Prevalence trend of metabolically unhealthy overweight and impact of educational levels on Chinese adults of Shanghai

YANG Yi-hui; CHENG Min-na; Yeerzhati Yeerjiang; SHI Yan; XU Wang-hong; LI Yan-yun

doi:10.16462/j.cnki.zhjbkz.2022.04.022

Volume 26 Issue 4

Apr. 2022

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YANG Yi-hui, CHENG Min-na, Yeerzhati Yeerjiang, SHI Yan, XU Wang-hong, LI Yan-yun. Prevalence trend of metabolically unhealthy overweight and impact of educational levels on Chinese adults of Shanghai[J]. CHINESE JOURNAL OF DISEASE CONTROL & PREVENTION, 2022, 26(4): 490-496. doi: 10.16462/j.cnki.zhjbkz.2022.04.022

Citation:

YANG Yi-hui, CHENG Min-na, Yeerzhati Yeerjiang, SHI Yan, XU Wang-hong, LI Yan-yun. Prevalence trend of metabolically unhealthy overweight and impact of educational levels on Chinese adults of Shanghai[J]. CHINESE JOURNAL OF DISEASE CONTROL & PREVENTION, 2022, 26(4): 490-496. doi: 10.16462/j.cnki.zhjbkz.2022.04.022

Citation:

YANG Yi-hui, CHENG Min-na, Yeerzhati Yeerjiang, SHI Yan, XU Wang-hong, LI Yan-yun. Prevalence trend of metabolically unhealthy overweight and impact of educational levels on Chinese adults of Shanghai[J]. CHINESE JOURNAL OF DISEASE CONTROL & PREVENTION, 2022, 26(4): 490-496. doi: 10.16462/j.cnki.zhjbkz.2022.04.022

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Prevalence trend of metabolically unhealthy overweight and impact of educational levels on Chinese adults of Shanghai

doi: 10.16462/j.cnki.zhjbkz.2022.04.022

1.
Department of Epidemiology, School of Public Health, Fudan University, Shanghai 200032, China
2.
Division of Chronic Non-communicable Disease and Injury, Shanghai Municipal Center for Disease Control and Prevention, Shanghai 200336, China

Funds:

National Nature Science Foundation of China 81573221

National Nature Science Foundation of China 81773504

Three-year Action Plan on Public Health, Phase IV, Shanghai, China 15GWZK0801

The Cultivation of Leading Medical Talents in Shanghai, China 2019LJ24

More Information

Corresponding author: XU Wang-hong, E-mail: wanghong.xu@fudan.edu.cn; LI Yan-yun, E-mail: liyanyun@scdc.sh.cn
Received Date: 2021-04-20
Rev Recd Date: 2021-07-12

Available Online: 2022-04-14

Publish Date: 2022-04-10

Abstract

Abstract

Objective Metabolically unhealthy overweight (MUO) is more harmful for human health than metabolically healthy overweight (MHO). This study aims to investigate the prevalence trend of MUO in Chinese adults in Shanghai, and to evaluate the impact of education attainment of the populations. Methods The study was based on three sampling surveys performed in residents aged 35-74 years in Shanghai in 2002-2003 (n=12 302), 2009 (n=7 400) and 2017 (n=19 023). All participants were classified into three groups according their educational levels: primary school or below, middle or high school and college or above, and categorized as four phenotypes based on the presence or absence of overweight and metabolic syndrome (MS): metabolically healthy, normal weight (MHNW), metabolically unhealthy, normal weight (MUNW), MHO and MUO. Multinomial Logistic regression and generalized estimating equation were employed to analyze the association between education level and four phenotypes. Results Both crude and age-standardized prevalence of MUO significantly increased in men and women (P < 0.001). The increase in age-standardized prevalence of MUO was observed in each subgroup of educational level and was the most substantial in the group of primary school or below. The age-standardized prevalence of MUO decreased along with increasing educational attainment in women in the three surveys, whereas the prevalence increased among men in the 2002-2003 and 2009 surveys (all P < 0.05). In the three surveys, after adjusting for age and other confounders, men with middle or high school educational level had a higher risk of MUO than those with educational level of primary school or below, whereas the risk was lower in women with educational levels of middle or high school and college or above (all P < 0.05). Conclusion The prevalence of MUO shows an upward trend in Chinese adults in Shanghai, and increases most among those with low educational levels. Interventions should be addressed in the population, particularly in women with lower educational levels.
- Overweight,
- Prevalence trend,
- Education

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References(16)

