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Article(id=1241034443838771307, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1241034441380917539, articleNumber=null, orderNo=null, doi=10.20043/j.cnki.MPM.202501205, pmid=null, cstr=null, oa=null, hot=null, price=null, onlineType=0, articleFormat=0, articleType=null, articleTypeStr=null, receivedDate=1736611200000, receivedDateStr=2025-01-12, revisedDate=null, revisedDateStr=null, acceptedDate=null, acceptedDateStr=null, onlineDate=1773815268715, onlineDateStr=2026-03-18, pubDate=1749484800000, pubDateStr=2025-06-10, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1773815268715, onlineIssueDateStr=2026-03-18, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1773815268715, creator=13701087609, updateTime=1773815268715, updator=13701087609, issue=Issue{id=1241034441380917539, tenantId=1146029695717560320, journalId=1227665162245664772, year='2025', volume='52', issue='11', pageStart='1921', pageEnd='2112', issueExtLink='null', onlineDate='null', pubDate='null', beforeIssueId=null, nextIssueId=null, price=null, status=1, issueComplete=1, articleOrder=1, issueType=-1, specialIssue=null, createTime=1773815268130, creator=13701087609, updateTime=1773815340947, updator=13701087609, preIssue=null, nextIssue=null, ext={EN=IssueExt(id=1241034746873049765, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1241034441380917539, language=EN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=), CN=IssueExt(id=1241034746873049766, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1241034441380917539, language=CN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=)}, issueFiles=null}, startPage=1935, endPage=1940, ext={EN=ArticleExt(id=1241034444589551737, articleId=1241034443838771307, tenantId=1146029695717560320, journalId=1227665162245664772, language=EN, title=Analysis of obesity metabolic phenotypes and their influencing factors in middle-aged and elderly populations in Hubei Province, columnId=1240413921954295836, journalTitle=Modern Preventive Medicine, columnName=Epidemiology and Statistical Methods, runingTitle=null, highlight=null, articleAbstract=
Objective

To analyze the prevalence and influencing factors of different obesity metabolic phenotypes in middle-aged and elderly populations in Hubei Province, aiming to provide scientific reference and decision-making basis for early prevention and intervention of obesity-related diseases.

Methods

A population involved in the “National Cardiovascular Disease High-risk Population Early Screening and Comprehensive Intervention Project” from January 2016 to December 2019 in Hubei Province was selected to analyze the prevalence and epidemiological characteristics of different obesity metabolic phenotypes and to explore the influencing factors of obesity metabolic phenotypes in middle-aged and elderly populations in Hubei.

Results

A total of 112 270 participants were included in this study. The prevalence rates of metabolically healthy overweight or obese, metabolically unhealthy normal weight, and metabolically unhealthy overweight or obese were 15.78%, 21.16%, and 42.82%, respectively. The results of the unordered multinomial logistic regression showed that, compared to the metabolically healthy normal weight group, living in rural areas (OR=1.08, 95%CI: 1.03-1.13; OR=1.21, 95%CI: 1.16-1.25), being in the older age group (aged 65 and above, OR=3.39,95%CI: 3.15-3.64; OR=3.31, 95%CI: 3.12-3.52), being male (OR=1.22, 95%CI: 1.16-1.29; OR=1.17, 95%CI: 1.12-1.22), and alcohol consumption (OR=1.15, 95%CI: 1.08-1.23; OR=1.14, 95%CI: 1.07-1.20) were associated with an increased risk of being metabolically healthy overweight or obese, metabolically unhealthy normal weight, and metabolically unhealthy overweight or obese.Higher education level (high school or above, OR=0.87, 95%CI: 0.84-0.92), higher household annual income (≥50 000 yuan, OR=0.81, 95%CI: 0.76-0.86), and smoking (OR=0.67, 95%CI: 0.63-0.70) were associated with a decreased risk of being metabolically unhealthy overweight or obese (all P < 0.01).

Conclusion

The prevalence of metabolically unhealthy overweight or obesity is high in Hubei Province, and it is essential to strengthen prevention and control efforts, particularly targeting older males in rural areas, those with low income, low education levels, and individuals with alcohol consumption habits.

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目的

分析湖北省中老年人群不同肥胖代谢表型的流行现状及影响因素，旨在为早期预防和干预肥胖相关疾病提供科学参考和决策依据。

方法

选取2016年1月—2019年12月参与“国家心血管病高危人群早期筛查与综合干预项目”湖北省项目点的人群，分析不同肥胖代谢表型的患病率及流行病学特征，并探究湖北省中老年人群肥胖代谢表型的影响因素。

结果

本研究共纳入112 270名研究对象，代谢正常超重或肥胖、代谢异常体重正常以及代谢异常超重或肥胖患病率分别为15.78%、21.16%、42.82%。无序多分类logistic回归结果显示，与代谢正常体重正常组相比，农村地区（OR=1.08，95%CI：1.03～1.13；OR=1.21，95%CI：1.16～1.25）、高年龄组（65岁及以上OR=3.39，95%CI：3.15～3.64；OR=3.31，95%CI：3.12～3.52）、男性（OR=1.22，95%CI：1.16～1.29；OR=1.17，95%CI：1.12～1.22）、饮酒（OR=1.15，95%CI：1.08～1.23；OR=1.14，95%CI：1.07～1.20）与代谢正常超重或肥胖、代谢异常体重正常及代谢异常超重或肥胖患病风险增加相关。高中及以上文化程度（OR=0.87，95%CI：0.84～0.92）、高家庭年收入（5万元及以上OR=0.81，95%CI：0.76～0.86）和吸烟（OR=0.67，95%CI：0.63～0.70）与代谢异常超重或肥胖患病风险下降相关（均有P<0.01）。

