Relationship between body weight status in early adulthood and body weight change to middle age and high-density lipoprotein cholesterol level in middle aged Chinese people

目的 探讨成年早期体重状态及至中年时期的体重变化与中年时期低高密度脂蛋白胆固醇(HDL-C)血症的关系.方法 利用1998年中国心血管流行病学多中心协作研究的12个省市15组35 ～ 59岁(男女各半)人群样本心血管病危险因素调查资料,根据研究对象25岁时的体重指数(BMI)水平分为低体重组(BMI＜ 18.5 kg/m2,n=1 331)、正常体重组(18.5 kg/m2≤BMI＜ 24 kg/m2,n=10 400)、超重组(24 kg/m2≤BMI＜ 28 kg/m2,n =2 019)和肥胖组(BMI≥28 kg/m2,n=133),根据研究对象25岁至中年时期体重差值分为＜-7.5 kg组(n=903)、-7.5～-2.6 kg组(n=1 883)、-2.5 ～2.5kg组(n=2 573)、2.6～7.5 kg组(n =2 786)、7.6～12.5 kg组(n=2 674)和＞12.5 kg组(n =3 064).采用多因素logistic回归分别探讨25岁时体重状态和随后的体重变化与低HDL-C血症的关系.结果 共有13 883人纳入分析,25岁时低体重组、正常体重组、超重组和肥胖组中年时期低HDL-C血症患病率分别为10.7％(143/1 331)、15.5％(1 612/10400)、16.3％(330/2 019)和24.8％(33/133),呈明显上升趋势(趋势检验P＜0.01).25岁至中年时期体重变化＜-7.5 kg组、-7.5～-2.6 kg组、-2.5～2.5 kg组、2.6～7.5 kg组、7.6～12.5k g组和＞12.5 kg组低HDL-C血症患病率分别为8.8％(79/903)、8.0％ (151/1 883)、10.5％(269/2 573)、13.4％ (373/2 786)、19.1％(511/2 674)和24.0％(735/3064),也呈明显上升趋势(趋势检验P＜0.01).多因素logistic回归结果显示,25岁时超重和肥胖以及随后的体重增加均与中年时期低HDL-C血症正相关(趋势检验P＜0.01).结论 成年早期超重和肥胖以及随后的体重增加均与中年时期罹患低HDL-C血症独立相关.提示应充分重视青年时期的肥胖防治,控制超重和肥胖是预防低HDL-C血症的有效措施.Objective To explore the relationship between early adulthood weight status and body weight changes from early adulthood to middle age and high-density lipoprotein cholesterol (HDL-C) level.Methods Data were obtained from China Multicenter Collaborative Study of Cardiovascular Epidemiology Study,which was conducted in 1998,15 participants population samples aged from 35-59 years old from 12 provinces were selected by random cluster sampling.Approximately 1 000 men and women in each sample population were surveyed for cardiovascular disease risk factors,body weight at age 25 from all participants were also obtained.Body mass index (BMI) at the age of 25 years was calculated with the weight at 25 years and the height measured during the survey,participants were divided into underweight (BMI ＜ 18.5 kg/m2,n =1 331),normal-weight (18.5 kg/m2 ≤BMI ＜24 kg/m2,n =10 400),overweight (24 kg/m2 ≤BMI ＜ 28 kg/m2,n =2 019) and obesity (BMI≥28 kg/m2,n =133) groups.Weight change was defined as the difference between the body weight at the age of 25 and at the survey and was grouped into ＜-7.5 kg (n =903),-7.5--2.6kg (n=1 883),-2.5-2.5 kg (n=2573),2.6-7.5 kg (n=2786),7.6-12.5 kg (n =2 674) and ＞ 12.5 kg (n =3 064).The association of body weight status in early adulthood and body weight change from early adulthood to middle age with HDL-C level was examined by logistic regression model.Results The prevalence of low HDL-C in underweight,normal weight,overweight and obesity groups at age of 25 years were 10.7％ (143/1 331),15.5％ (1 612/10 400),16.3％ (330/2 019) and 24.8％ (33/133),respectively (P for trend ＜ 0.01).The prevalence of low HDL-C for adult weight change were 8.8％ (79/903),8.0％ (151/1 883),10.5％ (269/2 573),13.4％ (373/2 786),19.1％ (511/2 674),and 24.0％ (735/3 064) (P for trend ＜0.01)for weight change of ＜-7.5 kg,-7.5--2.6 kg,-2.5-2.5 kg,2.6-7.5 kg,7.6-12.5 kg and ＞ 12.5 kg,respectively.Multivariate logistic regression showed that overweight and obesity at age of 25 years and subsequent weight gain till middle age were positively correlated with low HDL-C after adjusted other risk factors(all P for trend ＜ 0.01).Conclusion Overweight and obesity in early adulthood and significant adult weight gain from early adulthood to middle age were both independently associated with marked increases in the risk of low HDL-C in middle-aged Chinese men and women.Thus,body weight control at early adulthood could be a key strategy to reduce the incidence of low HDL-C at middle-aged population.“九五”国家科技攻关计划(96-906-02-01)National Key Technologies R&D Program of China during the 9th Five-Year Plan Period中文核心期刊要目总览(PKU)中国科技核心期刊(ISTIC)中国科学引文数据库(CSCD)8678-6834