中年女性肥胖、吸烟与心血管危险因素的长期变化趋势：来自哥德堡人群研究 1980 至 2003 年的数据。

Obesity, smoking and secular trends in cardiovascular risk factors in middle-aged women: data from population studies in Göteborg from 1980 to 2003.

机构信息

Department of Emergency and Cardiovascular Medicine, Sahlgrenska University Hospital/Östra, Göteborg, Sweden.

出版信息

J Intern Med. 2010 Dec;268(6):594-603. doi: 10.1111/j.1365-2796.2010.02278.x.

DOI:10.1111/j.1365-2796.2010.02278.x

PMID:21091809

Abstract

BACKGROUND

To study the trends in cardiovascular risk factors in middle-aged city-dwelling Swedish women from 1980 to 2003.

METHODS

Using cross-sectional population-based surveys, five random population samples of a total of 1915 women aged between 45 and 54 years, participating in the BEDA study in 1980, WHO MONICA studies in 1985, 1990 and 1995, and a study of 50-year-old women in 2003 were measured for the following parameters: anthropometry, serum cholesterol and triglyceride levels, smoking habits, blood pressure, physical activity and stress.

RESULTS

Over almost 25 years, middle-aged women gained on average 4.4 kg in weight, with a net increase in body mass index (BMI) from 24.7 to 25.6 kg m⁻². The proportion of participants classified as obese (≥30 kg m⁻²) increased by 50% from 10.4% to 15.1%. Women who were smokers in 2003 did not have lower BMI values than nonsmokers. Mean serum cholesterol concentrations decreased markedly, whereas smoking habits did not significantly change. The prevalence of hypertension decreased by 8%, whereas that of diabetes remained stable at around 2%. Optimal risk factor status - no smoking, normotension and serum cholesterol <5 mmol l⁻¹ - was present in less than one in six women in 2003, and similar across BMI categories.

CONCLUSION

The favourable decline in cholesterol levels and hypertension and the increase in leisure time physical activity were offset by an increase in obesity, triglyceride levels and experience of stress, with only a minority of participants (less than one in six) having an optimal level of risk factors with respect to smoking, serum cholesterol and hypertension in 2003. This applied also to overweight and obese women. In earlier cohorts, subjects with low BMI values were more often smokers, whereas the opposite is observed in recent cohorts. Thus, women who smoke no longer have the advantage of lower weight.

摘要

背景

研究 1980 年至 2003 年期间瑞典中年城市女性心血管危险因素的变化趋势。

方法

采用横断面人群基础调查，对总共 1915 名年龄在 45 至 54 岁之间的女性进行了 5 次随机人群抽样，她们参加了 1980 年的 BEDA 研究、1985 年、1990 年和 1995 年的 WHO MONICA 研究以及 2003 年的 50 岁女性研究，对以下参数进行了测量：人体测量学、血清胆固醇和甘油三酯水平、吸烟习惯、血压、身体活动和压力。

结果

近 25 年来，中年女性平均体重增加了 4.4 公斤，体重指数（BMI）净增 0.9 个单位，从 24.7 增至 25.6 kg/m²。肥胖（≥30 kg/m²）患者的比例从 10.4%增加到 15.1%，增加了 50%。2003 年吸烟的女性 BMI 值并不比不吸烟者低。血清胆固醇浓度显著降低，而吸烟习惯没有明显变化。高血压患病率下降了 8%，而糖尿病患病率则稳定在 2%左右。2003 年，不到六分之一的女性具有最佳的危险因素状态——不吸烟、血压正常和血清胆固醇<5 mmol/l，且这种状态在不同 BMI 类别中相似。

结论

胆固醇水平和高血压的下降以及休闲时间体力活动的增加，被肥胖、甘油三酯水平和压力体验的增加所抵消，只有不到六分之一的参与者（不到六分之一）在 2003 年具有最佳的危险因素水平，包括吸烟、血清胆固醇和高血压。这也适用于超重和肥胖女性。在早期队列中，BMI 值较低的人群更多地吸烟，而在最近的队列中则相反。因此，现在吸烟的女性不再具有体重较低的优势。