结论

湖北地区代谢异常超重或肥胖患病率较高，应重点加强防控工作，尤其是针对农村地区的高龄、男性、低收入、低文化程度以及有饮酒习惯的人群。

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孙小杰与齐俊锋为共同通信作者。孙小杰，E-mail:；
齐俊锋，E-mail: ；
, copyrightStatement=本刊刊出的所有文章不代表中华预防医学会和本刊编委会的观点，除非特别声明。, copyrightOwner=中华预防医学会和四川大学华西公共卫生学院, extLink=null, articleAbsUrl=null, sourceXml=3OJpsJHWTeHsiIWQlkDMZA==, magXml=Ukp9SP5JAjgqjf5+f78ltw==, pdfUrl=null, pdf=47Syzm5MuZ1gIg5xdVYPtw==, pdfFileSize=549133, pdfExtLink=null, richHtmlUrl=null, mobilePdfUrl=null, reviewReport=null, pdfFirstPage=null, abstractGraph=null, abstractGraphContent=null, abstractVideo=null, citation=null, cebUrl=null, magXmlContent=pqI23dCd4TlnM5n/1YwY8A==, mapNumber=null, authorCompany=null, fund=null, authors=

周钰媛（2003-），女，本科在读，研究方向：预防医学

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Metabolism, 2019, 92: 98-107., articleTitle=Obesity and cardiovascular disease:revisiting an old relationship, refAbstract=null), Reference(id=1241050846679593163, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241034443838771307, doi=null, pmid=null, pmcid=null, year=2019, volume=104, issue=3, pageStart=738, pageEnd=752, url=null, language=null, rfNumber=[23], rfOrder=30, authorNames=Echouffo-Tcheugui JB, Short MI, Xanthakis V, journalName=Journal of Clinical Endocrinology & Metabolism, refType=null, unstructuredReference=Echouffo-Tcheugui JB, Short MI, Xanthakis V, et al. Natural history of obesity subphenotypes: dynamic changes over two decades and prognosis in the Framingham heart study[J]. Journal of Clinical Endocrinology & Metabolism, 2019, 104(3): 738-752., articleTitle=Natural history of obesity subphenotypes: dynamic changes over two decades and prognosis in the Framingham heart study, refAbstract=null), Reference(id=1241050846767673551, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241034443838771307, doi=null, pmid=null, pmcid=null, year=2017, volume=70, issue=12, pageStart=1429, pageEnd=1437, url=null, language=null, rfNumber=[24], rfOrder=31, authorNames=Caleyachetty R, Thomas GN, Toulis KA, journalName=Journal of the American College of Cardiology, refType=null, unstructuredReference=Caleyachetty R, Thomas GN, Toulis KA, et al. Metabolically healthy obese and incident cardiovascular disease events among 3.5 million men and women[J]. Journal of the American College of Cardiology, 2017, 70(12): 1429-1437., articleTitle=Metabolically healthy obese and incident cardiovascular disease events among 3.5 million men and women, refAbstract=null)], funds=[Fund(id=1241050840518161385, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241034443838771307, awardId=42207491, language=CN, fundingSource=国家自然科学基金青年项目(42207491), fundOrder=null, country=null), Fund(id=1241050840757236721, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241034443838771307, awardId=2025AFB488, language=CN, fundingSource=湖北省自然科学基金(2025AFB488), fundOrder=null, country=null)], companyList=[AuthorCompany(id=1241050832100192838, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241034443838771307, xref=1., ext=[AuthorCompanyExt(id=1241050832116970058, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241034443838771307, companyId=1241050832100192838, language=EN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=School of Public Health, Medical Department, Wuhan University of Science and Technology, Wuhan, Hubei 430065, China), AuthorCompanyExt(id=1241050832133747276, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241034443838771307, companyId=1241050832100192838, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=1.武汉科技大学医学部公共卫生学院，湖北 武汉 430065)]), AuthorCompany(id=1241050832259576409, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241034443838771307, xref=2., ext=[AuthorCompanyExt(id=1241050832267965018, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241034443838771307, companyId=1241050832259576409, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=2.湖北省疾病预防控制中心慢性病防治研究所，湖北 武汉 430079)])], figs=[ArticleFig(id=1241050838488118179, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241034443838771307, language=EN, label=Table 1, caption=

Basic characteristics of people with different metabolic phenotypes of obesity in Hubei Province ［n（%）］

