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ObjectiveObesity is often defined simply as a condition of abnormal or excessive fat accumulation in adipose tissue, which has caused adversely affects for health.With rapid economic development, elevated standard of living, changing lifestyle and ageing, obesity has become an important medical problem worldwide. The prevalence of obesity is increasing rapidly both in developed and developing countries. Obesity is a major contributor to the high prevalence of cardiovascular disease, type 2 diabetes mellitus, some cancers, and osteoarthritis, therefore obesity has been considered as one of the top ten risk factors for diseases by World Health Organization. In the past few decades, the prevalence of obesity in China increased rapidly and with it, the hazards and seriousness of the disease also increased quickly in the Chinese population.The International Collaborative Study of Cardiovascular Disease in Asia (InterASIA) was used to analyze the prevalence rates of overweight, overall obesity, and central obesity, the risk factors of obesity, and the appropriate cutoff for waist-to-hip ratio (WHR) that predict obesity in the Chinese adult population. MethodsInternational Collaborative Study of Cardiovascular Disease in ASIA (Inter ASIA), a cross-sectional study, was conducted in 2000～2001. A 4-stage stratified sampling method was used to select a nationally representative sample of the Chinese general population aged 35-74 years. 31 provinces (and municipalities) were stratified into northern and southern China, as divided by the Chang Jiang River. Five provinces or municipalities from northern China and five from southern China were selected to be representative of the geographic and economic developing status in their regions. A total of 15838 persons (7684 men and 8154 women) were selected and completed the study. The present analysis was restricted to the 15515 adults between 35 and 74 years old who had anthropometric measures. Data was collected by questionnaire review (demographic characteristics, medical history, and behavior risk factors), anthropometric measurements (height, weight, waist and hip circumferences and blood pressure) and laboratory measurements (FPG, TC, TG, HDL-C). Overweight and overall obesity were defined by subjects with 24 kg/m~2≤BMI<28 kg/m~2、BMI≥28kg/m~2, and central obesity was defined when men had a WC≥85cm or women had a WC≥80cm. Cross-sectional study and case-control study were used to investigate the prevalence and risk factors of obesity, and to identify cutoffs for waist-to-hip ratio (WHR) that predict central obesity in Chinese adult population.ResultsThe prevalence rates of overweight, overall obesity, and central obesity The prevalence rates of overweight, overall obesity and central obesity were 28.4%, 9.82%, and 34%, respectively. The prevalence rates of overall obesity and central obesity in women (11.55%, 37.68%) were statistically higher than those in men (8.17%, 30.51%) (P<0.0001), whereas there was no significantly statistical difference between men (28.19%) and women (28.63%) for the prevalence rate of overweight (P>0.05). There were significantly statistical differences among age groups for the prevalence of overweight and central obesity (P<0.01, P<0.0001), but there was no significant difference for overall obesity among age groups (P>0.05). The prevalence rates of overweight, overall obesity and central obesity in urban or north were higher than those in rural or north (P<0.0001). The prevalence rates of overweight, overall obesity and central obesity for participants with higher education level (high school or higher) (37.39%, 12.94%, 42.74%) were all higher than those for participants with lower education level (less than high school) (26.31%, 9.09%, 31.89%) (P<0.0001). Among participants with different occupations, the prevalence rates of overweight (40.01%), overall obesity (13.35%), and central obesity (46.49%) for professionals were higher than those for laborers (26.47%, 9.26%, 31.68%) (P<0.0001). The prevalence rates of overweight, overall obesity and central obesity were all increased with the average income. The prevalence rate of overweight for married (25.06%) was significantly lower than that for singled (28.71%) (P<0.05), but there were no statistical difference for the prevalence rates of overall obesity and central obesity (P>0.05). There were significant variations of prevalence rates of overweight, overall obesity, and central obesity among 10 provinces (and municipalities) in China. The risk factors of overweight or overall obesity, and central obesityMultivariate analysis showed that, after adjusted by gender and age, living in urban (OR=1.18, 95%CI=1.026-1.357), living in north (OR=3.655, 95CI%=3.253-4.108), intake frequency of nuts (OR=1.028, 95%CI=1.009-1.047), intake frequency of red meat (OR=1.033, 95%CI=1.020-1.047), intake frequency of white meat (OR=1.071, 95%CI=1.031-1.113) were significantly positively associated to overweight or obesity, whereas laborer occupation (OR=0.64, 95%CI=0.481-0.853), current smoking (OR=0.541, 95%CI=0.468-0.626), levels of physical activity (OR=0.988, 95%CI=0.985-0.991), intake frequency of milk (OR=0.646, 95%CI=0.557-0.748) were negatively associated to overweight or overall obesity.Living in north (OR=2.747, 95%CI=2.447-3.083), individual average income (OR=l.00004, 95%CI=1.00002-1.00005), intake frequency of fish (OR=1.059, 95%CI=1.026-1.092), intake frequency of bean (OR=1.018, 95%CI=1.001-1.034), intake frequency of red meat (OR=1.049, 95%CI=1.035-1.063), and intake frequency of white meat (OR=1.054, 95%CI=1.016-1.093) were significantly positively associated to central obesity. Current smoking (OK=0.669, 95%CI=0.577-0.775), physical activity (OR=0.987, 95%CI=0.984-0.990), and intake frequency of milk (OR=0.677, 95%CI=0.586-0.781) were negatively associated to central obesity.The appropriate WHR cutoff for identifying central obesity for the Chinese adults For both men and women, the mean SBP, DBP, LDL-cholesterol, and glucose values were increasing, but the mean HDL-cholesterol values were decreasing with the increasing of WHR values. More over, the prevalence rates of hypertension, type 2 diabetes, high LDL-cholesterol, and low HDL-cholesterol were significantly increased with the level of WHR for both men and women. The shortest distance in the ROC curve was at 0.86 for men and 0.82 for women.ConclusionsThe prevalence of obesity in the Chinese adults shows a rapidly increasing trend inrecent years. It’s urgent to prevent obesity effectively in this population.The healthy lifestyle is very important for the prevention and treatment of obesity andobesity related chronic diseases.WHR levels are positively associated to hypertension, type 2 diabetes, anddyslipidemia both in men and women. The WHR cutoff of 0.86 for men, and 0.82 forwomen were suggested for identifying central obesity for the Chinese adults.
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