Lv Jun, Chen Wei, Sun Dianjianyi, Li Shengxu, Millwood Iona Y, Smith Margaret, Guo Yu, Bian Zheng, Yu Canqing, Zhou Huiyan, Tan Yunlong, Chen Junshi, Chen Zhengming, Li Liming
Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, Beijing, China.
Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, Beijing, China; Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University, New Orleans, Louisiana, United States of America.
PLoS One. 2015 Apr 21;10(4):e0124586. doi: 10.1371/journal.pone.0124586. eCollection 2015.
Lifestyle factors are well-known important modifiable risk factors for obesity; the association between tobacco smoking and central obesity, however, is largely unknown in the Chinese population. This study examined the relationship between smoking and central obesity in 0.5 million Chinese adults, a population with a low prevalence of general obesity, but a high prevalence of central obesity.
A total of 487,527 adults (200,564 males and 286,963 females), aged 30-79 years, were enrolled in the baseline survey of the China Kadoorie Biobank (CKB) Study conducted during 2004-2008. Waist circumference (WC) and WC/height ratio (WHtR) were used as measures of central obesity.
The prevalence of regular smokers was significantly higher among males (60.6%) than among females (2.2%). The prevalence of central obesity increased with age and BMI levels, with a significant gender difference (females>males). Of note, almost all obese adults (99.4%) were centrally obese regardless of gender. In multivariable regression analyses, adjusting for age, education, physical activity, alcohol use and survey site, regular smoking was inversely associated with BMI in males (standardized regression coefficients, β= -0.093, p<0.001) and females (β= -0.025, p<0.001). Of interest, in the BMI stratification analyses in 18 groups, all βs of regular smoking for WHtR were positive in both genders; the βs showed a significantly greater increasing trend with increasing BMI in males than in females. In the analyses with model adjustment for BMI, the positive associations between regular smoking and WHtR were stronger in males (β= 0.021, p<0.001) than in females (β= 0.008, p<0.001) (p<0.001 for gender difference). WC showed considerably consistent results.
The data indicate that tobacco smoking is an important risk factor for central obesity, but the association is gender-specific and depends on the adjustment for general obesity.
生活方式因素是众所周知的肥胖重要可改变风险因素；然而，在中国人群中，吸烟与中心性肥胖之间的关联在很大程度上尚不清楚。本研究在50万中国成年人中调查了吸烟与中心性肥胖之间的关系，该人群总体肥胖患病率较低，但中心性肥胖患病率较高。
共有487,527名年龄在30至79岁之间的成年人（200,564名男性和286,963名女性）纳入了2004年至2008年期间进行的中国嘉道理生物银行（CKB）研究的基线调查。腰围（WC）和腰围身高比（WHtR）用作中心性肥胖的衡量指标。
男性中经常吸烟者的患病率（60.6%）显著高于女性（2.2%）。中心性肥胖的患病率随年龄和体重指数（BMI）水平增加，存在显著的性别差异（女性>男性）。值得注意的是，几乎所有肥胖成年人（99.4%）无论性别均为中心性肥胖。在多变量回归分析中，调整年龄、教育程度、身体活动、饮酒情况和调查地点后，经常吸烟与男性的BMI呈负相关（标准化回归系数，β = -0.093，p<0.001），与女性的BMI也呈负相关（β = -0.025，p<0.001）。有趣的是，在18组的BMI分层分析中，吸烟对WHtR的所有β系数在两性中均为正值；男性中β系数随BMI增加的上升趋势比女性显著更大。在对BMI进行模型调整的分析中，经常吸烟与WHtR之间的正相关在男性中（β = 0.021，p<0.001）比在女性中（β = 0.008，p<0.001）更强（性别差异p<0.001）。WC显示出相当一致的结果。
数据表明吸烟是中心性肥胖的重要风险因素，但这种关联具有性别特异性，并且取决于对总体肥胖的调整。
