Neovius M, Teixeira-Pinto A, Rasmussen F
Department of Public Health Sciences, Karolinska Institutet, Karolinska University Hospital (Norrbacka), Stockholm, Sweden.
Int J Obes (Lond). 2008 May;32(5):832-6. doi: 10.1038/sj.ijo.0803784. Epub 2007 Dec 18.
To assess whether the composition of the obese category (body mass index (BMI)> or =30) has changed during the last one-third of a century in young adult men.
Retrospective study of 1,580,913 men (18.3+/-0.4 years) representing 82% of the Swedish male population at military conscription age between 1969 and 2005. Measured height and weight were used to define moderate and morbid obesity as BMI 30-34.9 and > or =35, respectively. Data on socio-economic position (SEP), place of residence (urban, semi-urban and rural), age and test center were also collected.
From the period 1969-1974 to 2000-2005, the prevalence of moderate obesity almost quintupled (0.8-3.8%; P<0.0001), while morbid obesity increased 10-fold (0.1-1.3%; P<0.0001). The composition of the obese category changed from 12.9 to 25.1% morbidly obese during the same time, corresponding to an annual growth in the odds of 2.8% (CI(95%) 2.5-3.1%) per year within the obese category. Compared to 1969-1974, the odds ratios of obesity and morbid obesity, respectively, were 1.6 (1.6-1.7) and 1.9 (1.7-2.2) in 1980-1984, 2.8 (2.7-2.9) and 4.0 (3.5-4.5) in 1990-1994, and 6.0 (5.7-6.3) and 11.4 (10.1-12.9) in 2000-2005, after adjustment for SEP, urban/rural place of residence, age and test center. Extrapolation of the growth rate during the observation period resulted in an estimated 4% morbidly obese in 2020.
Morbid obesity increased faster than moderate obesity during the last 35 years. As the health risks and costs of obesity-related morbidity increase disproportionately in the morbidly obese, it is important to assess morbid obesity in prevalence studies, and distinguish the morbidly from the moderately obese in cost analyses.
评估在过去三分之一世纪中，年轻成年男性肥胖类别（体重指数（BMI）≥30）的构成是否发生了变化。
对1580913名男性（18.3±0.4岁）进行回顾性研究，这些男性占1969年至2005年瑞典男性征兵年龄人口的82%。测量的身高和体重被用于将中度肥胖和病态肥胖分别定义为BMI 30 - 34.9和≥35。还收集了社会经济地位（SEP）、居住地点（城市、半城市和农村）、年龄和检测中心的数据。
从1969 - 1974年到2000 - 2005年，中度肥胖的患病率几乎增长了四倍（0.8% - 3.8%；P<0.0001），而病态肥胖增长了10倍（0.1% - 1.3%；P<0.0001）。在同一时期内，肥胖类别中病态肥胖的构成从12.9%变为25.1%，相当于肥胖类别中每年的比值比增长2.8%（95%CI 2.5 - 3.1%）。与1969 - 1974年相比，在调整了SEP、城乡居住地点、年龄和检测中心后，1980 - 1984年肥胖和病态肥胖的比值比分别为1.6（1.6 - 1.7）和1.9（1.7 - 2.2）；1990 - 1994年分别为2.8（2.7 - 2.9）和4.0（3.5 - 4.5）；2000 - 2005年分别为6.0（5.7 - 6.3）和11.4（10.1 - 12.9）。根据观察期内的增长率推算，预计到2020年病态肥胖率将达到4%。
在过去35年中，病态肥胖的增长速度快于中度肥胖。由于病态肥胖中与肥胖相关的发病的健康风险和成本增长不成比例，在患病率研究中评估病态肥胖，并在成本分析中区分病态肥胖和中度肥胖非常重要。
