Skip to main content
Top
Published in: Health and Quality of Life Outcomes 1/2014

Open Access 01-12-2014 | Research

Abdominal obesity and its association with health-related quality of life in adults: a population-based study in five Chinese cities

Authors: Shunquan Wu, Rui Wang, An Jiang, Yingying Ding, Meijing Wu, Xiuqiang Ma, Yanfang Zhao, Jia He

Published in: Health and Quality of Life Outcomes | Issue 1/2014

Login to get access

Abstract

Background

This study aimed to investigate the prevalence of abdominal obesity and its association with the health-related quality of life (HRQOL) in a randomly selected Chinese sample.

Methods

A population-based sample of 3,600 residents aged 18–80 years was selected randomly from 5 Chinese cities. Demographic information, and waist and hip circumference measurements were obtained. The Mandarin version of the Short Form 36 Health Survey questionnaire (SF-36) was used to assess the HRQOL. Waist circumference (WC) and waist-to-hip ratio (WHR) were used as measures of abdominal obesity, and the prevalence of abdominal obesity and its association with HRQOL were analysed.

Results

Among the 3,184 participants included in the analysis, the prevalence of abdominal obesity was about 45% in both women and men as evaluated by WC, and about 40% in women and 33% in men as evaluated by WHR. The prevalence varied by city, region, age, marital status, education level, family income, smoking, and the presence of chronic diseases. Both WC and WHR increased with age, and men had larger WC and WHR than women in most age groups. In women, abdominal obesity, as determined by both WC and WHR, was associated with meaningful impairments in 4 physical health scales and 2 mental health scales. In men, abdominal obesity, as determined by WC, was associated with 1 physical health scale and 1 mental health scale, and it was associated with 2 physical health scales based on WHR.