, figureFileSmall=null, figureFileBig=null, tableContent=
变量人数代谢正常
体重正常		代谢正常
超重或肥胖		代谢异常
体重正常		代谢异常
超重或肥胖		χ2值P值
地区375.33<0.01
农村81 302 (72.42)15 626 (68.77)12 331 (69.62)17 326 (72.91)36 019 (74.93)
城市30 968 (27.58)7 097 (31.23)5 381 (30.38)6 436 (27.09)12 054 (25.07)
性别31.00<0.01
男41 304 (36.79)8 395 (36.94)6 619 (37.37)8 380 (35.27)17 910 (37.26)
女70 966 (63.21)14 328 (63.06)11 093 (62.63)15 382 (64.73)30 163 (62.74)
年龄组（岁）3 484.30<0.01
35～4410 403 (9.27)3 640 (16.02)2 119 (11.96)1 589 (6.69)3 055 (6.35)
45～5432 108 (28.60)7 492 (32.97)6 024 (34.01)5 883 (24.76)12 709 (26.44)
55～6439 936 (35.57)7 025 (30.92)5 647 (31.88)9 064 (38.14)18 200 (37.86)
≥6529 823 (26.56)4 566 (20.09)3 922 (22.14)7 226 (30.41)14 109 (29.35)
婚姻状况272.28<0.01
已婚102 276 (91.10)20 863 (91.81)16 117 (90.99)21 520 (90.56)43 776 (91.06)
未婚394 (0.35)103 (0.45)65 (0.37)90 (0.38)136 (0.28)
离异/分居/丧偶6 959 (6.20)1 125 (4.95)944 (5.33)1 693 (7.12)3 197 (6.65)
不详/拒答2 641 (2.35)632 (2.78)586 (3.31)459 (1.93)964 (2.01)
文化程度829.87<0.01
初中及以下90 024 (80.19)17 223 (75.80)13 764 (77.71)19 384 (81.58)39 653 (82.48)
高中及以上18 358 (16.35)4 611 (20.29)2 924 (16.51)3 826 (16.10)6 997 (14.55)
不详/拒答3 888 (3.46)889 (3.91)1 024 (5.78)552 (2.32)1 423 (2.96)
家庭年收入（万元）697.37<0.01
<129 254 (26.06)5 218 (22.96)4 088 (23.08)6 784 (28.55)13 164 (27.38)
1～563 852 (56.87)13 221 (58.18)9 893 (55.85)13 565 (57.09)27 173 (56.52)
>510 594 (9.44)2 642 (11.63)2 113 (11.93)1 790 (7.53)4 049 (8.42)
不详/拒答8 570 (7.63)1 642 (7.23)1 618 (9.14)1 623 (6.83)3 687 (7.67)
吸烟145.97<0.01
否93 070 (82.90)18 236 (80.25)14 795 (83.53)19 750 (83.12)40 289 (83.81)
是19 200 (17.10)4 487 (19.75)2 917 (16.47)4 012 (16.88)7 784 (16.19)
饮酒30.26<0.01
否99 391 (88.53)20 243 (89.09)15 828 (89.36)20 982 (88.30)42 338 (88.07)
是12 879 (11.47)2 480 (10.91)1 884 (10.64)2 780 (11.70)5 735 (11.93)
高血压19 951.00<0.01
否52 181 (46.48)17 930 (78.91)11 845 (66.88)8 995 (37.85)13 411 (27.90)
是60 089 (53.52)4 793 (21.09)5 867 (33.12)14 767 (62.15)34 662 (72.10)
糖尿病7 804.80<0.01
否90 835 (80.91)21 497 (94.60)16 639 (93.94)18 482 (77.78)34 217 (71.18)
是21 435 (19.09)1 226 (5.40)1 073 (6.06)5 280 (22.22)13 856 (28.82)
血脂异常1 087.50<0.01
否101 289 (90.22)21 455 (94.42)16 570 (93.55)21 144 (88.98)42 120 (87.62)
是10 981 (9.78)1 268 (5.58)1 142 (6.45)2 618 (11.02)5 953 (12.38)
合计112 270 (100.00)22 723 (20.24)17 712 (15.78)23 762 (21.16)48 073 (42.82)
), ArticleFig(id=1241050838597170093, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241034443838771307, language=CN, label=表1, caption=

湖北省不同肥胖代谢表型人群的基本特征［n（%）］

, figureFileSmall=null, figureFileBig=null, tableContent=
变量人数代谢正常
体重正常		代谢正常
超重或肥胖		代谢异常
体重正常		代谢异常
超重或肥胖		χ2值P值
地区375.33<0.01
农村81 302 (72.42)15 626 (68.77)12 331 (69.62)17 326 (72.91)36 019 (74.93)
城市30 968 (27.58)7 097 (31.23)5 381 (30.38)6 436 (27.09)12 054 (25.07)
性别31.00<0.01
男41 304 (36.79)8 395 (36.94)6 619 (37.37)8 380 (35.27)17 910 (37.26)
女70 966 (63.21)14 328 (63.06)11 093 (62.63)15 382 (64.73)30 163 (62.74)
年龄组（岁）3 484.30<0.01
35～4410 403 (9.27)3 640 (16.02)2 119 (11.96)1 589 (6.69)3 055 (6.35)
45～5432 108 (28.60)7 492 (32.97)6 024 (34.01)5 883 (24.76)12 709 (26.44)
55～6439 936 (35.57)7 025 (30.92)5 647 (31.88)9 064 (38.14)18 200 (37.86)
≥6529 823 (26.56)4 566 (20.09)3 922 (22.14)7 226 (30.41)14 109 (29.35)
婚姻状况272.28<0.01
已婚102 276 (91.10)20 863 (91.81)16 117 (90.99)21 520 (90.56)43 776 (91.06)
未婚394 (0.35)103 (0.45)65 (0.37)90 (0.38)136 (0.28)
离异/分居/丧偶6 959 (6.20)1 125 (4.95)944 (5.33)1 693 (7.12)3 197 (6.65)
不详/拒答2 641 (2.35)632 (2.78)586 (3.31)459 (1.93)964 (2.01)
文化程度829.87<0.01
初中及以下90 024 (80.19)17 223 (75.80)13 764 (77.71)19 384 (81.58)39 653 (82.48)
高中及以上18 358 (16.35)4 611 (20.29)2 924 (16.51)3 826 (16.10)6 997 (14.55)
不详/拒答3 888 (3.46)889 (3.91)1 024 (5.78)552 (2.32)1 423 (2.96)
家庭年收入（万元）697.37<0.01
<129 254 (26.06)5 218 (22.96)4 088 (23.08)6 784 (28.55)13 164 (27.38)
1～563 852 (56.87)13 221 (58.18)9 893 (55.85)13 565 (57.09)27 173 (56.52)
>510 594 (9.44)2 642 (11.63)2 113 (11.93)1 790 (7.53)4 049 (8.42)
不详/拒答8 570 (7.63)1 642 (7.23)1 618 (9.14)1 623 (6.83)3 687 (7.67)
吸烟145.97<0.01
否93 070 (82.90)18 236 (80.25)14 795 (83.53)19 750 (83.12)40 289 (83.81)
是19 200 (17.10)4 487 (19.75)2 917 (16.47)4 012 (16.88)7 784 (16.19)
饮酒30.26<0.01
否99 391 (88.53)20 243 (89.09)15 828 (89.36)20 982 (88.30)42 338 (88.07)
是12 879 (11.47)2 480 (10.91)1 884 (10.64)2 780 (11.70)5 735 (11.93)
高血压19 951.00<0.01
否52 181 (46.48)17 930 (78.91)11 845 (66.88)8 995 (37.85)13 411 (27.90)
是60 089 (53.52)4 793 (21.09)5 867 (33.12)14 767 (62.15)34 662 (72.10)
糖尿病7 804.80<0.01
否90 835 (80.91)21 497 (94.60)16 639 (93.94)18 482 (77.78)34 217 (71.18)
是21 435 (19.09)1 226 (5.40)1 073 (6.06)5 280 (22.22)13 856 (28.82)
血脂异常1 087.50<0.01
否101 289 (90.22)21 455 (94.42)16 570 (93.55)21 144 (88.98)42 120 (87.62)
是10 981 (9.78)1 268 (5.58)1 142 (6.45)2 618 (11.02)5 953 (12.38)
合计112 270 (100.00)22 723 (20.24)17 712 (15.78)23 762 (21.16)48 073 (42.82)
), ArticleFig(id=1241050838802691001, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241034443838771307, language=EN, label=Table 2, caption=

