Background
Methods
Study design and sample
WC and WHR
Measures of health-related quality of life
Statistical analysis
Results
Characteristics of participants and the prevalence of abdominal obesity
N (%) | WC categories (cm)a | WHR categoriesb | |||||
---|---|---|---|---|---|---|---|
Normal WC (<80) | Mild abdominal obesity (80–90) | Severe abdominal obesity (≥90) | P-value | Normal WHR (<0.85) | Abdominal obesity (≥0.85) | P-value | |
Total | 936(55.9) | 453(27.1) | 284(17.0) | 1018(60.9) | 655(39.2) | ||
City | |||||||
Shanghai | 189(53.8) | 111(31.6) | 51(14.5) | <0.001 | 218(62.1) | 133(37.9) | <0.001 |
Beijing | 151(45.5) | 96(28.9) | 85(25.6) | 160(48.2) | 172(51.8) | ||
Wuhan | 193(57.6) | 85(25.4) | 57(17.0) | 207(61.8) | 128(38.2) | ||
Xian | 179(53.4) | 90(26.9) | 66(19.7) | 210(62.7) | 125(37.3) | ||
Guangzhou | 224(70.0) | 71(22.2) | 25(7.8) | 223(69.7) | 97(30.3) | ||
Region | |||||||
Urban | 479(58.8) | 230(28.2) | 106(13.0) | <0.001 | 546(67.0) | 269(33.0) | <0.001 |
Rural | 457(53.3) | 223(26.0) | 178(20.7) | 472(55.0) | 386(45.0) | ||
Age (years) | |||||||
18–29 | 322(84.5) | 49(12.9) | 10(2.6) | <0.001 | 307(80.6) | 74(19.4) | <0.001 |
30–39 | 260(71.4) | 81(22.3) | 23(6.3) | 277(76.1) | 87(23.9) | ||
40–49 | 204(49.9) | 132(32.3) | 73(17.8) | 263(64.3) | 146(35.7) | ||
50–59 | 90(34.9) | 95(36.8) | 73(28.3) | 106(41.1) | 152(58.9) | ||
60–80 | 60(23.0) | 96(36.8) | 105(40.2) | 65(24.9) | 196(75.1) | ||
Marital status | |||||||
Married | 687(52.3) | 382(29.1) | 244(18.6) | <0.001 | 777(59.2) | 536(40.80) | <0.001 |
Unmarried | 213(87.0) | 28(11.4) | 4(1.6) | 202(82.4) | 43(17.6) | ||
Separated/divorced/widowed | 36(31.3) | 43(37.4) | 36(31.3) | 39(33.9) | 76(66.1) | ||
Education | |||||||
Primary school/uneducated | 136(35.5) | 125(32.6) | 122(31.9) | <0.001 | 135(35.3) | 248(64.7) | <0.001 |
Secondary/high school | 578(58.0) | 269(27.0) | 149(15.0) | 651(65.4) | 345(34.6) | ||
College graduate | 222(75.5) | 59(20.1) | 13(4.4) | 232(78.9) | 62(21.1) | ||
Occupationc | |||||||
Office worker | 299(70.4) | 89(20.9) | 37(8.7) | <0.001 | 318(74.8) | 107(25.2) | <0.001 |
Manual worker | 635(51.0) | 364(29.2) | 247(19.8) | 700(56.2) | 546(43.8) | ||
Family income/month (Yuan) | |||||||
~1999 | 439(49.6) | 251(28.3) | 196(22.1) | <0.001 | 463(52.3) | 423(47.7) | <0.001 |
2000~ | 406(62.3) | 171(26.2) | 75(11.5) | 459(70.4) | 193(29.6) | ||