Conclusions

Physical health, but not mental health, was more vulnerable to impairment with abdominal obesity, and the impairments varied between genders. Public health agencies should emphasize that abdominal obesity impairs physical health.
Appendix
Available only for authorised users
Literature
1.
go back to reference Ogden CL, Carroll MD, Kit BK, Flegal KM: Prevalence of obesity in the United States, 2009–2010. NCHS Data Brief 2012, 82: 1–8.PubMed Ogden CL, Carroll MD, Kit BK, Flegal KM: Prevalence of obesity in the United States, 2009–2010. NCHS Data Brief 2012, 82: 1–8.PubMed
2.
go back to reference Ma GS, Li YP, Wu YF, Zhai FY, Cui ZH, Hu XQ, Luan DC, Hu YH, Yang XG: The prevalence of body overweight and obesity and its changes among Chinese people during 1992 to 2002. Chin J Prev Med (Zhonghua Yu Fang Yi Xue Za Zhi) 2005, 39(5):311–315. in Chinese Ma GS, Li YP, Wu YF, Zhai FY, Cui ZH, Hu XQ, Luan DC, Hu YH, Yang XG: The prevalence of body overweight and obesity and its changes among Chinese people during 1992 to 2002. Chin J Prev Med (Zhonghua Yu Fang Yi Xue Za Zhi) 2005, 39(5):311–315. in Chinese
3.
go back to reference Folsom AR, Kaye SA, Sellers TA, Hong CP, Cerhan JR, Potter JD, Prineas RJ: Body fat distribution and 5-year risk of death in older women. JAMA 1993, 269(4):483–487. 10.1001/jama.1993.03500040049035CrossRefPubMed Folsom AR, Kaye SA, Sellers TA, Hong CP, Cerhan JR, Potter JD, Prineas RJ: Body fat distribution and 5-year risk of death in older women. JAMA 1993, 269(4):483–487. 10.1001/jama.1993.03500040049035CrossRefPubMed
4.
go back to reference Wei M, Gaskill SP, Haffner SM, Stern MP: Waist circumference as the best predictor of noninsulin dependent diabetes mellitus (NIDDM) compared to body mass index, waist/hip ratio and other anthropometric measurements in Mexican Americans–a 7-year prospective study. Obes Res 1997, 5(1):16–23. 10.1002/j.1550-8528.1997.tb00278.xCrossRefPubMed Wei M, Gaskill SP, Haffner SM, Stern MP: Waist circumference as the best predictor of noninsulin dependent diabetes mellitus (NIDDM) compared to body mass index, waist/hip ratio and other anthropometric measurements in Mexican Americans–a 7-year prospective study. Obes Res 1997, 5(1):16–23. 10.1002/j.1550-8528.1997.tb00278.xCrossRefPubMed
5.
go back to reference Yusuf S, Hawken S, Ounpuu S, Bautista L, Franzosi MG, Commerford P, Lang CC, Rumboldt Z, Onen CL, Lisheng L, Tanomsup S, Wangai P Jr, Razak F, Sharma AM, Anand SS, INTERHEART Study Investigators: Obesity and the risk of myocardial infarction in 27,000 participants from 52 countries: a case–control study. Lancet 2005, 366(9497):1640–1649. 10.1016/S0140-6736(05)67663-5CrossRefPubMed Yusuf S, Hawken S, Ounpuu S, Bautista L, Franzosi MG, Commerford P, Lang CC, Rumboldt Z, Onen CL, Lisheng L, Tanomsup S, Wangai P Jr, Razak F, Sharma AM, Anand SS, INTERHEART Study Investigators: Obesity and the risk of myocardial infarction in 27,000 participants from 52 countries: a case–control study. Lancet 2005, 366(9497):1640–1649. 10.1016/S0140-6736(05)67663-5CrossRefPubMed
6.
go back to reference Hu D, Xie J, Fu P, Zhou J, Yu D, Whelton PK, He J, Gu D: Central rather than overall obesity is related to diabetes in the Chinese population: the InterASIA study. Obesity (Silver Spring) 2007, 15(11):2809–2816. 10.1038/oby.2007.333CrossRef Hu D, Xie J, Fu P, Zhou J, Yu D, Whelton PK, He J, Gu D: Central rather than overall obesity is related to diabetes in the Chinese population: the InterASIA study. Obesity (Silver Spring) 2007, 15(11):2809–2816. 10.1038/oby.2007.333CrossRef
7.
