Wang Y, Mi J, Shan X-Y, Wang Q J, Ge K-Y
Center for Human Nutrition, Department of International Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA.
Int J Obes (Lond). 2007 Jan;31(1):177-88. doi: 10.1038/sj.ijo.0803354. Epub 2006 May 2.
Over the past two decades, China has enjoyed impressive economic development, and her citizens have experienced many remarked changes in their lifestyle. These changes are often associated with an increase in obesity and chronic disease.
In this meta-analysis, based on nationally representative data, we studied the current prevalence of obesity and the trends in obesity, mortality and morbidity in China.
Between 1992 and 2002, the prevalence of overweight and obesity increased in all gender and age groups and in all geographic areas. Using the World Health Organization body mass index cut points, the combined prevalence of overweight and obesity increased from 14.6 to 21.8%. The Chinese obesity standard shows an increase from 20.0 to 29.9%. The annual increase rate was highest in men aged 18-44 years and women aged 45-59 years (approximately 1.6 and 1.0% points, respectively). In general, male subjects, urban residents, and high-income groups had a greater increase. With the increase in overweight and obesity, obesity-, and diet-related chronic diseases (e.g., hypertension, cardiovascular disease (CVD), and type 2 diabetes) also increased over the past decade and became a more important preventable cause of death. Hypertension increased from 14.4% in 1991 to 18.8% in 2002 in adults; in older adults aged 35-74 years, it increased from 19.7 to 28.6%. Between 1993 and 2003, the prevalence of CVD increased from 31.4 to 50.0%; diabetes increased from 1.9 to 5.6%. During 1990-2003, although total mortality rate (per 100 000) decreased, overall the mortality rate and contribution (as percentages) to total death of obesity-related chronic disease increased, in particular, in rural areas. Mortality rate (per 100 000) of CVD increased from 128 to 145 and its contribution to total death, 27 to 32%, in rural areas; the figures decreased slightly in urban areas. The mortality rate of 'nutrition, endocrinology and metabolism-related disease' (NEMD) increased in both rural and urban areas between 1990 and 2000, 8.0 to 10.6 and 4.9 to 5.3, respectively. The current prevalence of hypertension, dyslipidaemia, metabolic syndrome, and diabetes among Chinese adults is approximately 20, 20, 15, and 3%, respectively.
The prevalence of overweight and obesity and obesity-related chronic diseases have increased in China in the past decade. Our findings provide useful information for the projection of future trends and the formulation of national strategies and programmes that can address the challenges of the growing obesity and chronic disease epidemic.
在过去二十年里，中国经济取得了令人瞩目的发展，其公民的生活方式也经历了许多显著变化。这些变化往往与肥胖和慢性病的增加有关。
在这项荟萃分析中，基于具有全国代表性的数据，我们研究了中国目前的肥胖患病率以及肥胖、死亡率和发病率的趋势。
1992年至2002年间，所有性别、年龄组以及所有地理区域的超重和肥胖患病率均有所上升。按照世界卫生组织的体重指数切点，超重和肥胖的合并患病率从14.6%升至21.8%。中国的肥胖标准显示从20.0%升至29.9%。年增长率在18 - 44岁男性和45 - 59岁女性中最高（分别约为1.6和1.0个百分点）。总体而言，男性、城市居民和高收入群体的增长幅度更大。随着超重和肥胖情况的增加，过去十年中与肥胖和饮食相关的慢性病（如高血压、心血管疾病（CVD）和2型糖尿病）也有所增加，并成为更重要的可预防死亡原因。成年人中高血压患病率从1991年的14.4%升至2002年的18.8%；在35 - 74岁的老年人中，从19.7%升至28.6%。1993年至2003年间，心血管疾病患病率从31.4%升至50.0%；糖尿病从1.9%升至5.6%。1990 - 2003年期间，尽管总死亡率（每10万人）有所下降，但总体而言，肥胖相关慢性病的死亡率及其在总死亡中的占比（百分比）有所上升，尤其是在农村地区。农村地区心血管疾病死亡率（每10万人）从128升至145，其在总死亡中的占比从27%升至32%；城市地区的这两个数字略有下降。1990年至2000年间，农村和城市地区“营养、内分泌和代谢相关疾病”（NEMD）的死亡率均有所上升，分别从8.0升至|10.6以及从4.9升至5.3。中国成年人中目前高血压、血脂异常、代谢综合征和糖尿病的患病率分别约为20%、20%、15%和3%。
过去十年中，中国超重和肥胖以及与肥胖相关的慢性病患病率有所上升。我们的研究结果为预测未来趋势以及制定应对肥胖和慢性病流行挑战的国家战略和计划提供了有用信息。
