| OBJECTIVEObesity refers to an excess storage of fat in the body. Obesity has reached epidemic proportions globally, and the situation is likely to get worse. One of the greatest public health challenges in the first half of the 21st century is to prevent the epidemic of obesity. Obesity itself is a kind of chronic disease, and it causes or exacerbates many health problems, both independently and in association with other diseases. In particular, it is associated with the development of cardiovascular disease (CVD) and Type 2 diabetes. The development of obesity results from both genetic and environmental risk factors, and the latter especially dietary and behavior factors are more important.The report of the Nutrition and Health Status of the Chinese People survey data in 2002 showed that the prevalence of overweight and obesity has been significantly increased among both children and adults. In Chinese adults, the prevalence of overweight was 22.8%, and the prevalence of obesity was 7.1%, and the estimated total numbers were 200 million and over 60 million. As our country becomes moreaffluent and the people's lifestyle changes, the prevalence of diseases associated with obesity is increasing dramatically, while obesity itself is increasing as well.Anyang iron and steel company is a large industrial corporation in Anyang city of Henan. The community belongs to this company is called Angang community, which is an experimental unit for the prevention and control of chronic noninfectious diseases in China, and its population is stable, the compliance of residents is good, has a consummate community service system of public health. So we select this community to carry out an epidemiological investigation of obesity to study its prevalence, risk factors, risk of co-morbidities of obesity for the prevention and control of this disease in this community. METHODSThe cluster sampling method was used to select the study participants and thus the forth area from six resident areas was chosen as the study site in Angang community. From March to August 2003, 738 men and 1053 women were enrolled into the study. We carried out an epidemiological investigation of obesity in residents aged 40-88 years old of this resident area. Data was collected by questionnaire review (demographic characteristics, medical history, and behavior risk factors), anthropometric measurements (height, weight, waist and hip circumferences, blood pressure, pulse, and electrocardiogram) and laboratory measurements (FPG, 2-hPQ TC, TQ HDL-C, LDL-C, VLDL-C, ApoAl, ApoB). We used cross-sectional study and case-control study to investigate the prevalence, risk factors and the correlation with co-morbidities of obesity in this community, t test, ANOVA, Chi-Square test, correlation analysis, trend test (Cochran-Armitage test), and logistic regression analysis were employed to analyze the data. P value less than 0.05 was considered statistically significant.RESULTS1. Prevalence of obesity: The average BMI was 25.69kg/m2±3.23 kg/m2for males and 25.88kg/m2±3.82kg/m2 for females. The average WC was 88.01cm±9.35cm for males and 81.29cm±9.06cm for females. The prevalences of overweight and obesity were 46.06% and 10.68%, respectively among residents according toWHO diagnostic criteria defined by BMI, and were 45.22% and 23.76%, respectively according to WGOC criteria. The prevalence rates of abdominal obesity were 16.66% and 58.47%, respectively according to WHO and WGOC diagnostic criteria defined by WC.2. Distribution characteristics of obesity prevalence: According to WHO and WGOC diagnostic criteria of BMI, the prevalence of overweight in males was both significantly higher than in females, and the prevalence of obesity was significantly higher in females than males (p for gender differences < 0.05). According to WHO diagnostic criteria of WC, the prevalence of abdominal adiposity in females was significantly higher than in males and the prevalence was on the contrary according to WGOC criteria (p for gender differences < 0.05). The prevalence of obesity increased significantly with higher groups of age in females, and the same trend of abdominal adiposity prevalence was significant (p for trend analyse < 0.05). No significant differences were identified in males. The prevalences of obesity were not significantly different among groups of different occupation, average household income, labor intensity, physical activity status, and sedentary lifestyle. The prevalences of obesity were significantly different among groups of different culture level in female, and among groups of different smoking status in males (all p < 0.05). Moreover, the obese prevalences were higher for the participants of lower culture level in females, and of no tobacco or alcohol exposure in males.3. Risk factors of obesity: Socioeconomic status and lifestyle factors were potential risk factors. According to the WGOC classification of obesity, smoking status was associated with obesity in male after multi-factor adjustment. In females, age and sedentary lifestyle were associated with obesity. A significant association was not observed between other factors and obesity. Only sedentary lifestyle was associated with obesity in females under WHO definition of obesity. According to the WGOC classification of obesity, the results of logistic regression analysis showed that the major risk factors influencing obesity would include culture level, sedentary time, and tobacco exposure. The major risk factors of abdominaladiposity were age, occupation, tobacco or alcohol exposure status. 4. The risk of co-morbidities of obesity: A positive association was observed between BMI, WC, and WHR with diastolic and systolic blood pressures, fasting plasma glucose, 2-h post glucose load, total cholesterol, triglycerides, and glucose levels (all p < 0.01). Stratifying BMI by WHO diagnosis criterion, the prevalence rates of T2DM, high blood pressure, and dyslipidamia were all increased significantly with higher levels of BMI and WC. According to WHO diagnostic criteria, the odds ratios for T2DM, high blood pressure, and dyslipidamia were, for overweight vs. normal weight, 2.36, 2.60, and 2.40 respectively in males, and were 1.47, 1.97, and 2.09 respectively in females after adjustment for age, socioeconomic status, and lifestyle factors by using logistic regression analysis. Odds ratios, for obesity vs. normal weight, were 3.02, 5.57, and 3.74 respectively in males, and were 2.40, 3.34, and 2.73 respectively in females. CONCLUSIONS1. Overweight and obesity is a great health problem in the Angang community population, especially in middle-aged and older adults.2. It shows significant correlation between obesity and some socioeconomic status and lifestyle factors. Age, occupation, culture level, and smoking are the potential risk factors of obesity.3. Obesity correlate with T2DM, high blood pressure, dyslipidamia. The risk of co-morbidities of obesity is increased with BMI and WC levels.4. This research pointed out that prevention and control of noncommunicable chronic disease should follow the principle of "Three Step Prevention", effective strategies for primary prevention of obesity need to be introduced, especially in community in urban areas.
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