Metabolic indicators of different metabolic phenotypes of obesity in Hubei Province（）

, figureFileSmall=null, figureFileBig=null, tableContent=
变量代谢正常
体重正常		代谢正常
超重或肥胖		代谢异常
体重正常		代谢异常
超重或肥胖		F值P值
SBP (mm Hg)125.53±17.47131.25±19.21142.80±18.87146.00±19.377 377.10<0.01
DBP (mm Hg)75.13±9.9778.67±10.7281.76±10.8685.03±11.014 811.64<0.01
TC (mmol/L)4.58±0.934.64±0.934.75±1.044.77±1.04230.35<0.01
LDL-C (mmol/L)2.37±0.812.50±0.822.49±0.882.55±0.89226.02<0.01
HDL-C (mmol/L)1.72±0.371.60±0.351.55±0.421.39±0.384 139.81<0.01
TG (mmol/L)1.07±0.401.17±0.421.57±0.801.82±0.867 247.66<0.01
FPG (mmol/L)5.54±1.085.50±1.026.52±1.646.69±1.804 562.58<0.01
), ArticleFig(id=1241050839234704323, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241034443838771307, language=CN, label=表2, caption=

湖北省不同肥胖代谢表型人群的代谢指标情况（）

, figureFileSmall=null, figureFileBig=null, tableContent=
变量代谢正常
体重正常		代谢正常
超重或肥胖		代谢异常
体重正常		代谢异常
超重或肥胖		F值P值
SBP (mm Hg)125.53±17.47131.25±19.21142.80±18.87146.00±19.377 377.10<0.01
DBP (mm Hg)75.13±9.9778.67±10.7281.76±10.8685.03±11.014 811.64<0.01
TC (mmol/L)4.58±0.934.64±0.934.75±1.044.77±1.04230.35<0.01
LDL-C (mmol/L)2.37±0.812.50±0.822.49±0.882.55±0.89226.02<0.01
HDL-C (mmol/L)1.72±0.371.60±0.351.55±0.421.39±0.384 139.81<0.01
TG (mmol/L)1.07±0.401.17±0.421.57±0.801.82±0.867 247.66<0.01
FPG (mmol/L)5.54±1.085.50±1.026.52±1.646.69±1.804 562.58<0.01
), ArticleFig(id=1241050839767380945, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241034443838771307, language=EN, label=Table 3, caption=

Unordered multicategorical logistic analysis of the factors affecting different metabolic phenotypes of obesity in middle-aged and elderly people in Hubei Province

, figureFileSmall=null, figureFileBig=null, tableContent=
代谢正常超重或肥胖代谢异常体重正常代谢异常超重或肥胖
βOR值(95%CI)P值βOR值(95%CI)P值βOR值(95%CI)P值值
地区
城市1.001.001.00
农村0.001.00
(0.96～1.05)		0.980.081.08
(1.03～1.13)		<0.010.191.21
(1.16～1.25)		<0.01
性别
女1.001.001.00
男0.201.22
(1.16～1.29)		<0.01-0.020.98
(0.93～1.03)		0.340.161.17
(1.12～1.22)		<0.01
年龄组 （岁）
35～441.001.001.00
45～540.301.36
(1.27～1.45)		<0.010.541.72
(1.60～1.84)		<0.010.641.89
(1.79～2.00)		<0.01
55～640.301.34
(1.26～1.44)		<0.011.022.78
(2.60～2.98)		<0.011.042.83
(2.68～3.00)		<0.01
≥650.331.39
(1.30～1.50)		<0.011.223.39
(3.15～3.64)		<0.011.203.31
(3.12～3.52)		<0.01
婚姻状况
已婚1.001.001.00
未婚-0.150.86
(0.63～1.18)		0.340.041.05
(0.78～1.40)		0.77-0.310.73
(0.56～0.95)		0.02
离异/分居/丧偶0.051.05
(0.96～1.15)		0.330.091.10
(1.01～1.19)		0.020.061.06
(0.99～1.14)		0.11
不详/拒答-0.140.87
(0.76～1.00)		0.06-0.060.94
(0.81～1.09)		0.40-0.170.85
(0.75～0.96)		<0.01
文化程度
初中及以下1.001.001.00
高中及以上-0.210.81
(0.77～0.86)		<0.010.011.01
(0.95～1.06)		0.85-0.130.87
(0.84～0.92)		<0.01
不详/拒答0.341.41
(1.25～1.58)		<0.01-0.480.62
(0.54～0.71)		<0.01-0.270.76
(0.69～0.85)		<0.01
家庭年收入(万元）
<11.001.001.00
1～50.001.00
(0.95～1.05)		0.99-0.110.89
(0.85～0.93)		<0.01-0.060.94
(0.91～0.98)		<0.01
>50.111.12
(1.04～1.20)		<0.01-0.420.65
(0.61～0.71)		<0.01-0.210.81
(0.76～0.86)		<0.01
不详/拒答0.161.18
(1.08～1.29)		<0.01-0.050.96
(0.88～1.04)		0.300.111.11
(1.03～1.20)		<0.01
吸烟
否1.001.001.00
是-0.360.70
(0.65～0.74)		<0.01-0.230.79
(0.75～0.84)		<0.01-0.410.67
(0.63～0.70)		<0.01
饮酒
否1.001.001.00
是0.001.00
(0.93～1.08)		0.930.141.15
(1.08～1.23)		<0.010.131.14
(1.07～1.20)		<0.01
常量-0.53<0.01-0.68<0.01-0.15<0.01
), ArticleFig(id=1241050840220365782, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241034443838771307, language=CN, label=表3, caption=

