Department of Epidemiology and Health Monitoring, Robert Koch-Institut, General-Pape-Str, 62-66, 12101, Berlin, Germany.
BMC Public Health. 2012 Aug 15;12:658. doi: 10.1186/1471-2458-12-658.
Overweight has increased in many countries over the past 20 years and excessive body weight is an established risk factor for adverse health outcomes and chronic diseases. This study aimed to determine comorbidity associated with overweight and obesity in a nationally representative sample of German adults.
In the German National Health Interview and Examination Survey 1998 standardized measures of body weight, height and waist circumference (WC) were obtained for 7,124 men and women 18 to 79 years of age. Information on pre-existing health conditions, health-related behaviors, and sociodemographic characteristics was collected using physician-administered computer-assisted interviews and self-administered questionnaires. World Health Organization (WHO) cut-off criteria were applied to define overweight (BMI 25.0-29.9 kg/m2) and obesity (BMI ≥30.0 kg/m2) and abdominal obesity (men: WC ≥102 cm; women: WC ≥88 cm).
The crude prevalence of persons with cardiometabolic risk factors, diabetes mellitus, cardiovascular disease (CVD), gall bladder disease, and osteoarthritis showed a significant stepwise increase from the lowest to the highest BMI category in both sexes. In multiple logistic regression models adjusting for age, social status, and smoking, significant associations with overweight and obesity persisted for cardiometabolic risk factors and osteoarthritis. For example, obese persons had a three- to fourfold higher chance of having any cardiometabolic risk factor compared to normal weight persons (odds ratio (OR) = 4.07, 95% CI: 3.16-5.25 for men; OR = 3.40 (2.60-4.46) for women). Only in women, overweight and obesity as well as abdominal obesity, independent of BMI category, were significantly and consistently associated with diabetes (overweight: OR = 1.85 (1.03-3.30); obesity: OR = 2.94 (1.63-5.31); abdominal obesity: OR = 1.44 (1.08-1.92) and gall bladder disease (overweight: OR = 1.65 (1.22-2.25); obesity: OR = 3.06 (2.26-4.14); abdominal obesity: OR = 1.73 (1.25-2.39)).
Current estimates of disease burden underline the public health importance and clinical relevance related to overweight and obesity and needs to take into account comorbidity aspects.
在过去的 20 年中，许多国家的超重人口有所增加，而超重是不良健康结果和慢性疾病的既定风险因素。本研究旨在确定德国成年人全国代表性样本中与超重和肥胖相关的合并症。
在德国国家健康访谈和检查调查 1998 年，对 7124 名 18 至 79 岁的男性和女性进行了标准化的体重、身高和腰围（WC）测量。使用医生管理的计算机辅助访谈和自我管理问卷收集了关于预先存在的健康状况、与健康相关的行为以及社会人口统计学特征的信息。世界卫生组织（WHO）的截止标准用于定义超重（BMI 25.0-29.9kg/m2）和肥胖（BMI≥30.0kg/m2）和腹型肥胖（男性：WC≥102cm；女性：WC≥88cm）。
在两性中，患有心血管代谢风险因素、糖尿病、心血管疾病（CVD）、胆囊疾病和骨关节炎的人的粗患病率从最低 BMI 类别到最高 BMI 类别呈显著逐步增加。在调整年龄、社会地位和吸烟的多变量逻辑回归模型中，超重和肥胖与心血管代谢风险因素和骨关节炎持续存在显著关联。例如，与正常体重的人相比，肥胖的人患任何心血管代谢风险因素的几率高三到四倍（男性的比值比（OR）= 4.07，95%置信区间：3.16-5.25；女性的 OR=3.40（2.60-4.46））。仅在女性中，超重和肥胖以及腹部肥胖，独立于 BMI 类别，与糖尿病显著且一致相关（超重：OR=1.85（1.03-3.30）；肥胖：OR=2.94（1.63-5.31）；腹部肥胖：OR=1.44（1.08-1.92）和胆囊疾病（超重：OR=1.65（1.22-2.25）；肥胖：OR=3.06（2.26-4.14）；腹部肥胖：OR=1.73（1.25-2.39））。
目前对疾病负担的估计强调了超重和肥胖与公共卫生的重要性和临床相关性，并需要考虑合并症方面。