5000~ | 87(66.9) | 30(23.1) | 13(10.0) | 91(70.0) | 39(30.0) | ||
Smokingd | |||||||
Non-smokers | 918(56.2) | 443(27.1) | 272(16.7) | 0.044 | 999(61.2) | 634(38.8) | 0.080 |
Smokers | 18(45.0) | 10(25.0) | 12(30.0) | 19(47.5) | 21(52.5) | ||
Drinkinge | |||||||
Non-drinkers | 907(56.0) | 436(27.0) | 275(17.0) | 0.796 | 982(60.7) | 636(39.3) | 0.477 |
Drinkers | 29(52.7) | 17(30.9) | 9(16.4) | 36(65.5) | 19(34.5) | ||
Physical activity | |||||||
Never | 175(58.3) | 80(26.7) | 45(15.0) | <0.001 | 178(59.3) | 122(40.7) | <0.001 |
<4 times/month | 99(68.8) | 28(19.4) | 17(11.8) | 106(73.6) | 38(26.4) | ||
≥1 time/week | 155(64.3) | 56(23.2) | 30(12.5) | 168(69.7) | 73(30.3) | ||
≥1 time/day | 505(51.3) | 288(29.2) | 192(19.5) | 565(57.4) | 420(42.6) | ||
Hypertension | |||||||
No | 898(61.2) | 383(26.1) | 187(12.7) | <0.001 | 965(65.7) | 503(34.3) | <0.001 |
Yes | 38(18.5) | 70(34.2) | 97(47.3) | 53(25.8) | 152(74.2) | ||
Angina pectoris | |||||||
No | 932(56.8) | 443(27.0) | 265(16.2) | <0.001 | 1013(61.8) | 627(38.2) | <0.001 |
Yes | 4(12.1) | 10(30.3) | 19(57.6) | 5(15.2) | 28(84.8) | ||
Cerebrovascular disease | |||||||
No | 924(57.1) | 429(26.5) | 265(16.4) | <0.001 | 1005(62.1) | 613(37.9) | <0.001 |
Yes | 12(21.8) | 24(43.6) | 19(34.6) | 13(23.6) | 42(76.4) | ||
Chronic bronchitis | |||||||
No | 909(56.8) | 433(27.0) | 259(16.2) | <0.001 | 988(61.7) | 613(38.3) | <0.001 |
Yes | 27(37.5) | 20(27.8) | 25(34.7) | 30(41.7) | 42(58.3) | ||
Rheumatoid arthritis | |||||||
No | 906(57.3) | 428(27.0) | 248(15.7) | <0.001 | 982(62.1) | 600(37.9) | <0.001 |
Yes | 30(33.0) | 25(27.5) | 36(39.5) | 36(39.6) | 55(60.4) | ||
Osteoarthritis | |||||||
No | 909(56.9) | 427(26.7) | 261(16.3) | <0.001 | 989(61.9) | 608(38.1) | <0.001 |
Yes | 27(35.5) | 26(34.2) | 23(30.3) | 29(38.2) | 47(61.8) | ||
Diabetes | |||||||
No | 929(57.4) | 438(27.0) | 252(15.6) | <0.001 | 1007(62.2) | 612(37.8) | <0.001 |
Yes | 7(12.9) | 15(27.8) | 32(59.3) | 11(20.4) | 43(79.6) |
N (%) | WC categories (cm)a | WHR categoriesb | |||||
---|---|---|---|---|---|---|---|
Normal WC (<85) | Mild abdominal obesity (85–95) | Severe abdominal obesity (≥95) | P-value | Normal WHR (<0.90) | Abdominal obesity (≥0.90) | P-value | |
Total | 842(55.7) | 452(29.9) | 217(14.4) | 1011(66.9) | 500(33.1) | ||
City | |||||||
Shanghai | 119(41.0) | 111(38.3) | 60(20.7) | <0.001 | 163(56.2) | 127(43.8) | <0.001 |