go back to reference Angleman SB, Harris TB, Melzer D: The role of waist circumference in predicting disability in periretirement age adults. Int J Obes (Lond) 2006, 30(2):364–373. 10.1038/sj.ijo.0803130CrossRef Angleman SB, Harris TB, Melzer D: The role of waist circumference in predicting disability in periretirement age adults. Int J Obes (Lond) 2006, 30(2):364–373. 10.1038/sj.ijo.0803130CrossRef
8.
go back to reference Janssen I, Katzmarzyk PT, Ross R: Waist circumference and not body mass index explains obesity-related health risk. Am J Clin Nutr 2004, 79(3):379–384.PubMed Janssen I, Katzmarzyk PT, Ross R: Waist circumference and not body mass index explains obesity-related health risk. Am J Clin Nutr 2004, 79(3):379–384.PubMed
9.
go back to reference Pouliot MC, Despres JP, Lemieux S, Moorjani S, Bouchard C, Tremblay A, Nadeau A, Lupien PJ: Waist circumference and abdominal sagittal diameter: best simple anthropometric indexes of abdominal visceral adipose tissue accumulation and related cardiovascular risk in men and women. Am J Cardiol 1994, 73(7):460–468. 10.1016/0002-9149(94)90676-9CrossRefPubMed Pouliot MC, Despres JP, Lemieux S, Moorjani S, Bouchard C, Tremblay A, Nadeau A, Lupien PJ: Waist circumference and abdominal sagittal diameter: best simple anthropometric indexes of abdominal visceral adipose tissue accumulation and related cardiovascular risk in men and women. Am J Cardiol 1994, 73(7):460–468. 10.1016/0002-9149(94)90676-9CrossRefPubMed
10.
go back to reference Dobbelsteyn CJ, Joffres MR, MacLean DR, Flowerdew G: A comparative evaluation of waist circumference, waist-to-hip ratio and body mass index as indicators of cardiovascular risk factors. The Canadian Heart Health Surveys. Int J Obes Relat Metab Disord 2001, 25(5):652–661. 10.1038/sj.ijo.0801582CrossRefPubMed Dobbelsteyn CJ, Joffres MR, MacLean DR, Flowerdew G: A comparative evaluation of waist circumference, waist-to-hip ratio and body mass index as indicators of cardiovascular risk factors. The Canadian Heart Health Surveys. Int J Obes Relat Metab Disord 2001, 25(5):652–661. 10.1038/sj.ijo.0801582CrossRefPubMed
11.
go back to reference Esmaillzadeh A, Mirmiran P, Azizi F: Waist-to-hip ratio is a better screening measure for cardiovascular risk factors than other anthropometric indicators in Tehranian adult men. Int J Obes Relat Metab Disord 2004, 28(10):1325–1332. 10.1038/sj.ijo.0802757CrossRefPubMed Esmaillzadeh A, Mirmiran P, Azizi F: Waist-to-hip ratio is a better screening measure for cardiovascular risk factors than other anthropometric indicators in Tehranian adult men. Int J Obes Relat Metab Disord 2004, 28(10):1325–1332. 10.1038/sj.ijo.0802757CrossRefPubMed
12.
go back to reference de Koning L, Merchant AT, Pogue J, Anand SS: Waist circumference and waist-to-hip ratio as predictors of cardiovascular events: meta-regression analysis of prospective studies. Eur Heart J 2007, 28(7):850–856. 10.1093/eurheartj/ehm026CrossRefPubMed de Koning L, Merchant AT, Pogue J, Anand SS: Waist circumference and waist-to-hip ratio as predictors of cardiovascular events: meta-regression analysis of prospective studies. Eur Heart J 2007, 28(7):850–856. 10.1093/eurheartj/ehm026CrossRefPubMed
13.
go back to reference Wing RR, Matthews KA, Kuller LH, Meilahn EN, Plantinga P: Waist to hip ratio in middle-aged women. Associations with behavioral and psychosocial factors and with changes in cardiovascular risk factors. Arterioscler Thromb 1991, 11(5):1250–1257. 10.1161/01.ATV.11.5.1250CrossRefPubMed Wing RR, Matthews KA, Kuller LH, Meilahn EN, Plantinga P: Waist to hip ratio in middle-aged women. Associations with behavioral and psychosocial factors and with changes in cardiovascular risk factors. Arterioscler Thromb 1991, 11(5):1250–1257. 10.1161/01.ATV.11.5.1250CrossRefPubMed