References

[1]	Lassale C, Tzoulaki I, Moons K, et al. Separate and combined associations of obesity and metabolic health with coronary heart disease: a pan-European case-cohort analysis[J]. Eur Heart J, 2018, 39(5): 397-406. DOI: 10.1093/eurheartj/ehx448.
[2]	Wang BY, Zhang M, Wang S, et al. Dynamic status of metabolically healthy overweight/obesity and metabolically unhealthy and normal weight and the risk of type 2 diabetes mellitus: A cohort study of a rural adult Chinese population[J]. Obes Res Clin Pract, 2018, 12(1): 61-71. DOI: 10.1016/j.orcp.2017.10.005.
[3]	Blanquet M, Legrand A, Pélissier A, et al. Socio-economics status and metabolic syndrome: a meta-analysis[J]. Diabetes Metab Syndr, 2019, 13(3): 1805-1812. DOI: 10.1016/j.dsx.2019.04.003.
[4]	Jaacks LM, Vandevijvere S, Pan A, et al. The obesity transition: stages of the global epidemic[J]. Lancet Diabetes Endocrinol, 2019, 7(3): 231-240. DOI: 10.1016/S2213-8587(19)30026-9.
[5]	中国心血管健康与疾病报告编写组. 中国心血管健康与疾病报告2019概要[J]. 中国循环杂志, 2020, 35(9): 833-854. DOI: 10.3969/j.issn.1000-3614.20.09.001. The Writing Committee of the Report on Cardiovascular Health and Diseases in China. Report on cardiovascular health and diseases in China 2019: An updated summary[J]. Chin Circul J, 2020, 35(9): 833-854. DOI: 10.3969/j.issn.1000-3614.20.09.001.
[6]	Li YY, Jiang HK, Cheng MN, et al. Performance and costs of multiple screening strategies for type 2 diabetes: two population-based studies in Shanghai, China[J]. BMJ Open Diabetes Res Care, 2020, 8(1): e001569. DOI: 10.1136/bmjdrc-2020-001569.
[7]	World Health Organization, Regional Office for the Western Pacific. The Asia-Pacific perspective: redefining obesity and its treatment[M]. Sydney: Health Communications Australia, 2000.
[8]	Grundy SM, Cleeman JI, Daniels SR, et al. Diagnosis and management of the metabolic syndrome: an American Heart Association/National Heart, Lung, and Blood Institute Scientific Statement[J]. Circulation, 2005, 112(17): 2735-2752. DOI: 10.1161/CIRCULATIONAHA.105.169404.
[9]	Doll R, Payne P, Waterhouse J. Cancer incidence in five continents, Vol. I[M]. Geneva: Union Internationale Contre le Cancer, 1966. DOI: 10.1007/978-3-642-85849-9
[10]	Segi M. Cancer mortality for selected sites in 24 countries (1950-57)[M]. Sendai: Department of Public Health, Tohoku University of Medicine, 1960.
[11]	Homma Y, Saewyc E, Zumbo BD. Is it getting better? An analytical method to test trends in health disparities, with tobacco use among sexual minority vs. heterosexual youth as an example[J]. Int J Equity Health, 2016, 15: 79. DOI: 10.1186/s12939-016-0371-3.
[12]	Xu H, Li X, Adams H, et al. Etiology of Metabolic Syndrome and Dietary Intervention[J]. Int J Mol Sci, 2018, 20(1): 128. DOI: 10.3390/ijms20010128.
[13]	Moore JX, Chaudhary N, Akinyemiju T. Metabolic syndrome prevalence by race/ethnicity and sex in the United States, National Health and Nutrition Examination Survey, 1988-2012[J]. Prev Chronic Dis, 2017, 14: E24. DOI: 10.5888/pcd14.160287.
[14]	Jiwani SS, Carrillo-Larco RM, Hernández-Vásquez A, et al. The shift of obesity burden by socioeconomic status between 1998 and 2017 in Latin America and the Caribbean: a cross-sectional series study[J]. Lancet Glob Health, 2019, 7(12): e1644-e1654. DOI: 10.1016/S2214-109X(19)30421-8.
[15]	Wu H, Bragg F, Yang L, et al. Sex differences in the association between socioeconomic status and diabetes prevalence and incidence in China: cross-sectional and prospective studies of 0.5 million adults[J]. Diabetologia, 2019, 62(8): 1420-1429. DOI: 10.1007/s00125-019-4896-z.
[16]	Chen ML, Wu YK, Narimatsu H, et al. Socioeconomic status and physical activity in Chinese adults: a report from a community-based survey in Jiaxing, China[J]. PloS one, 2015, 10(7): e0132918.