Zhao J, Su C, Sun J, Fan D D, Wang H J, Zhang B
Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences, Beijing 100005, China.
National Institute of Nutrition and Health, Chinese Center for Disease Control and Prevention, Beijing 100050, China.
Zhonghua Liu Xing Bing Xue Za Zhi. 2021 Nov 10;42(11):1962-1968. doi: 10.3760/cma.j.cn112338-20210106-00009.
To investigate longitudinal association between smoking behavior and obesity risk in male adults in China from 1991 to 2015. A total of 32 169 male adults aged 18-64 years who participated in two or more rounds of China Health and Nutrition Survey (CHNS, 1991-2015) and had complete information of demographic characteristics, smoking status and physical measurements were selected as the study subjects. According to whether the subjects smoked or not and the number of cigarettes smoked per day, the subjects were divided into four groups: nonsmoker, light smoker (1-14 cigarettes/d), moderate smoker (15-24 cigarettes/d) and heavy smoker (≥25 cigarettes/d). The distribution of body mass index (BMI), waist circumference (WC), general obesity and central obesity of subjects with different smoking status were observed. Two-level mixed effect linear regression model and logistic regression model were used to analyze the relationship between smoking status and obesity risk. Compared with nonsmokers, the BMI decreased by 0.19 kg/m in light smokers (95%:-0.27--0.10), 0.40 kg/m in moderate smokers (95%:-0.49--0.31), and 0.36 kg/m in heavy smokers (95%:-0.53--0.19), respectively, and the WC decreased by 0.49 cm in light smokers (95%:-0.76--0.21), 0.80 cm in moderate smokers (95%:-1.08--0.51) and 0.79 cm in heavy smokers (95%:-1.38--0.36) in, respectively. Compared with nonsmokers, the odds ratio of the risk for general and abdominal obesity were 0.70 (95%:0.62-0.79) and 0.78 (95%:0.73-0.84) in light smokers, 0.61 (95%:0.55-0.69) and 0.74 (95%:0.70-0.79) in moderate smokers and 0.78 (95%:0.65-0.96) and 0.84 (95%:0.76-0.95) in heavy smokers, respectively. From 1991 to 2015, the BMI, WC, prevalence of general and abdominal obesity in male adults showed a significant upward trends in both nonsmokers and smokers (light, moderate and heavy) in China, suggesting that smoking is negatively associated with the risk for obesity in male adults.
为研究1991年至2015年中国成年男性吸烟行为与肥胖风险之间的纵向关联。选取32169名年龄在18 - 64岁、参加过两轮或更多轮中国健康与营养调查（CHNS，1991 - 2015年）且拥有完整人口统计学特征、吸烟状况及身体测量信息的成年男性作为研究对象。根据受试者是否吸烟及每日吸烟量，将其分为四组：不吸烟者、轻度吸烟者（1 - 14支/天）、中度吸烟者（15 - 24支/天）和重度吸烟者（≥25支/天）。观察不同吸烟状况受试者的体重指数（BMI）、腰围（WC）、全身肥胖及中心性肥胖的分布情况。采用二级混合效应线性回归模型和逻辑回归模型分析吸烟状况与肥胖风险之间的关系。与不吸烟者相比，轻度吸烟者的BMI分别降低0.19kg/m²（95%置信区间：-0.27 - -0.10），中度吸烟者降低0.40kg/m²（95%置信区间：-0.49 - -0.31），重度吸烟者降低0.36kg/m²（95%置信区间：-0.53 - -0.19）；轻度吸烟者的WC分别降低0.49cm（95%置信区间：-0.76 - -0.21），中度吸烟者降低0.80cm（95%置信区间：-1.08 - -0.51），重度吸烟者降低0.79cm（95%置信区间：-1.38 - -0.36）。与不吸烟者相比，轻度吸烟者全身肥胖和腹型肥胖风险的比值比分别为0.70（95%置信区间：0.62 - 0.79）和0.78（95%置信区间：0.73 - 0.84），中度吸烟者分别为0.61（95%置信区间：0.55 - 0.69）和0.74（95%置信区间：0.70 - 0.79），重度吸烟者分别为0.78（95%置信区间：0.65 - 0.96）和0.84（95%置信区间：0.76 - 0.95）。1991年至2015年，中国成年男性（包括不吸烟者以及轻度、中度和重度吸烟者）的BMI、WC、全身肥胖及腹型肥胖患病率均呈显著上升趋势，提示吸烟与成年男性肥胖风险呈负相关。
