Department of Nutrition, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina 27599-7461, USA.
Metab Syndr Relat Disord. 2011 Feb;9(1):55-62. doi: 10.1089/met.2010.0045. Epub 2010 Nov 20.
The associations between adiposity and metabolic risk factors have been suggested to vary across ethnicities. Studies in Caucasians have shown that after adjusting for waist circumference and body mass index (BMI), a larger hip circumference may be protective for metabolic risk factors. To our knowledge, these associations have never been examined in a Chinese population.
Baseline (1987-1988) and follow-up (1993-1994) data were from the People's Republic of China Study (n = 1,144 men, n = 1,776 women). Logistic models were stratified by sex and adjusted for age, smoking, center, and education. Incidence differences (ID) comparing the sex specific 85(th) percentile to the 15(th) percentile of hip circumference were computed for elevated blood pressure, blood glucose and triglycerides, low high-density lipoprotein cholesterol (HDL-C), and multiple metabolic abnormalities (three or more of the aforementioned).
In models adjusted for waist circumference and BMI, the ID [95% confidence interval (CI)] per 1,000 persons associated with a 12-cm larger hip were -132 (-237, -26) for low HDL-C; -85 (-138, -31) for elevated triglycerides; and -49 (-83, -4) for multiple metabolic abnormalities. In males, a larger hip circumference was not associated with a reduction of incident risk factors, although the ID tended to be negative.
In Chinese women, greater mass in the lower trunk region was inversely associated with incident high triglycerides, low HDL-C, and multiple metabolic abnormalities when adjusted for general and central adiposity. This association was not detected in men. Additional research is needed to better understand the mechanisms by which fat at different depots results in differential risk.
肥胖与代谢危险因素之间的关联在不同种族中存在差异。在白种人群体中的研究表明，在调整腰围和体重指数（BMI）后，较大的臀围可能对代谢危险因素具有保护作用。据我们所知，这些关联从未在中国人群中进行过研究。
本研究的数据来源于中国健康与营养调查（1987-1988 年基线调查和 1993-1994 年随访调查），共纳入 1144 名男性和 1776 名女性。采用 logistic 模型进行分层分析，并按性别、年龄、吸烟状况、中心和教育程度进行了调整。计算了臀围第 85 百分位数与第 15 百分位数之间的差异（ID），用于比较升高的血压、血糖和甘油三酯、低高密度脂蛋白胆固醇（HDL-C）以及多种代谢异常（上述三种情况中的三种或更多）的发生率。
在调整腰围和 BMI 后，与每增加 12cm 的臀围相关的 ID [95%置信区间（CI）]分别为 -132（-237，-26）与低 HDL-C；-85（-138，-31）与升高的甘油三酯；-49（-83，-4）与多种代谢异常。在男性中，较大的臀围与降低的危险因素发生率无关，尽管 ID 呈负值趋势。
在中国女性中，在调整全身和中心性肥胖后，下躯干区域的脂肪量增加与发生高甘油三酯、低 HDL-C 和多种代谢异常呈负相关。这种关联在男性中未被检测到。需要进一步研究以更好地了解不同脂肪沉积部位导致不同风险的机制。