Beijing | 96(37.4) | 108(42.0) | 53(20.6) | 153(59.5) | 104(40.5) | ||
Wuhan | 208(64.0) | 70(21.5) | 47(14.5) | 244(75.1) | 81(24.9) | ||
Xian | 198(64.1) | 71(23.0) | 40(12.9) | 213(68.9) | 96(31.1) | ||
Guangzhou | 221(67.0) | 92(27.9) | 17(5.1) | 238(72.1) | 92(27.9) | ||
Region | |||||||
Urban | 374(49.3) | 255(33.6) | 130(17.1) | <0.001 | 509(67.1) | 250(32.9) | 0.899 |
Rural | 468(62.2) | 197(26.2) | 87(11.6) | 502(66.8) | 250(33.2) | ||
Age (years) | |||||||
18–29 | 264(75.0) | 55(15.6) | 33(9.4) | <0.001 | 295(83.8) | 57(16.2) | <0.001 |
30–39 | 214(58.6) | 106(29.0) | 45(12.3) | 270(74.0) | 95(26.0) | ||
40–49 | 180(52.2) | 113(32.7) | 52(15.1) | 219(63.5) | 126(36.5) | ||
50–59 | 101(44.9) | 83(36.9) | 41(18.2) | 122(54.2) | 103(45.8) | ||
60–80 | 83(37.1) | 95(42.4) | 46(20.5) | 105(46.9) | 119(53.1) | ||
Marital status | |||||||
Married | 590(51.0) | 385(33.3) | 181(15.7) | <0.001 | 724(62.6) | 432(37.4) | <0.001 |
Unmarried | 235(74.4) | 52(16.5) | 29(9.2) | 264(83.5) | 52(16.5) | ||
Separated/divorced/widowed | 16(42.1) | 15(39.5) | 7(18.4) | 22(57.9) | 16(42.1) | ||
Education | |||||||
Primary school/uneducated | 102(54.5) | 60(32.1) | 25(13.4) | 0.021 | 109(58.3) | 78(41.7) | 0.026 |
Secondary/high school | 575(58.6) | 277(28.2) | 130(13.2) | 666(67.8) | 316(32.2) | ||
College graduate | 165(48.3) | 115(33.6) | 62(18.1) | 236(69.0) | 106(31.0) | ||
Occupationc | |||||||
Office worker | 249(52.0) | 158(33.0) | 72(15.0) | 0.105 | 317(66.2) | 162(33.8) | 0.690 |
Manual worker | 591(57.5) | 293(28.5) | 144(14.0) | 691(67.2) | 337(32.8) | ||
Family income/month (Yuan) | |||||||
~1999 | 457(61.8) | 185(25.0) | 98(13.2) | <0.001 | 500(67.6) | 240(32.4) | 0.801 |
2000~ | 316(50.9) | 208(33.5) | 97(15.6) | 414(66.7) | 207(33.3) | ||
5000~ | 66(45.5) | 58(40.0) | 21(14.5) | 94(64.8) | 51(35.2) | ||
Smokingd | |||||||
Non-smokers | 350(58.9) | 170(28.6) | 74(12.5) | 0.028 | 426(71.7) | 168(28.3) | 0.001 |
Smokers | 492(53.6) | 282(30.8) | 143(15.6) | 585(63.8) | 332(36.2) | ||
Drinkinge | |||||||
Non-drinkers | 531(59.7) | 242(27.2) | 117(13.1) | 0.001 | 629(70.7) | 261(29.3) | <0.001 |
Drinkers | 311(50.2) | 209(33.7) | 100(16.1) | 381(61.5) | 239(38.5) | ||
Physical activity | |||||||
Never | 115(50.9) | 70(31.0) | 41(18.1) | 0.078 | 132(58.4) | 94(41.6) | 0.007 |
<4 times/month | 87(54.4) | 51(31.9) | 22(13.8) | 115(71.9) | 45(28.1) | ||