湖北省不同肥胖代谢表型人群影响因素的无序多分类logistic分析

, figureFileSmall=null, figureFileBig=null, tableContent=
代谢正常超重或肥胖代谢异常体重正常代谢异常超重或肥胖
βOR值(95%CI)P值βOR值(95%CI)P值βOR值(95%CI)P值值
地区
城市1.001.001.00
农村0.001.00
(0.96～1.05)		0.980.081.08
(1.03～1.13)		<0.010.191.21
(1.16～1.25)		<0.01
性别
女1.001.001.00
男0.201.22
(1.16～1.29)		<0.01-0.020.98
(0.93～1.03)		0.340.161.17
(1.12～1.22)		<0.01
年龄组 （岁）
35～441.001.001.00
45～540.301.36
(1.27～1.45)		<0.010.541.72
(1.60～1.84)		<0.010.641.89
(1.79～2.00)		<0.01
55～640.301.34
(1.26～1.44)		<0.011.022.78
(2.60～2.98)		<0.011.042.83
(2.68～3.00)		<0.01
≥650.331.39
(1.30～1.50)		<0.011.223.39
(3.15～3.64)		<0.011.203.31
(3.12～3.52)		<0.01
婚姻状况
已婚1.001.001.00
未婚-0.150.86
(0.63～1.18)		0.340.041.05
(0.78～1.40)		0.77-0.310.73
(0.56～0.95)		0.02
离异/分居/丧偶0.051.05
(0.96～1.15)		0.330.091.10
(1.01～1.19)		0.020.061.06
(0.99～1.14)		0.11
不详/拒答-0.140.87
(0.76～1.00)		0.06-0.060.94
(0.81～1.09)		0.40-0.170.85
(0.75～0.96)		<0.01
文化程度
初中及以下1.001.001.00
高中及以上-0.210.81
(0.77～0.86)		<0.010.011.01
(0.95～1.06)		0.85-0.130.87
(0.84～0.92)		<0.01
不详/拒答0.341.41
(1.25～1.58)		<0.01-0.480.62
(0.54～0.71)		<0.01-0.270.76
(0.69～0.85)		<0.01
家庭年收入(万元）
<11.001.001.00
1～50.001.00
(0.95～1.05)		0.99-0.110.89
(0.85～0.93)		<0.01-0.060.94
(0.91～0.98)		<0.01
>50.111.12
(1.04～1.20)		<0.01-0.420.65
(0.61～0.71)		<0.01-0.210.81
(0.76～0.86)		<0.01
不详/拒答0.161.18
(1.08～1.29)		<0.01-0.050.96
(0.88～1.04)		0.300.111.11
(1.03～1.20)		<0.01
吸烟
否1.001.001.00
是-0.360.70
(0.65～0.74)		<0.01-0.230.79
(0.75～0.84)		<0.01-0.410.67
(0.63～0.70)		<0.01
饮酒
否1.001.001.00
是0.001.00
(0.93～1.08)		0.930.141.15
(1.08～1.23)		<0.010.131.14
(1.07～1.20)		<0.01
常量-0.53<0.01-0.68<0.01-0.15<0.01
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湖北省中老年人群肥胖代谢表型及其影响因素分析
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周钰媛 1 , 李俊琳 2 , 祝淑珍 2 , 周婷 1 , 齐俊锋 2 , 孙小杰 1
现代预防医学 | 流行病与统计方法 2025,52(11): 1935-1940
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现代预防医学 | 流行病与统计方法 2025, 52(11): 1935-1940
湖北省中老年人群肥胖代谢表型及其影响因素分析
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周钰媛1, 李俊琳2, 祝淑珍2, 周婷1, 齐俊锋2 , 孙小杰1
作者信息
  • 1.武汉科技大学医学部公共卫生学院，湖北 武汉 430065
  • 2.湖北省疾病预防控制中心慢性病防治研究所，湖北 武汉 430079

    • 周钰媛（2003-），女，本科在读，研究方向：预防医学

通讯作者:

