[Relationship between smoking status and obesity risk in males aged 18-64 years in 9 provinces of China, 1991-2015].

Objective: To investigate longitudinal association between smoking behavior and obesity risk in male adults in China from 1991 to 2015. Methods: A total of 32 169 male adults aged 18-64 years who participated in two or more rounds of China Health and Nutrition Survey (CHNS, 1991-2015) and had complete information of demographic characteristics, smoking status and physical measurements were selected as the study subjects. According to whether the subjects smoked or not and the number of cigarettes smoked per day, the subjects were divided into four groups: nonsmoker, light smoker (1-14 cigarettes/d), moderate smoker (15-24 cigarettes/d) and heavy smoker (≥25 cigarettes/d). The distribution of body mass index (BMI), waist circumference (WC), general obesity and central obesity of subjects with different smoking status were observed. Two-level mixed effect linear regression model and logistic regression model were used to analyze the relationship between smoking status and obesity risk. Results: Compared with nonsmokers, the BMI decreased by 0.19 kg/m2 in light smokers (95%CI:-0.27--0.10), 0.40 kg/m2 in moderate smokers (95%CI:-0.49--0.31), and 0.36 kg/m2 in heavy smokers (95%CI:-0.53--0.19), respectively, and the WC decreased by 0.49 cm in light smokers (95%CI:-0.76--0.21), 0.80 cm in moderate smokers (95%CI:-1.08--0.51) and 0.79 cm in heavy smokers (95%CI:-1.38--0.36) in, respectively. Compared with nonsmokers, the odds ratio of the risk for general and abdominal obesity were 0.70 (95%CI:0.62-0.79) and 0.78 (95%CI:0.73-0.84) in light smokers, 0.61 (95%CI:0.55-0.69) and 0.74 (95%CI:0.70-0.79) in moderate smokers and 0.78 (95%CI:0.65-0.96) and 0.84 (95%CI:0.76-0.95) in heavy smokers, respectively. Conclusions: From 1991 to 2015, the BMI, WC, prevalence of general and abdominal obesity in male adults showed a significant upward trends in both nonsmokers and smokers (light, moderate and heavy) in China, suggesting that smoking is negatively associated with the risk for obesity in male adults.目的： 分析1991-2015年中国9省份18~64岁成年男性居民吸烟状况与肥胖患病风险的关系。 方法： 利用“中国健康与营养调查”1991-2015年9轮调查资料，选取参加两轮及以上、有完整人口统计学特征、吸烟状况和体格测量数据的18~64岁成年男性居民作为研究对象，共计32 169名。依据研究对象是否吸烟以及吸烟者每日吸烟数量将研究对象分为不吸烟、轻度吸烟（1~14支/d）、中度吸烟（15~24支/d）和重度吸烟（≥25支/d）组。观察不同吸烟程度下研究对象的BMI、腰围、全身性肥胖和中心性肥胖的分布情况，利用两水平混合效应线性回归模型和logistic回归模型分析男性吸烟状况与肥胖患病风险的关系。 结果： 不同吸烟程度下调查对象的BMI、腰围、全身性肥胖和中心性肥胖的患病率呈现逐年上升的趋势。在校正混杂因素后，轻、中和重度吸烟者BMI分别比不吸烟人群减少了0.19 kg/m2（95%CI：-0.27~-0.10）、0.40 kg/m2（95%CI：-0.49~-0.31）和0.36 kg/m2（95%CI：-0.53~-0.19）；腰围分别减少了0.49 cm（95%CI：-0.76~-0.21）、0.80 cm（95%CI：-1.08~-0.51）和0.79 cm（95%CI：-1.38~-0.36）。男性轻、中和重度吸烟者患全身性肥胖的风险分别是不吸烟者的0.70倍（OR=0.70，95%CI：0.62~0.79）、0.61倍（OR=0.61，95%CI：0.55~0.69）和0.78倍（OR=0.78，95%CI：0.65~0.96）；患中心性肥胖的风险分别是不吸烟者的0.78倍（OR=0.78，95%CI：0.73~0.84）、0.74倍（OR=0.74，95%CI：0.70~0.79）和0.84倍（OR=0.84，95%CI：0.76~0.95）。 结论： 1991-2015年间，男性不吸烟与吸烟（轻、中和重度）居民的BMI、腰围和肥胖患病率均呈现显著上升趋势。成年男性居民吸烟与肥胖患病风险呈显著性负向关联。.