背景 超重、肥胖和中心性肥胖现已成为全球范围内影响居民生命健康的严重公共卫生问题.分析山西省居民超重、肥胖和中心性肥胖的流行趋势,可为相关疾病防治提供一定的科学价值.目的 分析 2010-2018 年山西省 20 岁及以上成年人超重、肥胖及中心性肥胖情况,分析其流行趋势.方法 选取 2010 年 8 月—2018 年 11 月(2010、2013、2015 和 2018 年)中国慢病监测项目中山西省部分 20 岁及以上成年人的调查数据,计算不同年份、性别、年龄和地区 20 岁及以上成年人的超重率、肥胖率和中心性肥胖率,分析不同特征成年人的超重、肥胖和中心性肥胖的流行趋势.结果 本研究 2010、2013、2015、2018 年分别获得有效人数 3 527、4 066、4 545、4 788 人,年龄20~108 岁.调查对象以 40~59 岁年龄段人群较多,女性居民较男性居民多,农村居民较城市居民多.山西省 2010-2018 年 20 岁及以上成年人整体超重粗率和经年龄、性别标化后的标化超重率分别为 37.7%~40.1%、36.1%~39.6%,无明显上升趋势(Z=0.005、2.413,P=0.942、0.120);整体标化肥胖率和整体中心性肥胖粗率、标化中心性肥胖率分别由 2010 年的 17.2%、53.8%、52.4%增长至 2018 年的 20.0%、61.6%、60.2%(Z=8.100、10.994、12.218,P<0.05).2010-2018年,不同年龄、性别、地区20岁及以上成年人整体超重粗率和标化超重率比较,无明显变化趋势(P>0.05).2013 年男性标化超重率高于女性(χ2=4.259,P=0.039)、男性标化肥胖率低于女性(χ2=13.724,P<0.001),其余时间点男女标化超重率和标化肥胖率比较,差异均无统计学意义(P>0.05).20~39 岁年龄组的整体肥胖率、男性肥胖率以及男、女性中心性肥胖率均呈现上升趋势(P<0.05).2010-2018 年城市居民的标化超重率、肥胖率、中心性肥胖率均高于农村居民(P<0.05),其中,城市和农村居民,2013 年和 2015 年的标化超重率,2010 年和 2015 年的标化肥胖率以及2015年和2018年的标化中心性肥胖率比较,差异有统计学意义(P<0.05).Joinpoint回归分析结果显示,2010-2018 年山西省女性标化超重率呈下降趋势(APC=-0.57,P<0.05),男性标化肥胖率呈上升趋势(APC=2.72,P<0.05),城市和农村居民的标化超重率、肥胖率和中心性肥胖率呈上升趋势(P>0.05),不同性别和地区之间的变化趋势也无明显差异(P>0.05).结论 2010-2018 年山西省 20 岁及以上成年居民超重率趋于稳定,肥胖率和中心性肥胖率整体呈现上升趋势.肥胖、中心性肥胖防治方面应以 20~39 岁青壮年为重点干预人群,减缓增长速度,以 40岁以上人群为重点防治人群,采取相应预防干预措施,以控制超重、肥胖和中心性肥胖的流行.
Background Overweight,obesity,and central obesity have become significant public health issues globally,affecting the well-being of residents.Analyzing the prevalence trends of overweight,obesity,and central obesity among residents in Shanxi Province can provide valuable scientific insights for the prevention and control of related diseases.Objective To analyze the prevalence and trends of overweight,obesity,and central obesity among adults aged 20 and above in Shanxi Province between 2010 and 2018.Methods The survey data of adults aged 20 and above in Shanxi Province were collected during four rounds of the China Chronic Disease Surveillance project from August 2010 to November 2018(in 2010,2013,2015,and 2018)to calculate the rates of overweight,obesity,and central obesity among adults aged 20 and above in different years,and analyze the prevalence trends of overweight,obesity and central obesity for different characteristics of the study subjects.Results From 2010 to 2018,the overall crude rates and age-and gender-standardized rates of overweight among adults aged 20 and above in Shanxi Province ranged from 37.7%to 40.1%and 36.1%to 39.6%,respectively,with no significant upward trend(Z=0.005,2.413;P=0.942,0.120).The overall standardized obesity rate,overall crude rate of central obesity and the standardized rate central of obesity increased from 17.2%,53.8%,and 52.4%in 2010 to 20.0%,61.6%,and 60.2%in 2018,respectively(Z=8.100,10.994,12.218;P<0.05).From 2010 to 2018,there was no significant trends in the comparison of the overall crude overweight rate and the standardized overweight rate among adults aged 20 years and above by age,gender and region(P>0.05);the standardized overweight rate for males was higher than that for females(χ2=4.259,P<0.05),while the standardized obesity rate was lower than that for females(χ2=13.724,P<0.001)in 2013;no statistically significant differences between genders were observed at other time points(P>0.05);the overall obesity rate,male obesity rate,and both male and female central obesity rates in the age group of 20-39 years old showed an upward trend during the 8-year period(P<0.05).From 2010 to 2018,the standardized rates of overweight,obesity,and central obesity among urban residents were overall higher than those among rural residents(P<0.05).Specifically,significant differences were observed in the standardized overweight rates in 2013 and 2015,the standardized obesity rates in 2010 and 2015,and the standardized central obesity rates in 2015 and 2018(P<0.05).The results of the Joinpoint regression analysis revealed that,from 2010 to 2018,the age-standardized overweight rate among females in Shanxi Province exhibited a decreasing trend(APC=-0.57,P<0.05),while the age-standardized obesity rate among males showed an increasing trend(APC=2.72,P<0.05).The standardized rates of overweight,obesity,and central obesity among urban and rural residents remained relatively stable over the 8-year period(P>0.05).There was also no significant difference in the trends of these rates between different genders and regions(P>0.05).Conclusion From 2010 to 2018,the overweight rate among residents aged 20 and above in Shanxi Province remained stable,while the overall trends for obesity and central obesity rates showed an increasing trend.The prevention and control of obesity and central obesity should focus on the population aged 20-39 years to slow down the growth rate.For residents aged 40 and above,as well as urban residents,targeted prevention strategies should be implemented,so as to control the prevalence of overweight,obesity,and central obesity.