郝丽鑫, 张兵, 王惠君, 王柳森, 姜红如, 王邵顺子, 李惟怡, 王志宏. 1989—2018年我国15个省(自治区、直辖市)18~35岁成年人超重和肥胖变化趋势及流行特征[J]. 环境与职业医学, 2022, 39(5): 471-477. DOI: 10.11836/JEOM21386
引用本文: 郝丽鑫, 张兵, 王惠君, 王柳森, 姜红如, 王邵顺子, 李惟怡, 王志宏. 1989—2018年我国15个省(自治区、直辖市)18~35岁成年人超重和肥胖变化趋势及流行特征[J]. 环境与职业医学, 2022, 39(5): 471-477. DOI: 10.11836/JEOM21386
HAO Lixin, ZHANG Bing, WANG Huijun, WANG Liusen, JIANG Hongru, WANG Shaoshunzi, LI Weiyi, WANG Zhihong. Trends and epidemic characteristics of overweight and obesity among adults aged 18-35 in 15 provinces (autonomous regions/municipalities) of China from 1989 to 2018[J]. Journal of Environmental and Occupational Medicine, 2022, 39(5): 471-477. DOI: 10.11836/JEOM21386
Citation: HAO Lixin, ZHANG Bing, WANG Huijun, WANG Liusen, JIANG Hongru, WANG Shaoshunzi, LI Weiyi, WANG Zhihong. Trends and epidemic characteristics of overweight and obesity among adults aged 18-35 in 15 provinces (autonomous regions/municipalities) of China from 1989 to 2018[J]. Journal of Environmental and Occupational Medicine, 2022, 39(5): 471-477. DOI: 10.11836/JEOM21386

1989—2018年我国15个省(自治区、直辖市)18~35岁成年人超重和肥胖变化趋势及流行特征

Trends and epidemic characteristics of overweight and obesity among adults aged 18-35 in 15 provinces (autonomous regions/municipalities) of China from 1989 to 2018

  • 摘要: 背景 超重和肥胖在全球范围呈上升趋势,且与多种慢性病相关,18~35岁人群相关研究缺乏。

    目的 探讨1989—2018年中国18~35岁成年人超重肥胖变化趋势及2018年流行特征。

    方法 选取1989、1991、1993、1997、2000、2004、2006、2009、2011、2015和2018年“中国健康与营养调查”22425名18~35岁成年人作研究对象。按WST 428—2013《成人体重判定》判断超重肥胖。体重指数(BMI)水平年份趋势分析采用一般线性模型,超重肥胖率年份趋势分析采用趋势卡方检验。采用Joinpoint回归模型计算年均变化百分比(AAPC)和年度变化百分比(APC)。采用log-binomial回归模型分析人口经济学特征与超重肥胖的关系,以性别分层,分析不同亚组中人口经济学特征与超重肥胖的关系。

    结果 1989—2018年18~35岁成年人BMI、超重率和肥胖率呈上升趋势,BMI从1989年的(21.3±2.3)kg·m−2上升至2018年的(23.3±4.0)kg·m−2,超重肥胖率从12.1%上升至36.8%。Joinpoint回归模型结果显示,2000年是1个节点,1989—2000年和2000—2018年超重率APC为4.1%和2.4%(P<0.05),肥胖率APC分别为15.2%和7.5%(P<0.05)。1989—2018年超重率以年均3.1%的速度上升(AAPC=3.1%,95%CI:2.4%~3.7%,P<0.05),肥胖率以年均10.3%的速度上升(AAPC=10.3%,95%CI:7.6%~13.2%,P<0.05)。男性、25~35岁组、北方人超重肥胖率分别为49.5%、38.7%、45.4%,25~35岁男性超重肥胖率为52.6%。log-binomial回归分析显示,女性较男性、南方人较北方人超重肥胖率降低(RR=0.54,95%CI:0.44~0.65;RR=0.74,95%CI:0.61~0.91),25~35岁组较18~24岁组超重肥胖率增加(RR=1.41,95%CI:1.07~1.87)。进一步以性别分层,log-binomial回归分析显示,与18~34岁男性相比,25~35岁男性超重肥胖率增加(RR=1.50,95%CI:1.04~2.14),与北方女性相比,南方女性超重肥胖率降低(RR=0.63,95%CI:0.46~0.87)。

    结论 我国18~35岁成年人超重肥胖问题日益严峻,目前男性、25~35岁人群、北方人应当重点干预和防控,尤其应关注25~35岁男性。

     

    Abstract: Background Overweight and obesity are on the rise all over the world and are related to a variety of chronic diseases. There is a lack of such research on the population aged 18-35.

    Objective To explore the trends of overweight and obesity in adults aged 18-35 from 1989 to 2018 and the epidemiological characteristics in 2018.

    Methods A total of 22425 adults aged 18-35 enrolled in the China Health and Nutrition Survey in 1989, 1991, 1993, 1997, 2000, 2004, 2006, 2009, 2011, 2015, and 2018 were selected as study subjects. Overweight and obesity were judged in accordance with WST 428-2013 Determination of adult weight. The trend analysis of body mass index (BMI) level adopted a general linear model, and the trend analysis of overweight and obesity rate adopted a chi-square test for trend. A joinpoint regression model was used to calculate the average annual percentage change (AAPC) and annual percentage change (APC). A log-binomial regression model was used to analyze the relationship between socioeconomic factors and overweight/obesity, and a model with sex stratification was also constructed.

    Results In the period of 1989–2018, the BMI, overweight rate, and obesity rate of adults aged 18-35 all showed an upward trend. The BMI increased from (21.3±2.3) kg·m−2 to (23.3±4.0) kg·m−2, and the rate of overweight and obesity increased from 12.1% to 36.8%. The results of joinpoint regression model showed that 2000 was a joinpoint, and the APCs of overweight rates of 1989–2000 and 2000–2018 were 4.1% and 2.4% respectively (P < 0.05), and the APCs of obesity rates were 15.2% and 7.5% respectively ( P < 0.05). From 1989 to 2018, the overweight rate increased at an average annual rate of 3.1% (AAPC=3.1%, 95% CI: 2.4%-3.7%, P<0.05), and the obesity rate increased at an average annual rate of 10.3% (AAPC=10.3%, 95%CI: 7.6%-13.2%, P<0.05). The overweight and obesity rates of men, the 25-35 age group, and northerners were 49.5%, 38.7%, and 45.4% respectively. About 52.6% of men aged 25-35 were overweight and obese. The results of log-binomial regression analysis showed that the risks of overweight and obesity were lower in women (with men as reference,RR=0.54, 95%CI: 0.44-0.65) and in southerners (with northerners as reference, RR=0.74, 95%CI: 0.61-0.91), but was higher in the 25-35 year old group (with the 18-24 year old group as reference, RR=1.41, 95%CI: 1.07-1.87). After stratification by sex, the results of log-binomial regression analysis showed that compared with men aged 18-34, men aged 25-35 had an increased risk of overweight and obesity (RR=1.50, 95%CI: 1.04-2.14), and compared with women in the north, women in the south had a lower risk of overweight and obesity (RR=0.63, 95%CI: 0.46-0.87).

    Conclusion The problem of overweight and obesity of Chinese adults aged 18-35 is serious. We should give priority to intervene and prevent the overweight and obesity of men, people aged 25-35, and northerners, especially men aged 25-35.

     

/

返回文章
返回