孙小杰与齐俊锋为共同通信作者。孙小杰，E-mail:；
齐俊锋，E-mail: ；
Analysis of obesity metabolic phenotypes and their influencing factors in middle-aged and elderly populations in Hubei Province
Yu-yuan ZHOU1, Jun-lin LI2, Shu-zhen ZHU2, Ting ZHOU1, Jun-feng QI2 , Xiao-jie SUN1
Affiliations
  • School of Public Health, Medical Department, Wuhan University of Science and Technology, Wuhan, Hubei 430065, China
出版时间: 2025-06-10 doi: 10.20043/j.cnki.MPM.202501205
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摘要
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目的

分析湖北省中老年人群不同肥胖代谢表型的流行现状及影响因素，旨在为早期预防和干预肥胖相关疾病提供科学参考和决策依据。

方法

选取2016年1月—2019年12月参与“国家心血管病高危人群早期筛查与综合干预项目”湖北省项目点的人群，分析不同肥胖代谢表型的患病率及流行病学特征，并探究湖北省中老年人群肥胖代谢表型的影响因素。

结果

本研究共纳入112 270名研究对象，代谢正常超重或肥胖、代谢异常体重正常以及代谢异常超重或肥胖患病率分别为15.78%、21.16%、42.82%。无序多分类logistic回归结果显示，与代谢正常体重正常组相比，农村地区（OR=1.08，95%CI：1.03～1.13；OR=1.21，95%CI：1.16～1.25）、高年龄组（65岁及以上OR=3.39，95%CI：3.15～3.64；OR=3.31，95%CI：3.12～3.52）、男性（OR=1.22，95%CI：1.16～1.29；OR=1.17，95%CI：1.12～1.22）、饮酒（OR=1.15，95%CI：1.08～1.23；OR=1.14，95%CI：1.07～1.20）与代谢正常超重或肥胖、代谢异常体重正常及代谢异常超重或肥胖患病风险增加相关。高中及以上文化程度（OR=0.87，95%CI：0.84～0.92）、高家庭年收入（5万元及以上OR=0.81，95%CI：0.76～0.86）和吸烟（OR=0.67，95%CI：0.63～0.70）与代谢异常超重或肥胖患病风险下降相关（均有P<0.01）。

结论

湖北地区代谢异常超重或肥胖患病率较高，应重点加强防控工作，尤其是针对农村地区的高龄、男性、低收入、低文化程度以及有饮酒习惯的人群。

中老年人  /  肥胖  /  代谢表型  /  影响因素
Objective

To analyze the prevalence and influencing factors of different obesity metabolic phenotypes in middle-aged and elderly populations in Hubei Province, aiming to provide scientific reference and decision-making basis for early prevention and intervention of obesity-related diseases.

Methods

A population involved in the “National Cardiovascular Disease High-risk Population Early Screening and Comprehensive Intervention Project” from January 2016 to December 2019 in Hubei Province was selected to analyze the prevalence and epidemiological characteristics of different obesity metabolic phenotypes and to explore the influencing factors of obesity metabolic phenotypes in middle-aged and elderly populations in Hubei.

Results

A total of 112 270 participants were included in this study. The prevalence rates of metabolically healthy overweight or obese, metabolically unhealthy normal weight, and metabolically unhealthy overweight or obese were 15.78%, 21.16%, and 42.82%, respectively. The results of the unordered multinomial logistic regression showed that, compared to the metabolically healthy normal weight group, living in rural areas (OR=1.08, 95%CI: 1.03-1.13; OR=1.21, 95%CI: 1.16-1.25), being in the older age group (aged 65 and above, OR=3.39,95%CI: 3.15-3.64; OR=3.31, 95%CI: 3.12-3.52), being male (OR=1.22, 95%CI: 1.16-1.29; OR=1.17, 95%CI: 1.12-1.22), and alcohol consumption (OR=1.15, 95%CI: 1.08-1.23; OR=1.14, 95%CI: 1.07-1.20) were associated with an increased risk of being metabolically healthy overweight or obese, metabolically unhealthy normal weight, and metabolically unhealthy overweight or obese.Higher education level (high school or above, OR=0.87, 95%CI: 0.84-0.92), higher household annual income (≥50 000 yuan, OR=0.81, 95%CI: 0.76-0.86), and smoking (OR=0.67, 95%CI: 0.63-0.70) were associated with a decreased risk of being metabolically unhealthy overweight or obese (all P < 0.01).

Conclusion

The prevalence of metabolically unhealthy overweight or obesity is high in Hubei Province, and it is essential to strengthen prevention and control efforts, particularly targeting older males in rural areas, those with low income, low education levels, and individuals with alcohol consumption habits.

