An update on overweight and obesity in rural Northeast China: from lifestyle risk factors to cardiometabolic comorbidities

BMC Public Health, Oct 2014

Background Not enough is known about the prevalence of overweight and obesity in rural China in the current decade. We aim to update our knowledge of the prevalence of obesity and its associated risk factors and comorbidities in a large population sample in rural Northeast China. Methods A population-based survey of 11,579 participants aged 35 years and older was conducted in rural areas of Liaoning Province during 2012–2013. Anthropometric measurements, information on health-related variables and blood biochemical indexes were collected by well-trained personnel. Results The prevalence of general obesity and overweight was found to be 7.8% and 37.2%, respectively. The overall prevalence of abdominal obesity was 15.1%. Female gender, ethnic minority, middle-school education and a family income of 5,000–20,000 CNY per year were found to be risk factors for general obesity, while older age, female gender, ethnic minority and longer sleep duration (>8 h/d) increased the risk of abdominal obesity, after adjusting for confounders. Overweight and obese participants had significantly higher risks to develop prehypertension, hypertension, high LDL-C and low HDL-C compared with normal weight participants, while abdominal obesity was associated with increased risks of diabetes and high TG after adjusted for multiple factors. Compared with participants with a normal BMI and no abdominal obesity, the participants classified as abdominally obese and normal BMI; as abdominally obese and overweight; and abdominally obese and generally obese each had a progressive increase in the odds of hypertension (OR: 1.961, 95% CI: 1.154 to 3.331, OR: 2.744, 95% CI: 2.126 to 3.541, and OR: 8.990, 95% CI: 5.858 to 13.795, respectively) and high TG (OR: 3.165, 95% CI: 2.183 to 4.588, OR: 3.980, 95% CI: 3.332 to 4.755, and OR: 4.340, 95% CI: 3.574 to 5.271, respectively). Conclusions The prevalence of obesity in rural Northeast China exhibited a remarkably increasing upwards trend. General and abdominal obesity were associated with different subtypes of cardiometabolic comorbidities, the combined effects of which on the comorbidities dramatically increased.

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An update on overweight and obesity in rural Northeast China: from lifestyle risk factors to cardiometabolic comorbidities

BMC Public Health An update on overweight and obesity in rural Northeast China: from lifestyle risk factors to cardiometabolic comorbidities Xiaofan Guo 0 3 Zhao Li 0 3 Liang Guo 0 3 Liqiang Zheng 2 Shasha Yu 0 3 Hongmei Yang 0 3 Lu Zou 0 3 Ying Zhou 0 3 Yaowen Zhang 0 3 Luoning Zhu 1 Yonghong Zhang 4 Yingxian Sun 0 3 0 Department of Cardiology, the First Hospital of China Medical University , 155 Nanjing North Street, Heping District, Shenyang, Liaoning 110001 , People's Republic of China 1 Department of Cardiology, Dongfang Hospital affiliated to Tongji University , Shanghai , People's Republic of China 2 Department of Clinical Epidemiology, Library, Shengjing Hospital of China Medical University , Shenyang, Liaoning , People's Republic of China 3 Department of Cardiology, the First Hospital of China Medical University , 155 Nanjing North Street, Heping District, Shenyang, Liaoning 110001 , People's Republic of China 4 Department of Epidemiology, School of Public Health, Medical College of Soochow University , Suzhou, Jiangsu , People's Republic of China Background: Not enough is known about the prevalence of overweight and obesity in rural China in the current decade. We aim to update our knowledge of the prevalence of obesity and its associated risk factors and comorbidities in a large population sample in rural Northeast China. Methods: A population-based survey of 11,579 participants aged 35 years and older was conducted in rural areas of Liaoning Province during 2012-2013. Anthropometric measurements, information on health-related variables and blood biochemical indexes were collected by well-trained personnel. Results: The prevalence of general obesity and overweight was found to be 7.8% and 37.2%, respectively. The overall prevalence of abdominal obesity was 15.1%. Female gender, ethnic minority, middle-school education and a family income of 5,000-20,000 CNY per year were found to be risk factors for general obesity, while older age, female gender, ethnic minority and longer sleep duration (>8 h/d) increased the risk of abdominal obesity, after adjusting for confounders. Overweight and obese participants had significantly higher risks to develop prehypertension, hypertension, high LDL-C and low HDL-C compared with normal weight participants, while abdominal obesity was associated with increased risks of diabetes and high TG after adjusted for multiple factors. Compared with participants with a normal BMI and no abdominal obesity, the participants classified as abdominally obese and normal BMI; as abdominally obese and overweight; and abdominally obese and generally obese each had a progressive increase in the odds of hypertension (OR: 1.961, 95% CI: 1.154 to 3.331, OR: 2.744, 95% CI: 2.126 to 3.541, and OR: 8.990, 95% CI: 5.858 to 13.795, respectively) and high TG (OR: 3.165, 95% CI: 2.183 to 4.588, OR: 3.980, 95% CI: 3.332 to 4.755, and OR: 4.340, 95% CI: 3.574 to 5.271, respectively). Conclusions: The prevalence of obesity in rural Northeast China exhibited a remarkably increasing upwards trend. General and abdominal obesity were associated with different subtypes of cardiometabolic comorbidities, the combined effects of which on the comorbidities dramatically increased. General obesity; Abdominal obesity; Prevalence; Risk factor; Comorbidities Background The prevalence of overweight and obesity has been increasing rapidly all over the world [ 1,2 ], posing a major public health burden worldwide. In developing countries, rates of obesity have tripled in the past 20 years [3]. Aside from being a potentially modifiable cardiovascular disease (CVD) risk factor on its own, this non-communicable disease has propelled an upsurge in other cardiometabolic comorbidities, including hypertension, dyslipidaemia, Type 2 diabetes and metabolic syndrome [ 3,4 ]. The frequently-used anthropometric measurements of adiposity are body mass index (BMI) and waist circumference (WC). Abdominal fat deposition measured by WC has been suggested as a better indicator of obesity in relation to CVDs than BMI [ 5,6 ]. Because BMI reflects a combination of both fat mass and lean mass and WC reflects a measure of central fat distribution, the combination of these two indexes might be a more powerful predictor for health risks. Incorporating evaluation of WC in addition to BMI in clinical practice was advocated by many previous studies [ 7,8 ]. However, there have been limited studies clarifying the associations between these two parameters and cardiometabolic comorbidities, such as hypertension, diabetes and dyslipidaemia, in the rural Chinese population. As in other developing countries, overweight and obesity have become an important public health problem in China. In China in 2000–2001 the prevalence of overweight reached 26.9% in men and 31.1% in women [ 9 ]. Our previous study conducted during 2004–2005 found that in rural Northeast China the overall prevalence of overweight was 18.6% [ 10 ]. Rural Ch (...truncated)


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Xiaofan Guo, Zhao Li, Liang Guo, Liqiang Zheng, Shasha Yu, Hongmei Yang, Lu Zou, Ying Zhou, Yaowen Zhang, Luoning Zhu, Yonghong Zhang, Yingxian Sun. An update on overweight and obesity in rural Northeast China: from lifestyle risk factors to cardiometabolic comorbidities, BMC Public Health, 2014, pp. 1046, 14, DOI: 10.1186/1471-2458-14-1046