14.
go back to reference Doll HA, Petersen SE, Stewart-Brown SL: Obesity and physical and emotional well-being: associations between body mass index, chronic illness, and the physical and mental components of the SF-36 questionnaire. Obes Res 2000, 8(2):160–170. 10.1038/oby.2000.17CrossRefPubMed Doll HA, Petersen SE, Stewart-Brown SL: Obesity and physical and emotional well-being: associations between body mass index, chronic illness, and the physical and mental components of the SF-36 questionnaire. Obes Res 2000, 8(2):160–170. 10.1038/oby.2000.17CrossRefPubMed
15.
go back to reference Coakley EH, Kawachi I, Manson JE, Speizer FE, Willet WC, Colditz GA: Lower levels of physical functioning are associated with higher body weight among middle-aged and older women. Int J Obes Relat Metab Disord 1998, 22(10):958–965. 10.1038/sj.ijo.0800698CrossRefPubMed Coakley EH, Kawachi I, Manson JE, Speizer FE, Willet WC, Colditz GA: Lower levels of physical functioning are associated with higher body weight among middle-aged and older women. Int J Obes Relat Metab Disord 1998, 22(10):958–965. 10.1038/sj.ijo.0800698CrossRefPubMed
16.
go back to reference Han TS, Tijhuis MA, Lean ME, Seidell JC: Quality of life in relation to overweight and body fat distribution. Am J Public Health 1998, 88(12):1814–1820. 10.2105/AJPH.88.12.1814PubMedCentralCrossRefPubMed Han TS, Tijhuis MA, Lean ME, Seidell JC: Quality of life in relation to overweight and body fat distribution. Am J Public Health 1998, 88(12):1814–1820. 10.2105/AJPH.88.12.1814PubMedCentralCrossRefPubMed
17.
go back to reference Yan X, Wang R, Zhao Y, Ma X, Fang J, Yan H, Kang X, Yin P, Hao Y, Li Q, Dent J, Sung J, Zou D, Johansson S, Halling K, Liu W, He J: Systematic investigation of gastrointestinal diseases in China (SILC): validation of survey methodology. BMC Gastroenterol 2009, 9: 86. 10.1186/1471-230X-9-86PubMedCentralCrossRefPubMed Yan X, Wang R, Zhao Y, Ma X, Fang J, Yan H, Kang X, Yin P, Hao Y, Li Q, Dent J, Sung J, Zou D, Johansson S, Halling K, Liu W, He J: Systematic investigation of gastrointestinal diseases in China (SILC): validation of survey methodology. BMC Gastroenterol 2009, 9: 86. 10.1186/1471-230X-9-86PubMedCentralCrossRefPubMed
18.
go back to reference Zhou BF: Predictive values of body mass index and waist circumference for risk factors of certain related diseases in Chinese adults–study on optimal cut-off points of body mass index and waist circumference in Chinese adults. Biomed Environ Sci 2002, 15(1):83–96.PubMed Zhou BF: Predictive values of body mass index and waist circumference for risk factors of certain related diseases in Chinese adults–study on optimal cut-off points of body mass index and waist circumference in Chinese adults. Biomed Environ Sci 2002, 15(1):83–96.PubMed
19.
go back to reference Du SM, Ma GS, Li YP, Fang HY, Hu XQ, Yang XG, Hu YH: Relationship of body mass index, waist circumference and cardiovascular risk factors in Chinese adult. Biomed Environ Sci 2010, 23(2):92–101. 10.1016/S0895-3988(10)60037-2CrossRefPubMed Du SM, Ma GS, Li YP, Fang HY, Hu XQ, Yang XG, Hu YH: Relationship of body mass index, waist circumference and cardiovascular risk factors in Chinese adult. Biomed Environ Sci 2010, 23(2):92–101. 10.1016/S0895-3988(10)60037-2CrossRefPubMed
20.
