目的了解河北省唐山市45～64岁城乡居民肥胖流行现状,为采取干预措施提供参考依据。方法采用随机整群抽样方法对在河北省唐山市14个县(市)区抽取的5 759名45～64岁城乡居民进行问卷调查和体格检查。结果按WHO成人体质指数(BMI)分类标准,唐山市城乡居民超重率、超重/肥胖率、肥胖率分别为44.0%、12.3%、56.3%,男性和女性居民分别为41.3%和45.5%、50.0%和59.7%、8.7%和14.2%,男性居民超重率、超重/肥胖率和肥胖率均低于女性居民(P<0.01);按中国成人超重和肥胖症预防控制指南,唐山市城乡居民超重率、肥胖率、超重/肥胖率、中心性肥胖率分别为43.3%、24.8%、68.1%、73.5%,男性和女性居民分别为44.6%和42.5%、18.6%和28.2%、63.2%和70.7%、65.2%和77.9%,男性居民肥胖率、超重/肥胖率和中心性肥胖率均低于女性居民(P=0.000),男性和女性居民超重率间差异无统计学意义(P>0.05);按中国成人血脂异常防治指南推荐标准,中心性肥胖率为54.1%,男性居民中心性肥胖率为48.1%,低于女性居民的57.3%,差异有统计学意义(χ2=44.59,P=0.000);按WHO成人BMI分类标准,不同年龄男性居民和不同文化程度女性居民肥胖率均不同(P<0.05);按中国成人超重和肥胖症预防控制指南,不同年龄、文化程度男性居民和不同文化程度女性居民肥胖率均不同(P<0.05),不同文化程度、地区男性居民和不同年龄、文化程度、地区女性居民中心性肥胖率均不同(P<0.05);按中国成人血脂异常防治指南推荐标准,不同年龄、文化程度、地区男性和女性居民中心性肥胖率均不同(P<0.05)。结论唐山市45～64岁城乡居民超重和肥胖率较高,女性居民超重/肥胖率、肥胖率和中心性肥胖率均高于男性居民。 Objective To understand the prevalence of obesity in 45-64-year-old urban and rural residents in Tangshan, Hebei Province, and to provide a reference for the intervention. Methods A random sample of 5 759 urban and rural residents aged 45-64 years was collected from 14 counties (cities) in Tangshan City of Hebei Province by questionnaire and physical examination. Results According to the classification criteria of the WHO Adult Body Mass Index (BMI), the overweight rate, overweight / obesity rate and obesity rate of urban and rural residents in Tangshan were 44.0%, 12.3% and 56.3% respectively, while the male and female residents were 41.3% and 45.5% % And 59.7%, 8.7% and 14.2%, respectively. The rates of overweight, overweight / obesity and obesity in male were lower than those in female (P <0.01). According to the guidelines for the prevention and control of overweight and obesity in adults in China, The rates of obesity, obesity, overweight / obesity and central obesity were 43.3%, 24.8%, 68.1% and 73.5% respectively, while the male and female residents were 44.6% and 42.5%, 18.6% and 28.2%, 63.2% and 70.7 respectively %, 65.2% and 77.9% respectively. The obesity rate, overweight / obesity rate and central obesity rate of male residents were lower than those of female residents (P = 0.000). There was no significant difference between male and female overweight rates (P> 0.05) ; According to the recommended guidelines for the prevention and treatment of dyslipidemia in Chinese adults, the central obesity rate was 54.1%, the male obesity rate was 48.1%, lower than that of female residents (57.3%), the difference was statistically significant (χ2 = 44.59, P = 0.000 ); According to WHO BMI classification criteria for adults of different ages and different levels of female residents of obesity (P <0.05). According to the guidelines for the prevention and control of overweight and obesity in Chinese adults, the obesity rates of male residents of different ages and educational level and female residents of different educational levels were all different (P <0.05). The male students of different educational level, (P <0.05). According to the recommendation of Chinese guidelines for the prevention and treatment of dyslipidemia, the central obesity rates of male and female residents in different age and educational level were different P <0.05). Conclusion The overweight and obesity rates of urban and rural residents aged 45-64 years in Tangshan City are higher than that of male residents. Overweight / obesity rates, obesity rates and central obesity rates of female residents are higher than those of male residents.