Félix-Redondo Francisco Javier, Grau María, Baena-Díez José Miguel, Dégano Irene R, de León Antonio Cabrera, Guembe Maria Jesús, Alzamora María Teresa, Vega-Alonso Tomás, Robles Nicolás R, Ortiz Honorato, Rigo Fernando, Mayoral-Sanchez Eduardo, Tormo Maria José, Segura-Fragoso Antonio, Fernández-Bergés Daniel
Grupo de Epidemiología y Genética Cardiovascular, Programa de Investigación en Procesos Inflamatorios y Cardiovasculares, IMIM (Institut Hospital del Mar d'Investigacions Mèdiques), Barcelona, Spain.
BMC Public Health. 2013 Jun 5;13:542. doi: 10.1186/1471-2458-13-542.
To estimate the prevalence of overweight and obesity in the Spanish population as measured with body mass index (BMI), waist circumference (WC) and waist to height ratio (WHtR) and to determine the associated cardiovascular risk factors.
Pooled analysis with individual data from 11 studies conducted in the first decade of the 21st century. Participants aged 35-74 years were asked about the history of cardiovascular diseases, hypertension, diabetes and hypercholesterolemia. Height, weight, WC, blood pressure, glycaemia, total cholesterol, low-density and high-density lipoprotein cholesterol and coronary risk were measured. The prevalence of overweight (BMI 25-29.9 kg/m(2)), general obesity (BMI ≥ 30 kg/m(2)), suboptimal WC (≥ 80 cm and < 88 in women, ≥ 94 and < 102 in men), abdominal obesity (WC ≥88 cm ≥102 cm in women and men, respectively) and WHtR ≥0.5 was estimated, standardized for the European population.
We included 28,743 individuals. The prevalence of overweight and suboptimal WC was 51% and 30% in men and 36% and 22% in women, respectively; general obesity was 28% in both sexes and abdominal obesity 36% in men and 55% in women. The prevalence of WHtR ≥0.5 was 89% and 77% in men and women, respectively. All cardiovascular risk factors were significantly associated with abnormal increased values of BMI, WC and WHtR. Hypertension showed the strongest association with overweight [OR = 1.99 (95% confidence interval 1.81-2.21) and OR = 2.10 (1.91-2.31)]; suboptimal WC [OR = 1.78 (1.60-1.97) and OR = 1.45 (1.26-1.66)], with general obesity [OR = 4.50 (4.02-5.04), and OR = 5.20 (4.70-5.75)] and with WHtR ≥0.5 [OR = 2.94 (2.52-3.43), and OR = 3.02 (2.66-3.42)] in men and women respectively, besides abdominal obesity in men only [OR = 3.51 (3.18-3.88)]. Diabetes showed the strongest association with abdominal obesity in women [OR = 3,86 (3,09-4,89).
The prevalence of obesity in Spain was high. Overweight, suboptimal WC, general, abdominal obesity and WHtR ≥0.5 was significantly associated with diabetes, hypertension, hypercholesterolemia and coronary risk. The use of lower cut-off points for both BMI and particularly WC and could help to better identify the population at risk and therefore achieve more effective preventive measures.
采用体重指数（BMI）、腰围（WC）和腰高比（WHtR）评估西班牙人群中超重和肥胖的患病率，并确定相关的心血管危险因素。
对21世纪第一个十年进行的11项研究的个体数据进行汇总分析。询问年龄在35 - 74岁的参与者有关心血管疾病、高血压、糖尿病和高胆固醇血症的病史。测量身高、体重、腰围、血压、血糖、总胆固醇、低密度和高密度脂蛋白胆固醇以及冠心病风险。估计超重（BMI 25 - 29.9 kg/m²）、一般肥胖（BMI≥30 kg/m²）、腰围未达最佳（女性≥80 cm且<88 cm，男性≥94 cm且<102 cm）、腹型肥胖（女性腰围≥88 cm，男性腰围≥102 cm）和腰高比≥0.5的患病率，并根据欧洲人群进行标准化。
我们纳入了28743名个体。超重和腰围未达最佳的患病率在男性中分别为51%和30%，在女性中分别为36%和22%；一般肥胖在两性中均为28%，腹型肥胖在男性中为36%，在女性中为55%。腰高比≥0.5的患病率在男性中为89%，在女性中为77%。所有心血管危险因素均与BMI、腰围和腰高比的异常升高值显著相关。高血压与超重的关联最强[男性OR = 1.99（95%置信区间1.81 - 2.21），女性OR = 2.10（1.91 - 2.31）]；与腰围未达最佳[男性OR = 1.78（1.60 - 1.97），女性OR = 1.45（1.26 - 1.66）]、一般肥胖[男性OR = 4.50（4.02 - 5.04），女性OR = 5.20（4.70 - 5.75）]以及腰高比≥0.5[男性OR = 2.94（2.52 - 3.43），女性OR = 3.02（2.66 - 3.42）]均显著相关，此外仅男性腹型肥胖与之相关[OR = 3.51（3.18 - 3.88）]。糖尿病与女性腹型肥胖的关联最强[OR = 3.86（（3.09 - 4.89）]。
西班牙肥胖患病率较高。超重、腰围未达最佳、一般肥胖、腹型肥胖和腰高比≥0.5与糖尿病、高血压、高胆固醇血症和冠心病风险显著相关。采用更低的BMI切点，尤其是腰围切点，有助于更好地识别高危人群，从而采取更有效的预防措施。