go back to reference Wang W, Wang K, Li T, Xiang H, Ma L, Fu Z, Chen J, Liu Z, Bai J, Feng J, Jin S, Li Y, Qin R, Chen H: A discussion on utility and purposed value of obesity and abdomen obesity when body mass index, waist circumference, waist to hip ratio used as indexes predicting hypertension and hyper-blood glucose. Chin J Epidemiol (Zhonghua Liu Xing Bing Xue Za Zhi) 2002, 23(1):16–19. Wang W, Wang K, Li T, Xiang H, Ma L, Fu Z, Chen J, Liu Z, Bai J, Feng J, Jin S, Li Y, Qin R, Chen H: A discussion on utility and purposed value of obesity and abdomen obesity when body mass index, waist circumference, waist to hip ratio used as indexes predicting hypertension and hyper-blood glucose. Chin J Epidemiol (Zhonghua Liu Xing Bing Xue Za Zhi) 2002, 23(1):16–19.
21.
go back to reference Li L, Wang HM, Shen Y: Chinese SF-36 health survey: translation, cultural adaptation, validation, and normalisation. J Epidemiol Community Health 2003, 57(4):259–263. 10.1136/jech.57.4.259PubMedCentralCrossRefPubMed Li L, Wang HM, Shen Y: Chinese SF-36 health survey: translation, cultural adaptation, validation, and normalisation. J Epidemiol Community Health 2003, 57(4):259–263. 10.1136/jech.57.4.259PubMedCentralCrossRefPubMed
22.
go back to reference Wang R, Wu C, Zhao Y, Yan X, Ma X, Wu M, Liu W, Gu Z, Zhao J, He J: Health related quality of life measured by SF-36: a population-based study in Shanghai, China. BMC Public Health 2008, 8: 292. 10.1186/1471-2458-8-292PubMedCentralCrossRefPubMed Wang R, Wu C, Zhao Y, Yan X, Ma X, Wu M, Liu W, Gu Z, Zhao J, He J: Health related quality of life measured by SF-36: a population-based study in Shanghai, China. BMC Public Health 2008, 8: 292. 10.1186/1471-2458-8-292PubMedCentralCrossRefPubMed
23.
go back to reference Wake JEKM, Keller SD: SF-36 Physical and Mental Health Summary Scales: A User’s Manual. Boston, MA: The Health Institute; 1994. Wake JEKM, Keller SD: SF-36 Physical and Mental Health Summary Scales: A User’s Manual. Boston, MA: The Health Institute; 1994.
24.
go back to reference Björntorp P: Do stress reactions cause abdominal obesity and comorbidities? Obes Rev 2001, 2(2):73–86. 10.1046/j.1467-789x.2001.00027.xCrossRefPubMed Björntorp P: Do stress reactions cause abdominal obesity and comorbidities? Obes Rev 2001, 2(2):73–86. 10.1046/j.1467-789x.2001.00027.xCrossRefPubMed
25.
go back to reference Kouvonen A, Kivimäki M, Virtanen M, Pentti J, Vahtera J: Work stress, smoking status, and smoking intensity: an observational study of 46,190 employees. J Epidemiol Community Health 2005, 59(1):63–69. 10.1136/jech.2004.019752PubMedCentralCrossRefPubMed Kouvonen A, Kivimäki M, Virtanen M, Pentti J, Vahtera J: Work stress, smoking status, and smoking intensity: an observational study of 46,190 employees. J Epidemiol Community Health 2005, 59(1):63–69. 10.1136/jech.2004.019752PubMedCentralCrossRefPubMed
26.
go back to reference Vasse RM, Nijhuis FJ, Kok G: Associations between work stress, alcohol consumption and sickness absence. Addiction 1998, 93(2):231–241. 10.1046/j.1360-0443.1998.9322317.xCrossRefPubMed Vasse RM, Nijhuis FJ, Kok G: Associations between work stress, alcohol consumption and sickness absence. Addiction 1998, 93(2):231–241. 10.1046/j.1360-0443.1998.9322317.xCrossRefPubMed
27.
go back to reference Laitinen J, Pietiläinen K, Wadsworth M, Sovio U, Järvelin MR: Predictors of abdominal obesity among 31-y-old men and women born in Northern Finland in 1966. Eur J Clin Nutr 2004, 58(1):180–190. 10.1038/sj.ejcn.1601765CrossRefPubMed Laitinen J, Pietiläinen K, Wadsworth M, Sovio U, Järvelin MR: Predictors of abdominal obesity among 31-y-old men and women born in Northern Finland in 1966. Eur J Clin Nutr 2004, 58(1):180–190. 10.1038/sj.ejcn.1601765CrossRefPubMed
28.
