CAJ | 학술논문

目的了解上海市中老年男性肥胖的流行现状及其与慢性病的关系.方法利用上海市男性健康队列研究的基线调查资料.研究对象为上海市某区8个街道40～74岁的中老年男性,2002-2006年期间共调查61 500人.采用体重指数(BMI)和腰围臀围比(WHR)作为肥胖的测量指标.利用非条件logistic回归模型分析肥胖和各种慢性病之间的关系.结果被访者超重、肥胖和向心性肥胖的标化患病率分别为36.8%、7.7%和49.7%.在所有被访者中,66.7%患有一种及以上慢性疾病.高血压标化患病率(26.5%)居首位.分别调整WHR和BMI,高血压、冠心病、胆结石、泌尿道结石、中风的患病率随BMI和WHR的增高而上升.与正常BMI组相比,肥胖组患5种疾病的OR值为1.16～3.13;WHR最大组与最小组相比,5种疾病的OR值为1.20～1.69.趋势检验P值均＜0.05.糖尿病与WHR呈正相关,WHR最大组的患病率是最小组2.40倍(95%CI:2.14～2.70),而糖尿病与BMI无关.慢性阻塞性肺病的患病率随BMI增高而下降,肥胖组与正常BMI组相比,OR=0.87(95%CI:0.77～0.98);而WHR结果则相反,WHR最大组的OR值为最小组的1.26倍(95%CI:1.14～1.40).结论高血压、胆结石、泌尿道结石、心脑血管疾病在肥胖男性中患病率较高.糖尿病患病率与向心性肥胖呈正相关.
목적 료해상해시중노년남성비반적류행현상급기여만성병적관계.방법 이용상해시남성건강대렬연구적기선조사자료.연구대상위상해시모구8개가도40～74세적중노년남성,2002-2006년기간공조사61 500인.채용체중지수(BMI)화요위둔위비(WHR)작위비반적측량지표.이용비조건logistic회귀모형분석비반화각충만성병지간적관계.결과 피방자초중、비반화향심성비반적표화환병솔분별위36.8%、7.7%화49.7%.재소유피방자중,66.7%환유일충급이상만성질병.고혈압표화환병솔(26.5%)거수위.분별조정WHR화BMI,고혈압、관심병、담결석、비뇨도결석、중풍적환병솔수BMI화WHR적증고이상승.여정상BMI조상비,비반조환5충질병적OR치위1.16～3.13;WHR최대조여최소조상비,5충질병적OR치위1.20～1.69.추세검험P치균＜0.05.당뇨병여WHR정정상관,WHR최대조적환병솔시최소조2.40배(95%CI:2.14～2.70),이당뇨병여BMI무관.만성조새성폐병적환병솔수BMI증고이하강,비반조여정상BMI조상비,OR=0.87(95%CI:0.77～0.98);이WHR결과 칙상반,WHR최대조적OR치위최소조적1.26배(95%CI:1.14～1.40).결론 고혈압、담결석、비뇨도결석、심뇌혈관질병재비반남성중환병솔교고.당뇨병환병솔여향심성비반정정상관.
Objective To investigate the epidemiological characteristics of obesity and how they related to chronic diseases among middle aged and elderly men in urban Shanghai.Methods A cross-sectional analysis was conducted using data from a baseline survey from an on-going cohort study of 61 500 men between 40-74 of age in urban Shanghai.Study subjects were recruited from 8 communities of an urban district in Shanghai during 2002 to 2006.General obesity was measured by body mass index (BMI≥28) and,central obesity by waist to hip ratio (WHR≥0.9).Unconditional logistic regression model was used to estimate the odds ratio and 95% confidence interval of chronic diseases associated with obesity after adjustment for potential confounding factors.Results The aged-adjusted prevalence rates of overweight,overall obesity and central obesity were 36.8%,7.7% and 49.7% respectively.In this population,66.7% subjects had ever been diagnosed with one or more kinds of chronic diseases,in which hypertension ranked first with an age-adjusted prevalence rate of 26.5%.After mutual adjustment for WHR and BMI,obesity (BMI≥28) appeared to be associated with increased prevalence rates of hypertension,coronary heart disease,gallstone,urinary tract calculus and stroke comparing to men having normal BMI (18.5≤BMI＜24) with ORs ranged from 1.16 to 3.13.However,to the lowest quartile,the ORs associated with the highest WHR were between 1.20 and 1.69 for these 5 diseases.All P values for trend tests were less than 0.05.WHR was positively associated with diabetes,with OR as 2.40 (95% CI:2.14-2.70) for the highest quartile comparing to the lowest quartile.BMI was unrelated to the diabetes prevalence.Prevalence of chronic obstructive pulmonary disease decreased with increasing BMI,but increased with WHR.The corresponding OR was 0.87 (95% CI:0.77-0.98)for the obese men compared to those with normal BMI while 1.26(95%CI:1.14-1.40) for the subjects with the highest WHR comparing to those with the lowest WHR.Conclusion The prevalence rates of hypertension,gallstone,urinary tract calculus,cardiovascular and cerebrovascular diseases were higher in obesity men.Central obesity seemed to be related to high prevalence of diabetes.