Middle-aged and elderly  /  Obesity  /  Metabolic phenotype  /  Influencing factors
周钰媛, 李俊琳, 祝淑珍, 周婷, 齐俊锋, 孙小杰. 湖北省中老年人群肥胖代谢表型及其影响因素分析. 现代预防医学, 2025 , 52 (11) : 1935 -1940 . DOI: 10.20043/j.cnki.MPM.202501205
Yu-yuan ZHOU, Jun-lin LI, Shu-zhen ZHU, Ting ZHOU, Jun-feng QI, Xiao-jie SUN. Analysis of obesity metabolic phenotypes and their influencing factors in middle-aged and elderly populations in Hubei Province[J]. Modern Preventive Medicine, 2025 , 52 (11) : 1935 -1940 . DOI: 10.20043/j.cnki.MPM.202501205
正文
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肥胖已成为全球公共卫生的重大挑战。1990—2022年，全球成年女性肥胖率从8.8%上升到18.5%，成年男性肥胖率从4.8%上升到14.0%[1-2]。尽管肥胖与不良健康影响有关，但肥胖者之间存在相当大的异质性[3]。最新的研究指出，肥胖往往与高血压、高血糖以及血脂异常等代谢异常状况同时出现，共同决定了个体的健康风险，且肥胖人群中代谢不健康的群体比代谢健康的群体患心血管疾病和全因死亡率的风险更高[4]。我国是世界上超重和肥胖人数最多的国家[5]。因此，本研究基于2016年1月—2019年12月在湖北省开展的心血管病高危人群早期筛查与综合干预项目，探讨不同肥胖代谢表型的流行特征及相关影响因素，为制定适宜的防控策略提供参考依据。
1　对象与方法
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1.1　研究对象
本研究选取2016年1月—2019年12月参与“国家心血管病高危人群早期筛查与综合干预项目”湖北省项目点的初筛人群。初筛对象纳入标准：（1）年龄为35～75岁；（2）过去一年在项目点居住时间大于6个月；（3）自愿参加并且签署知情同意书。本研究共127 822人参与筛查[6]，剔除数据缺失及数据异常情况，以及依据研究目的剔除体重偏瘦者，即身体质量指数（body mass index，BMI）<18.5 kg/m2者，最终纳入研究对象112 270人。本项目已通过国家心血管病中心伦理委员会审查（伦理审批号：2014-574）。
1.2　调查内容
采用统一设计的问卷面对面收集调查对象基本人口学特征，包括性别、年龄、地区、文化程度、婚姻状况、家庭年收入、吸烟和饮酒以及既往患病情况如高血压、糖尿病以及高血脂等内容。
过去一年内，每天偶尔或大部分平均吸烟数≥1支/d被定义为吸烟；摄入含酒精饮品次数≥2次/周被定义为饮酒。调查时，由专业医护人员测量调查对象的身高、体重、腰围以及血压值；同时收集研究对象的空腹血样，检测空腹血糖（fasting blood glucose，FPG）与血脂四项等指标。
1.3　肥胖代谢表型判定标准
（1）肥胖：按照中国肥胖工作组的标准：身体质量指数（BMI）≥28 kg/m2者为肥胖；24≤BMI<28 kg/m2者为超重；18.5≤BMI<24 kg/m2者为体重正常。在此基础上，本研究参考《肥胖症诊疗指南（2024年版）》将男性腰围≥90 cm，女性腰围≥85 cm者也归为肥胖，本研究将超重和肥胖组合并，统称为超重或肥胖。（2）代谢异常：采用美国国家胆固醇治疗计划成人治疗方案III（National Cholesterol Education Program Adult Treatment Panel，ATPIII）的指标，具备以下任意两项及以上即可诊断为代谢异常：①血压异常：收缩压（systolic blood pressure，SBP）≥130 mm Hg或舒张压（diastolic blood pressure，DBP）≥85 mm Hg，或接受降压药物治疗；②FPG异常：FPG≥5.6 mmol/L或接受降糖药物治疗；③甘油三酯（triglyceride，TG）异常：TG≥1.70 mmol/L，或接受降脂药物治疗；④高密度脂蛋白胆固醇（high-density lipoprotein cholesterol，HDL-C）异常：男性<1.04 mmol/L，女性<1.29 mmol/L。（3）肥胖代谢表型：根据是否超重或肥胖和是否存在代谢异常，将研究对象分为代谢正常体重正常、代谢正常超重或肥胖、代谢异常体重正常和代谢异常超重或肥胖四种表型。
1.4　统计学分析
分类变量资料采用率或构成比（%）描述，采用分类变量资料采用率或构成比2检验比较不同肥胖代谢表型人群基本特征分布的差异。连续变量资料采用（均数±标准差）描述，采用方差分析比较不同肥胖代谢表型人群的代谢指标的差异。采用无序多分类logistic回归模型分析不同肥胖代谢表型的影响因素，效应值采用比值比（odds ratio，OR）值及其95%置信区间（confidence interval，CI）描述。采用R软件（4.4.1版）进行统计学分析，双侧检验，检验水准α=0.05。
2　结果
收起
2.1　调查对象基本情况
112 270名对象中，平均年龄为57.66岁，其中男性41 304人,占36.79%，女性70 966人,占63.21%；农村地区81 302人，占72.42%，城市地区30 968人，占27.58%。男性腰围为（85.12±8.93）cm，女性腰围为（81.73±8.98）cm；年龄以55～64岁组居多，占35.57%；正常体重者46 485人，占41.40%。见表1。
2.2　不同肥胖代谢表型对象的基本特征
研究对象中代谢正常体重正常者占20.24%（22 723/112 270），代谢正常超重或肥胖者占15.78%（17 712/112 270），代谢异常体重正常者占21.16%（23 762/112 270），代谢异常超重或肥胖者占42.82%（48 073/112 270）。各组在地区、性别、年龄组、婚姻情况、文化程度、家庭年收入、吸烟，饮酒、高血压、糖尿病等方面的差异均具有统计学意义（均有P<0.01）。见表1。
2.3　不同表型的健康指标
