=1.575~1.915)、BMI肥胖(OR=2.325,95%CI=2.012~2.687)、WC中心性肥胖(OR=1.773,95%CI=1.615~1.947)、WHR中心性肥胖(OR=1.956,95%CI=1.739~2.200)和WHtR中心性肥胖(OR=1.968,95%CI=1.788~2.166)均为扬中市中老年居民慢性病共病患病的危险因素,且以WC每增加1个标准差居民的慢性病共病患病风险为最大(OR=1.475,95%CI=1.406~1.547);BMI+WC(OR=2.590,95%CI=2.221~3.021)、BMI+WHR(OR=3.488,95%CI=2.908~4.185)和BMI+WHtR(OR=2.845,95%CI=2.438~3.321)复合型肥胖亦均为扬中市中老年居民慢性病共病患病的危险因素,且复合型肥胖居民与单一肥胖类型居民相比慢性病共病的患病风险更高。结论BMI肥胖、WC中心性肥胖、WHR中心性肥胖、WHtR中心性肥胖和复合型肥胖均为扬中市中老年居民慢性病共病患病的危险因素,其中WC中心性肥胖和复合型肥胖居民为该地区慢性病共病防控的重点人群。
Objective To examine the associations of different obesity phenotypes with chronic disease comorbidities among middle-aged and elderly residents in Yangzhong city for precise prevention and control of chronic disease comorbidy in the population.Methods Face-to-face interview with a questionnaire developed by domestic researchers,physical examination and laboratory tests were conducted among 6899 residents aged 40–69 years recruited with stratified multistage random cluster sample in urban and rural regions of Yangzhong city,Jiangsu province from November 2017 through June 2021.Multivariate ordered logistic regression model was applied to analyze the effect of different types of obesity on chronic disease comorbidity in the residents.Results Of 6581 participants finally included in the analysis,3957(60.1%)were identified as having chronic disease comorbidity;the proportions of body mass index(BMI in kg/m^(2))-based overweight(24.0–27.9)and obesity(≥28.0)were 40.7%and 12.1%;the proportions of central obesity based on waist circumference(WC,≥90 cm for males and≥85 cm for females),waist to hip ratio(WHR,≥0.90 for males and≥0.85 for females),and waist to height ratio(WHtR,≥0.50)were 35.3%,79.6%,and 63.7%;the proportions of mixed obesity indicated by BMI+WC,BMI+WHR,and BMI+WHtR were 10.5%,11.4%,and 11.8%,respectively.After adjusting for gender,age,education,marital status,annual household income,residence region,smoking,alcohol consumption,vegetable intake,fruit intake,physical activity,daily sleep duration and family history of chronic diseases,the results of multivariate ordered logistic regression analysis showed that the participants with following different obesity phenotypes were at increased risk of chronic disease comorbidity:BMI-based overweight(odds ratio[OR]=1.736,95%confidence interval[95%CI]:1.575–1.915),BMI-based obesity(OR=2.325,95%CI:2.012–2.687),WC-based central obesity(OR=1.773,95%CI:1.615–1.947),WHR-based central obesity(OR=1.956,95%CI:1.739–2.200),WHtR-based central obesity(OR=1.968,95%CI:1.788–2.166),BMI+WC-based mixed obesity(OR=2.590,95%CI:2.221–3.021),BMI+WHR-based mixed obesity(OR=3.488,95%CI:2.908–4.185),and BMI+WHtR-based mixed obesity(OR=2.845,95%CI:2.438–3.321).Conclusion BMI-based obesity,WC-,WHR-,and WHtR-based central obesity,and mixed obesity are all risk factors for chronic disease comorbidity among urban and rural middle-aged and elderly residents in Yangzhong city and special attention should be paid to the residents with WC-based central obesity and mixed obesity in prevention and control of chronic disease comorbidity.
作者
冯祥
华召来
施秋平
刘耀
周金意
仝海员
朱进华
FENG Xiang;HUA Zhaolai;SHI Qiuping;LIU Yao;ZHOU Jinyi;TONG Haiyuan;ZHU Jinhua(Institute of Tumor Prevention and Control,People’s Hospital of Yangzhong City,Yangzhong 212200,China;Institute of Chronic Disease Prevention and Control,Jiangsu Provincial Center for Disease Control and Prevention,Nanjing 210009,China;Department of Chronic Disease Prevention and Control,Yangzhong City Center for Disease Prevention and Control,Yangzhong 212200,China;Department of Gastroenterology,Zhongda Hospital,Southeast University,Nanjing 210000,China)
出处
《中国公共卫生》
CAS
CSCD
北大核心
2023年第11期1412-1418,共7页
Chinese Journal of Public Health
基金
镇江市重点研发计划-社会发展(SH2022051)
关键词
慢性病共病
肥胖类型
关系
中老年居民
chronic disease comorbidity
type of obesity
association
middle-aged and elderly residents
