Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena, CA 91101, USA.
Ann Epidemiol. 2012 Sep;22(9):609-16. doi: 10.1016/j.annepidem.2012.05.006. Epub 2012 Jul 4.
To identify population groups that are most susceptible to obesity-related health conditions at young age.
For this population-based cross-sectional study, measured weight and height, diagnosis, laboratory, and drug prescription information were extracted from electronic medical records of 1,819,205 patients aged 20 to 39 years enrolled in two integrated health plans in California in 2007 through 2009.
Overall, 29.9% of young adults were obese. Extreme obesity (body mass index [BMI] ≥ 40 kg/m(2)) was observed in 6.1% of women and 4.5% of men. The adjusted relative risk (RR) for diabetes, hypertension, dyslipidemia, and the metabolic syndrome increased sharply for those individuals with a BMI of 40 or greater, with the sharpest increase in the adjusted RR for hypertension and the metabolic syndrome. The association between weight class and dyslipidemia, hypertension, and the metabolic syndrome but not diabetes was stronger among 20.0- to 29.9-year-olds compared with 30.0- to 39.9-year-olds (P for interaction < .05). For example, compared with their normal weight counterparts of the same age group, young adults with a BMI of 40.0 to 49.9, 50.0 to 59.9, and 60 or greater kg/m(2) had a RR for hypertension of 11.73, 19.88, and 30.47 (95% confidence interval [CI], 26.39-35.17) at 20 to 29 years old, and 9.31, 12.41, and 15.43 (95% CI, 14.32-16.63) at 30 to 39 years old.
Although older individuals were more likely to be extremely obese, the association between obesity-related health conditions was stronger in younger individuals. Hispanics and Blacks are also more likely to be obese, including extremely obese, putting them at an elevated risk for premature cardiovascular disease and some cancers relative to non-Hispanic Whites.
确定易患肥胖相关健康问题的人群。
本项基于人群的横断研究从 2007 年至 2009 年参加加利福尼亚州两个综合健康计划的 1819205 名 20 至 39 岁患者的电子病历中提取了体重和身高、诊断、实验室和药物处方信息。
总体而言，29.9%的年轻人肥胖。在女性中，6.1%的人肥胖程度严重（体重指数[BMI]≥40kg/m2），而男性中这一比例为 4.5%。对于 BMI 为 40 或更高的个体，糖尿病、高血压、血脂异常和代谢综合征的调整后相对风险（RR）急剧增加，其中高血压和代谢综合征的调整后 RR 增加最为显著。与 30 至 39 岁的人群相比，20 至 29 岁人群的体重级别与血脂异常、高血压和代谢综合征的相关性更强（交互 P<.05），但与糖尿病的相关性则较弱。例如，与同年龄组的正常体重相比，BMI 为 40.0 至 49.9、50.0 至 59.9 和 60 或更高 kg/m2 的年轻人，其患高血压的 RR 在 20 至 29 岁时分别为 11.73、19.88 和 30.47（95%置信区间[CI]，26.39-35.17），在 30 至 39 岁时分别为 9.31、12.41 和 15.43（95% CI，14.32-16.63）。
尽管年龄较大的个体更可能肥胖程度严重，但肥胖相关健康问题与年轻个体的关联更强。西班牙裔和非裔美国人也更可能肥胖，包括肥胖程度严重的个体，与非西班牙裔白人相比，他们罹患心血管疾病和某些癌症的风险更高。