四组间在SBP、DBP、总胆固醇（total cholesterol，TC）、LDL-C、HDL-C、TG及FPG水平的差异具有统计学意义（均有P<0.01）。见表2。
2.4　不同肥胖代谢表型影响因素的多因素分析
以地区、性别、年龄组、婚姻状况、文化程度、家庭年收入、吸烟与饮酒为自变量，不同肥胖代谢表型为因变量，拟合无序多分类logistic回归模型。调整了社会人口学和生活方式因素后，结果显示，与代谢正常体重正常组相比，农村地区居民（代谢异常体重正常OR= 1.08；代谢异常超重或肥胖OR=1.21）、男性（代谢正常超重或肥胖OR=1.22；代谢异常超重或肥胖OR=1.17）、饮酒（代谢异常体重正常OR=1.15；代谢异常超重或肥胖OR=1.14）、45～54岁、55～64岁和65岁及以上年龄组与代谢正常超重或肥胖、代谢异常体重正常和代谢异常超重或肥胖的患病风险增加有关（均有P<0.01）。高中及以上文化程度（代谢正常超重或肥胖OR=0.81；代谢异常超重或肥胖OR=0.87）、家庭年收入大于5万元（代谢异常体重正常OR=0.65；代谢异常超重或肥胖OR=0.81）、吸烟（代谢正常超重或肥胖OR=0.70；代谢异常体重正常OR=0.79；代谢异常超重或肥胖OR=0.67）与代谢正常超重或肥胖、代谢异常体重正常和代谢异常超重或肥胖的患病风险呈负相关（均有P<0.01）。见表3。
3　讨论
收起
肥胖是导致心血管疾病、糖尿病等慢性病发生的重要风险因素之一[7]，然而不同代谢状态的肥胖人群慢性病患病风险存在差异[8-10]。本研究通过划分不同代谢表型与肥胖状态，识别其可能的危险行为及生活方式影响因素，预防心脑血管等慢性病的发生。本研究结果显示，湖北省中老年人群代谢正常超重或肥胖、代谢异常体重正常以及代谢异常超重或肥胖患病率分别为15.78%、21.16%、42.82%。本研究结果与江苏省成年人群不同代谢类型肥胖的患病现状研究中各肥胖代谢表型比例基本一致[11]，但代谢异常超重或肥胖患病率显著高于陕西地区（6.79%）以及深圳地区（25.8%）的成年人群[12-13]。患病率的差异可能与各研究人群的地理位置、年龄结构、饮食习惯和生活方式等差异有关。
本研究无序多分类分析结果显示，农村地区、高年龄组、饮酒是代谢异常体重正常及代谢异常超重或肥胖发生的危险因素。农村地区居民患代谢异常体重正常及代谢异常超重或肥胖的风险高于城市地区居民，农村地区居民可能由于教育水平、健康知识普及程度等因素，对健康生活方式的认识和重视程度不如城市居民。与35～44岁的居民相比，45岁及以上居民，特别是大于65岁的居民，患代谢正常超重或肥胖、代谢异常体重正常和代谢异常超重或肥胖的风险均显著增加，这可能与个体基础代谢率、体成分中肌肉含量以及日常活动量随着年龄上升而逐渐减少有关[14]，与杨曼等[15]的研究结果相似。饮酒是代谢异常体重正常及代谢异常超重或肥胖的危险因素，但未发现与代谢正常超重或肥胖有关，表明饮酒可能与更高的代谢异常风险相关。相关研究表明，饮酒是代谢综合征的危险因素之一[16]，且饮酒引起的慢性病发病及全因死亡已成为全球主要的疾病负担[17]。此外，本研究表明，与女性相比，男性患代谢正常超重或肥胖和代谢异常超重或肥胖的风险较高，这可能与男性健康意识相对较低，以及相比女性有更频繁的不良饮食习惯和生活方式有关，与余卫军等[13]的研究结果一致。
本研究发现高中及以上文化程度者和高家庭年收入者患代谢异常超重或肥胖的风险较低，这些可能与文化程度较高的人群对健康知识的理解更为深入、对自身健康的关注度更高，更注重自身的健康保养以及更易形成健康的生活习惯有关。高收入者通常有更好的文化程度和健康意识，易于识别健康风险，并采取相应的预防措施。众所周知，吸烟对人类健康构成了严重威胁，通常被认为是不良生活方式中导致慢性病的重要风险因素之一[18]。而本研究中则观察到吸烟者患代谢正常超重或肥胖、代谢异常体重正常及代谢异常超重或肥胖的风险较低，与之前研究结果类似[19-20]，这或许和吸烟抑制食欲、加速机体代谢能力有关[21]。
本研究深入考虑了我国人群的体质特点，采用了适合我国人群的超重或肥胖判定标准，从而为探究影响不同代谢表型肥胖人群的因素奠定了基础。但本研究也存在一定局限性。第一，本研究为现况研究，无法明确不同肥胖代谢表型与影响因素之间的因果关系，仍需要前瞻性研究进一步验证；第二，问卷调查采用面对面询问，虽已进行严格的质量控制，但可能仍会存在信息偏倚，例如吸烟、饮酒均为研究对象现场自报目前状况，可能会存在一定程度的回忆偏倚。
综上所述，超重或肥胖是多种心血管疾病的风险因素[22]，由于不同肥胖代谢表型对心脑血管事件及其临床结果具有不同程度的风险以及预后效果[23-24]，因此，在不同人群中基于超重或肥胖与代谢状态来探索各类肥胖代谢表型的影响因素，因地制宜地针对该人群的分布特征制定针对性的治疗和干预措施，对预防肥胖及相关代谢性疾病与慢性疾病的防控具有重要意义。具体实践中应重点加强对湖北农村地区、男性、高龄、低文化程度、低收入以及有饮酒习惯人群的防控工作，控制维持代谢健康超重或肥胖或代谢异常体重正常不向代谢异常超重或肥胖转化。
基金
收起
  • 国家自然科学基金青年项目(42207491)
  • 湖北省自然科学基金(2025AFB488)
文献
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参考文献 引证文献
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2025年第52卷第11期
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doi: 10.20043/j.cnki.MPM.202501205
  • 接收时间：2025-01-12
  • 首发时间：2026-03-18
  • 出版时间：2025-06-10
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  • 收稿日期：2025-01-12
基金
国家自然科学基金青年项目(42207491)
湖北省自然科学基金(2025AFB488)
作者信息
    1.武汉科技大学医学部公共卫生学院，湖北 武汉 430065
    2.湖北省疾病预防控制中心慢性病防治研究所，湖北 武汉 430079

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孙小杰与齐俊锋为共同通信作者。孙小杰，E-mail:；
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