≥1 time/week | 139(58.6) | 64(27.0) | 34(14.4) | 171(72.1) | 66(27.9) | ||
≥1 time/day | 499(56.6) | 265(30.0) | 118(13.4) | 591(67.0) | 291(33.0) | ||
Hypertension | |||||||
No | 784(60.3) | 364(28.0) | 152(11.7) | <0.001 | 916(70.5) | 384(29.5) | <0.001 |
Yes | 58(27.5) | 88(41.7) | 65(30.8) | 95(45.0) | 116(55.0) | ||
Angina pectoris | |||||||
No | 836(56.1) | 440(29.6) | 213(14.3) | 0.036 | 1001(67.2) | 488(32.8) | 0.031 |
Yes | 6(27.3) | 12(54.5) | 4(18.2) | 10(45.5) | 12(54.5) | ||
Cerebrovascular disease | |||||||
No | 830(56.3) | 436(29.6) | 208(14.1) | 0.005 | 992(67.3) | 482(32.7) | 0.042 |
Yes | 12(32.4) | 16(43.3) | 9(24.3) | 19(51.4) | 18(48.6) | ||
Chronic bronchitis | |||||||
No | 809(56.3) | 427(29.7) | 201(14.0) | 0.026 | 972(67.6) | 465(32.4) | 0.008 |
Yes | 33(44.6) | 25(33.8) | 16(21.6) | 39(52.7) | 35(47.3) | ||
Rheumatoid arthritis | |||||||
No | 808(55.7) | 433(29.8) | 210(14.5) | 0.693 | 974(67.1) | 477(32.9) | 0.379 |
Yes | 34(56.7) | 19(31.7) | 7(11.7) | 37(61.7) | 23(38.3) | ||
Osteoarthritis | |||||||
No | 826(56.0) | 437(29.6) | 213(14.4) | 0.561 | 993(67.3) | 483(32.7) | 0.049 |
Yes | 16(45.7) | 15(42.9) | 4(11.4) | 18(51.4) | 17(48.6) | ||
Diabetes | |||||||
No | 832(56.9) | 426(29.1) | 205(14.0) | <0.001 | 990(67.7) | 473(32.3) | <0.001 |
Yes | 10(20.8) | 26(54.2) | 12(25.0) | 21(43.8) | 27(56.2) |
The relationship between abdominal obesity and HRQOL
Scales | WC categories | WHR categories | |||
---|---|---|---|---|---|
Normal WC | Mild abdominal obesity | Severe abdominal obesity | Normal WHR | Abdominal obesity | |
Women | |||||
Physical functioning (PF) | 95.5(9.2) | 91.6(14.3)a | 84.4(21.0)a, b | 95.3(9.2) | 88.3(18.2)c |
Role-physical (RP) | 90.9(25.2) | 86.2(31.2)a | 75.2(40.2)a, b | 90.1(26.6) | 82.1(35.1)c |
Bodily pain (BP) | 88.8(17.3) | 86.0(21.0)a | 81.2(24.2)a, b | 88.1(18.0) | 84.7(22.3)c |
General health (GH) | 70.3(20.6) | 69.9(21.8) | 61.3(23.4)a, b | 70.2(20.6) | 65.8(23.0)c |
Vitality (VT) | 69.0(17.8) | 67.2(20.3) | 61.8(21.8)a, b | 68.5(18.2) | 65.4(20.9)c |
Social functioning (SF) | 88.6(15.1) | 87.6(16.1) | 84.7(17.4)a, b | 88.7(15.0) | 86.1(17.0)c |
Role-emotional (RE) | 88.6(28.3) | 89.3(28.6) | 84.6(34.6) | 89.2(27.8) | 86.61(32.0) |
Mental health (MH) | 77.7(15.1) | 78.1(16.5) | 75.7(17.5) | 77.4(15.4) | 77.5(16.7) |
Physical component summary (PCS) | 53.9(5.7) | 52.1(7.65)a | 48.4(9.4)a, b | 53.7(5.9) | 50.7(8.7)c |