go back to reference Risérus U, Ingelsson E: Alcohol intake, insulin resistance, and abdominal obesity in elderly men. Obesity 2007, 15(7):1766–1773. 10.1038/oby.2007.210CrossRefPubMed Risérus U, Ingelsson E: Alcohol intake, insulin resistance, and abdominal obesity in elderly men. Obesity 2007, 15(7):1766–1773. 10.1038/oby.2007.210CrossRefPubMed
29.
go back to reference Villareal DT, Apovian CM, Kushner RF, Klein S, American Society for Nutrition: Obesity in older adults: technical review and position statement of the American Society for Nutrition and NAASO, the Obesity Society. Am J Clin Nutr 2005, 82(5):923–934.PubMed Villareal DT, Apovian CM, Kushner RF, Klein S, American Society for Nutrition: Obesity in older adults: technical review and position statement of the American Society for Nutrition and NAASO, the Obesity Society. Am J Clin Nutr 2005, 82(5):923–934.PubMed
30.
go back to reference Janghorbani M, Amini M, Willett WC, Mehdi Gouya M, Delavari A, Alikhani S, Mahdavi A: First nationwide survey of prevalence of overweight, underweight, and abdominal obesity in Iranian adults. Obesity 2007, 15(11):2797–2808. 10.1038/oby.2007.332CrossRefPubMed Janghorbani M, Amini M, Willett WC, Mehdi Gouya M, Delavari A, Alikhani S, Mahdavi A: First nationwide survey of prevalence of overweight, underweight, and abdominal obesity in Iranian adults. Obesity 2007, 15(11):2797–2808. 10.1038/oby.2007.332CrossRefPubMed
31.
go back to reference Reynolds K, Gu D, Whelton PK, Wu X, Duan X, Mo J, He J, Inter ACG: Prevalence and risk factors of overweight and obesity in China. Obesity 2007, 15(1):10–18. 10.1038/oby.2007.527CrossRefPubMed Reynolds K, Gu D, Whelton PK, Wu X, Duan X, Mo J, He J, Inter ACG: Prevalence and risk factors of overweight and obesity in China. Obesity 2007, 15(1):10–18. 10.1038/oby.2007.527CrossRefPubMed
32.
go back to reference Park HS, Yun YS, Park JY, Kim YS, Choi JM: Obesity, abdominal obesity, and clustering of cardiovascular risk factors in South Korea. Asia Pac J Clin Nutr 2003, 12(4):411–418.PubMed Park HS, Yun YS, Park JY, Kim YS, Choi JM: Obesity, abdominal obesity, and clustering of cardiovascular risk factors in South Korea. Asia Pac J Clin Nutr 2003, 12(4):411–418.PubMed
33.
go back to reference Khang YH, Yun SC: Trends in general and abdominal obesity among Korean adults: findings from 1998, 2001, 2005, and 2007 Korea National Health and Nutrition Examination Surveys. J Korean Med Sci 2010, 25(11):1582–1588. 10.3346/jkms.2010.25.11.1582PubMedCentralCrossRefPubMed Khang YH, Yun SC: Trends in general and abdominal obesity among Korean adults: findings from 1998, 2001, 2005, and 2007 Korea National Health and Nutrition Examination Surveys. J Korean Med Sci 2010, 25(11):1582–1588. 10.3346/jkms.2010.25.11.1582PubMedCentralCrossRefPubMed
34.
go back to reference Li C, Ford ES, McGuire LC, Mokdad AH: Increasing trends in waist circumference and abdominal obesity among US adults. Obesity 2007, 15(1):216–224. 10.1038/oby.2007.505CrossRefPubMed Li C, Ford ES, McGuire LC, Mokdad AH: Increasing trends in waist circumference and abdominal obesity among US adults. Obesity 2007, 15(1):216–224. 10.1038/oby.2007.505CrossRefPubMed
Metadata
Title
Abdominal obesity and its association with health-related quality of life in adults: a population-based study in five Chinese cities
Authors
Shunquan Wu
Rui Wang
An Jiang
Yingying Ding
Meijing Wu
Xiuqiang Ma
Yanfang Zhao
Jia He
Publication date
01-12-2014
Publisher
BioMed Central
Published in
Health and Quality of Life Outcomes / Issue 1/2014
Electronic ISSN: 1477-7525
DOI
https://doi.org/10.1186/1477-7525-12-100

Other articles of this Issue 1/2014

Health and Quality of Life Outcomes 1/2014 Go to the issue