中国云南省农村地区肥胖患病率的变化趋势及其与社会经济梯度的关系。

Trends in prevalence of obesity and its association with hypertension across socioeconomic gradients in rural Yunnan Province, China.

机构信息

Yunnan Provincial Key Laboratory of Public Health and Biosafety & School of Public Health, Kunming Medical University, 1168 Yu Hua Street Chun Rong Road, Cheng Gong New City, Kunming, 650500, China.

The Second Affiliated Hospital of Kunming Medical University, 374 Yunnan- Myanmar Avenue, Wu Hua District, Kunming, 650106, China.

出版信息

BMC Cardiovasc Disord. 2024 Jan 28;24(1):75. doi: 10.1186/s12872-024-03741-1.

DOI:10.1186/s12872-024-03741-1

PMID:38281972

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10822144/

Abstract

BACKGROUND

This study aimed to uncover the changing prevalence of obesity and its association with hypertension across socioeconomic gradients in rural southwest China.

METHODS

Data were collected from two cross-sectional health interviews and surveys from 2011 to 2021 among individuals aged ≥ 35 years in rural China. Each participant's height, weight, waist circumference, and blood pressure were measured. The overall prevalence of obesity, central obesity, and hypertension was directly standardized by age based on the total population of the two surveys. Multivariate logistic regression was used to analyze the association between obesity and prevalence of hypertension and an individual socioeconomic position (SEP) index was constructed using principal component analysis.

RESULTS

From 2011 to 2021, the prevalence of obesity, central obesity, and hypertension increased substantially, from 5.9%, 50.2%, and 26.1-12.1%, 58.0%, and 40.4% (P < 0.01), respectively. These increasing rates existed in all subcategories, including sex, age, ethnicity, education, annual household income, access to medical services, and SEP (P < 0.05). In both 2011 and 2021, lower education level and poor access to medical services correlated with higher prevalence of central obesity, while higher SEP correlated with higher prevalence of obesity and central obesity (P < 0.01). Prevalence of obesity was higher in the Han ethnicity participants and individuals with poor access to medical services than in their counterparts (P < 0.01). Whereas the prevalence of central obesity was lower in Han participants than in ethnic minority participants in 2011 (P < 0.01), this trend reversed in 2021 (P < 0.01). A positive relationship between annual household income and prevalence of obesity and central obesity was only found in 2021 (P < 0.01). Obese and centrally obese participants were more likely to be hypertensive in both survey years (P < 0.01).

CONCLUSIONS

Future interventions to prevent and manage obesity in rural China should give increased attention to high income, less educated, poor access to medical services, and high SEP individuals. The implementation of these obesity interventions would also help reduce the prevalence of hypertension.

摘要

背景

本研究旨在揭示中国西南农村地区社会经济梯度中肥胖患病率的变化及其与高血压的关联。

方法

本研究于 2011 年至 2021 年期间，在中国农村地区开展了两次横断面健康访谈和调查，共纳入了年龄≥35 岁的个体。每位参与者的身高、体重、腰围和血压均进行了测量。根据两次调查的总人口，对肥胖、中心性肥胖和高血压的总体患病率进行了直接标准化。采用多变量 logistic 回归分析肥胖与高血压患病率之间的关系，并使用主成分分析构建个体社会经济地位（SEP）指数。

结果

2011 年至 2021 年期间，肥胖、中心性肥胖和高血压的患病率显著增加，分别从 5.9%、50.2%和 26.1%-12.1%、58.0%和 40.4%（P<0.01）增加到 12.1%、58.0%和 40.4%。这些增长速度在所有性别、年龄、民族、教育水平、年家庭收入、医疗服务可及性和 SEP 类别中均存在（P<0.05）。在 2011 年和 2021 年，较低的教育水平和较差的医疗服务可及性与中心性肥胖的高患病率相关，而较高的 SEP 与肥胖和中心性肥胖的高患病率相关（P<0.01）。汉族参与者和医疗服务可及性较差的参与者肥胖的患病率高于其对应者（P<0.01）。而在 2011 年，汉族参与者中心性肥胖的患病率低于少数民族参与者（P<0.01），但在 2021 年，这一趋势发生逆转（P<0.01）。只有在 2021 年，年家庭收入与肥胖和中心性肥胖的患病率呈正相关（P<0.01）。在两次调查年份中，肥胖和中心性肥胖的参与者患高血压的可能性更大（P<0.01）。