摘要目的 探讨江苏省成人中心型肥胖与主要心血管疾病危险因素及其聚集性的关系.方法 2010年10至12月,采用多阶段整群随机抽样方法,在江苏省14个成人慢性病及其危险因素监测点抽取8 400名18岁及以上常住居民进行问卷调查、体格检查和实验室检测,对其中资料完整的8 380名调查对象进行分析.将男性腰围≥85 cm和女性腰围≥80 cm定义为中心型肥胖.对样本进行复杂加权后,分析不同腰围人群的心血管危险因素及其聚集情况.结果 江苏省成人中心型肥胖率为46.2％,男性和女性分别为46.4％和46.1％ (P ＞0.05);不同年龄、地区、学历和职业人群的中心型肥胖率差异均有统计学意义(P均＜0.01).不同腰围人群的收缩压、舒张压、空腹血糖、总胆固醇、甘油三酯、高密度脂蛋白胆固醇和低密度脂蛋白胆固醇水平差异均有统计学意义(P均＜0.01).高血压、糖尿病和血脂异常患病率及心血管疾病危险因素聚集比例均随着腰围的增加而增加(P均＜0.05).多因素logistic回归分析显示,轻度和重度中心型肥胖者高血压、糖尿病、血脂异常、心血管疾病危险因素聚集的风险分别是正常者的2.2(OR =2.2,95％ CI:2.0～2.4)和4.7(OR=4.7,95％ CI:3.9 ～5.7)倍、2.1(OR =2.1,95％ CI:1.7 ～2.5)和3.8(OR =3.8,95％ CI:3.2～4.5)倍、2.3(OR =2.3,95％ CI:1.8 ～2.9)和4.1 (OR =4.1,95％ CI:3.2 ～5.3)倍、3.4(OR =3.4,95％ CI:2.9 ～3.9)和8.0(OR =8.0,95％ CI:6.2～10.2)倍.结论 江苏省成人中心型肥胖程度与心血管疾病危险因素及其聚集风险有关,应当及时采取综合干预措施控制肥胖.

abstractsObjective To explore the relationship between central obesity and cardiovascular risk factors and their clustering in adults of Jiangsu province.Methods Multi-stratified clustering sampling method was used to sample 8 400 residents aged 18 years and over from 14 diseases surveillance units in Jiangsu province from October to December 2010.Information was obtained with face-to-face interview,physical examination and laboratory testing.A total of 8 380 residents finished the study protocol and their data were analyzed.Central obesity was defined as waist circumference ≥ 85 cm in males or ≥ 80 cm in females.Following complex weighting of the samples,level and proportion of cardiovascular risk factors in group with different waist circumference were analyzed.Results The prevalence of central obesity among adults in Jiangsu province was 46.2％,the proportion of males and females was 46.4％ and 46.1％,respectively (P ＞ 0.05).The prevalence of center obesity varied significantly in residents with different age,area,education and occupation (all P ＜ 0.01).The level of systolic blood pressure,diastolic bloodpressure,fasting blood glucose,total cholesterol,triglyceride,high density lipoprotein cholesterol and low density lipoprotein cholesterol was also significantly different in residents with different degree of waist circumference (all P ＜ 0.01).The prevalence of hypertension,diabetes,dyslipidemia and clustering of cardiovascular risk factors increased in proportion to increasing waist circumference (all P ＜ 0.05).Multivariate logistic regression analysis showed that the risk of hypertension,diabetes,dyslipidemia and clustering of cardiovascular risk factors was 2.2 (OR =2.2,95％ CI:2.0-2.4) and 4.7 (OR =4.7,95％ CI:3.9-5.7);2.1 (OR=2.1,95％ CI:1.7-2.5) and3.8 (OR=3.8,95％ CI:3.2-4.5);2.3 (OR=2.3,95％ CI:1.8-2.9) and4.1(OR=4.1,95％ CI:3.2-5.3);3.4 (OR=3.4,95％CI:2.9-3.9) and 8.0 (OR =8.0,95％ CI:6.2-10.2) fold higher in residents with mild and severe central obesity than residents without central obesity.Conclusions The extent of central obesity positively correlates with the prevalence of cardiovascular risk factors and their clustering in adults of Jiangsu province.Comprehensive interventions on obesity serve as an important tool to reduce the cardiovascular risk in adult Jiangshu residents.