Supplementary Material for: Prevalence of Obesity and Abdominal Obesity in Swedish Primary Care and Occupational Health Clinics

<i>Background: </i>The objective of this study was to describe the prevalence of obesity and abdominal obesity in the Swedish primary and occupational health care setting. <i>Patients and Methods: </i>Weight, height, and waist circumference (WC) were measured in 1,583 consecutive patients, aged between 18–65 years (46.4 ± 12.7 years), in 39 primary care and occupational health practices in Sweden, in 2006. The National Cholesterol Education Program (NCEP) WC reference values were used to define abdominal obesity (102 and 88 cm for men and women, respectively). <i>Results: </i>The distribution across obesity categories differed significantly between men and women with close to 70 and 55% of men and women, respectively, having a body mass index (BMI) ≧ 25. More men than women were overweight (BMI 25–29.9; 45.1 vs. 31.1%) and obese (BMI 30–34.9; 19.8 vs. 12.9%), but less men than women were morbidly obese (4.0 vs. 8.9%; BMI ≧ 35). Increasing prevalence with age was seen until age 60 for both overweight and obesity. More women than men were abdominally obese (42.5 vs. 32.7%; p &lt; 0.001). Only 48 and 64% of the abdominally obese women and men, respectively, had a BMI ≧ 30. <i>Conclusion: </i>Compared to national Swedish data, the prevalence of overweight and obesity was higher in primary and occupational health care settings. Both morbid obesity and abdominal obesity were highly prevalent and more common in women, implying that awareness of sex differences may be important or that recommended cut-offs are not comparable across sex. Furthermore, a large fraction of the abdominally obese had a BMI &lt; 30. Both BMI and WC may therefore be important to determine routinely and incorporate into treatment guidelines, in order not to miss patients at risk of obesity-related morbidity.

背景：本研究旨在描述瑞典基层医疗与职业健康保健机构中肥胖及腹型肥胖的患病情况。
患者与方法：2006年，研究人员在瑞典39家基层医疗及职业健康保健机构中，纳入1583名年龄18~65岁（平均46.4±12.7岁）的连续就诊患者，测量其体重、身高与腰围（waist circumference, WC）。本研究采用美国国家胆固醇教育计划（National Cholesterol Education Program, NCEP）的腰围截断值定义腹型肥胖：男性腰围≥102cm、女性腰围≥88cm。
结果：不同肥胖分级的分布在男性与女性间存在显著差异：近70%的男性与55%的女性体重指数（body mass index, BMI）≥25。男性超重（BMI 25~29.9）与肥胖（BMI 30~34.9）的比例均高于女性，分别为45.1% vs. 31.1%和19.8% vs. 12.9%；但男性病态肥胖（BMI≥35）的比例低于女性，为4.0% vs. 8.9%。无论超重还是肥胖，其患病率均随年龄增长而上升，直至60岁。女性腹型肥胖的比例高于男性（42.5% vs. 32.7%；p<0.001）。仅48%的腹型肥胖女性与64%的腹型肥胖男性BMI≥30。
结论：与瑞典全国人群数据相比，本次研究纳入的基层医疗与职业健康保健机构中的超重与肥胖患病率更高。病态肥胖与腹型肥胖的患病率均处于较高水平，且在女性中更为常见，这提示需重视肥胖相关的性别差异，或现有肥胖判定截断值在不同性别间不具备可比性。此外，相当比例的腹型肥胖患者BMI<30。因此，临床常规诊疗中应同时测量体重指数与腰围，并将两项指标纳入治疗指南，以避免遗漏肥胖相关发病风险的患者。