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目的了解济南地区铁路职工超重、肥胖的流行特征,分析超重、肥胖与高血压、高血脂、脂肪肝之间的关系,为提高铁路职工的健康水平提供科学依据。方法采用多阶段分层随机抽样方法,于2014年3-6月对济南地区20~59岁的铁路职工1 850人进行面对面询问调查和体格检查,应用logistic回归分析铁路职工超重肥胖状况与高血压、高血脂和脂肪肝的关系。结果济南地区20~59岁的铁路职工超重率为33.8%,肥胖率为11.9%。调整年龄、文化程度、婚姻状况、吸烟、饮酒和睡眠等因素后,超重职工患高血压、高血脂和脂肪肝的危险性分别是正常体重职工的2.24倍(95%CI:1.57~3.19)、2.08倍(95%CI:1.37~3.16)和3.10倍(95%CI:2.27~4.23),肥胖职工患高血压、高血脂和脂肪肝的危险性分别是正常体重职工的5.10倍(95%CI:3.34~7.77)、4.66倍(95%CI:2.92~7.44)和7.76倍(95%CI:5.29~11.36)。超重、肥胖的程度与高血压、高血脂、脂肪肝之间均为正相关,存在明显的剂量-效应关系,且存在性别差异,在男性中呈现了稳定的剂量-效应关系。结论超重和肥胖已成为影响济南地区铁路职工健康的重要公共卫生问题,是高血压、高血脂和脂肪肝的重要危险因素。应对超重和肥胖职工给予充分关注,进行综合干预,维持理想体重,控制肥胖的发生,减少慢性病危险因素,提高职工身体健康水平。
Objective To understand the epidemiological characteristics of overweight and obesity among railroad workers in Jinan area and to analyze the relationship between overweight and obesity and hypertension, hyperlipidemia and fatty liver and provide a scientific basis for improving the health of railway workers. Methods The multi-stage stratified random sampling method was used to conduct face-to-face interviews and physical examinations of 1,850 railroad workers aged 20-59 in Jinan from March to June 2014. Logistic regression was used to analyze the relationship between overweight and obesity and hypertension , Hyperlipidemia and fatty liver. Results Jinan railway workers aged 20 to 59 overweight rate was 33.8%, obesity rate was 11.9%. After adjusting for such factors as age, education level, marital status, smoking, drinking and sleep, the overweight workers were 2.24 times (95% CI: 1.57 ~ 3.19) with hypertension, hyperlipidemia and fatty liver respectively, 2.08-fold (95% CI: 1.37-3.16) and 3.10-fold (95% CI: 2.27-4.23) respectively. The risk of obesity in workers with hypertension, hyperlipidemia and fatty liver were 5.10 times : 3.34 ~ 7.77), 4.66-fold (95% CI: 2.92 ~ 7.44) and 7.76-fold (95% CI: 5.29 ~ 11.36). The degree of overweight and obesity was positively correlated with hypertension, hyperlipidemia and fatty liver, and there was a significant dose-effect relationship with gender differences. A stable dose-response relationship was found in males. Conclusion Overweight and obesity have become important public health problems affecting the health of railway workers in Jinan area and are important risk factors of hypertension, hyperlipidemia and fatty liver. Should pay full attention to overweight and obese workers, to carry out comprehensive intervention to maintain the desired weight, control the incidence of obesity, reduce the risk factors for chronic diseases and improve the health level of workers.