Mental component summary (MCS) | 51.2(7.8) | 51.8(8.1) | 51.0(8.9) | 51.3(7.9) | 51.5(8.4) |
Men | |||||
Physical functioning (PF) | 96.2(9.1) | 95.7(9.5) | 92.8(16.0)a, b | 96.2(9.4) | 94.3(12.4)c |
Role-physical (RP) | 91.7(25.2) | 90.3(25.9) | 87.3(30.7) | 91.7(24.9) | 88.5(28.9)c |
Bodily pain (BP) | 90.0(17.6) | 89.5(18.4) | 88.6(19.0) | 90.0(17.6) | 89.0(18.9) |
General health (GH) | 71.2(20.2) | 70.7(20.2) | 71.7(19.2) | 71.5(20.1) | 70.5(20.0) |
Vitality (VT) | 70.6(17.5) | 70.6(18.9) | 70.9(18.3) | 71.9(17.2) | 70.0(19.5) |
Social functioning (SF) | 88.9(15.8) | 88.9(15.8) | 84.9(18.5)a, b | 88.8(16.0) | 87.3(16.8) |
Role-emotional (RE) | 90.9(26.4) | 91.7(25.3) | 90.3(27.5) | 91.2(25.8) | 90.8(26.9) |
Mental health (MH) | 76.7(15.9) | 79.9(15.2)a | 78.1(16.2)a | 77.3(15.7) | 78.9(16.0) |
Physical component summary (PCS) | 54.4(6.2) | 53.6(6.3) | 53.1(8.0)a, b | 54.3(6.2) | 53.3(7.1)c |
Mental component summary (MCS) | 51.3(8.0) | 52.4(7.5) | 51.7(8.0) | 51.6(7.7) | 52.0(8.2) |
Scales | WC categories (cm)b | WHRc | |
---|---|---|---|
Mild abdominal obesity | Severe abdominal obesity | Abdominal obesity | |
Women | |||
Physical functioning (PF) | 1.04(0.80, 1.36) | 1.40(0.99, 1.98) | 1.07(0.83, 1.36) |
Role-physical (RP) | 1.11(0.80, 1.54) |
1.56(1.06, 2.29)
| 1.09(0.81, 1.47) |
Bodily pain (BP) | 0.97(0.75, 1.25) | 1.05(0.76, 1.45) | 0.86(0.68, 1.09) |
General health (GH) | 1.26(0.63, 2.55) | 2.23(0.62, 8.05) | 0.73(0.40, 1.36) |
Vitality (VT) |
0.45(0.22, 0.90)
| 0.74(0.27, 2.05) | 0.52(0.27, 1.00) |
Social functioning (SF) | 1.13(0.89, 1.45) | 1.37(0.99, 1.88) | 1.12(0.89, 1.42) |
Role-emotional (RE) | 0.80(0.56, 1.14) | 0.78(0.51, 1.20) | 0.93(0.67, 1.28) |
Mental health (MH) | 0.66(0.40, 1.08) | 1.40(0.65, 3.01) | 0.69(0.43, 1.12) |
Men | |||
Physical functioning (PF) |
0.73(0.55, 0.97)
| 0.73(0.51, 1.06) | 0.89(0.69, 1.16) |
Role-physical (RP) | 1.29(0.89, 1.87) | 1.37(0.86, 2.18) | 1.14(0.81, 1.61) |
Bodily pain (BP) | 0.91(0.70, 1.20) | 0.84(0.59, 1.20) | 0.94(0.73, 1.21) |
General health (GH) | 0.95(0.48, 1.87) | 0.61(0.26, 1.39) | 1.48(0.76, 2.91) |
Vitality (VT) | 0.61(0.32, 1.18) | 0.49(0.22, 1.11) | 0.91(0.50, 1.65) |
Social functioning (SF) | 0.98(0.76, 1.26) |
1.41(1.02, 1.96)
| 1.17(0.92, 1.47) |
Role-emotional (RE) | 0.99(0.67, 1.46) | 1.13(0.69, 1.84) | 1.05(0.73, 1.50) |
Mental health (MH) | 0.86(0.49, 1.50) | 0.58(0.30, 1.12) | 0.96(0.58, 1.58) |