Hodge A M, Dowse G K, Toelupe P, Collins V R, Imo T, Zimmet P Z
International Diabetes Institute, Caulfield, Victoria, Australia.
Int J Obes Relat Metab Disord. 1994 Jun;18(6):419-28.
Obesity and an increasing prevalence of associated conditions such as diabetes and cardiovascular disease are frequently observed in Pacific populations as lifestyles become more modernized. In 1978, a survey conducted in three geographically defined populations in Western Samoa showed large differences in the prevalence of obesity (body mass index (BMI) > or = 30 kg/m2) between rural and urban populations. A follow-up survey using similar methods was performed in 1991 to examine the current level of obesity in these three locations and to assess changes over time. Cross-sectional differences in the prevalence of obesity, mean BMI and waist-hip circumference ratio (WHR) between urban Apia and rural Poutasi and Tuasivi were examined after adjusting for age. There were higher levels of obesity in urban vs rural areas: 74% of women in Apia were obese compared with 62% in Poutasi and 56% in Tuasivi. In men, comparable figures were 57%, 44% and 36% for Apia, Poutasi and Tuasivi respectively. Mean BMIs followed the same pattern. By contrast, WHR varied little between locations. Even in subjects aged 25-34 years, more than 50% of women in all locations, and 45% of urban men were obese. Increasing physical activity in men, but not women, was associated with lower mean BMI. Increasing education level and job status were associated with increasing BMI but these relationships were significant only in men. Multivariate analysis showed age, location (urban), occupation (high status, women), and in men, physical inactivity, to be independently associated with increased risk of obesity. Prevalence of obesity increased dramatically between 1978 and 1991 in all locations, but especially in Tuasivi, where in males the increase was 297% and in females 115%. There was a rightward shift in the distribution of body mass index in both sexes and all locations. These extreme increases in the prevalence of obesity, even in young adults, over the relatively short 13-year study period suggest an increasing burden of chronic diseases facing Western Samoa in the future, and emphasize the need for effective intervention to bring about lifestyle modification.
随着生活方式日益现代化，肥胖以及糖尿病和心血管疾病等相关病症在太平洋地区人群中愈发常见。1978年，在西萨摩亚三个地理区域的人群中开展的一项调查显示，农村和城市人口的肥胖患病率（体重指数（BMI）≥30kg/m²）存在巨大差异。1991年采用类似方法进行了一项后续调查，以研究这三个地区当前的肥胖水平，并评估随时间的变化情况。在调整年龄后，对阿皮亚市区与普塔西和图阿西维农村地区之间的肥胖患病率、平均BMI和腰臀围比（WHR）的横断面差异进行了研究。城市地区的肥胖水平高于农村地区：阿皮亚74%的女性肥胖，相比之下，普塔西为62%，图阿西维为56%。在男性中，阿皮亚、普塔西和图阿西维的相应数字分别为57%、44%和36%。平均BMI呈现相同模式。相比之下，各地区之间的WHR变化不大。即使在25至34岁的人群中，所有地区超过50%的女性以及45%的城市男性肥胖。男性身体活动增加与平均BMI降低相关，但女性并非如此。教育水平和工作地位提高与BMI增加相关，但这些关系仅在男性中显著。多变量分析显示，年龄、地点（城市）、职业（高地位，女性）以及男性的身体不活动与肥胖风险增加独立相关。1978年至1991年期间，所有地区的肥胖患病率均大幅上升，尤其是在图阿西维，男性患病率上升了297%，女性上升了115%。所有地区的男女体重指数分布均向右偏移。在相对较短的13年研究期间，肥胖患病率在甚至年轻成年人中都出现如此极端的上升，这表明西萨摩亚未来面临的慢性病负担日益加重，并强调需要进行有效干预以实现生活方式的改变。
