Changes in distributions of waist circumference, waist-to-hip ratio and waist-to-height ratio over an 18-year period among Chinese adults: a longitudinal study using quantile regression
Abstract Background Little is known about the long-term shifts in distributions of three abdominal-obesity-related indicators, waist circumference (WC), waist-to-hip ratio (WHpR) and waist-to-height ratio (WHtR) among Chinese adults. Traditional mean regression models used in the previous analyses w...
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doaj-1187407e539747758019c7640a0cd0e72020-11-25T03:53:59ZengBMCBMC Public Health1471-24582019-06-0119111010.1186/s12889-019-6927-6Changes in distributions of waist circumference, waist-to-hip ratio and waist-to-height ratio over an 18-year period among Chinese adults: a longitudinal study using quantile regressionXiwen Qian0Chang Su1Bing Zhang2Guoyou Qin3Huijun Wang4Zhenyu Wu5Department of Biostatistics, School of Public Health, Key Laboratory of Public Health Safety and Collaborative Innovation Center of Social Risks Governance in Health, Fudan UniversityNational Institute for Nutrition and Health, Chinese Center for Disease Control and PreventionNational Institute for Nutrition and Health, Chinese Center for Disease Control and PreventionDepartment of Biostatistics, School of Public Health, Key Laboratory of Public Health Safety and Collaborative Innovation Center of Social Risks Governance in Health, Fudan UniversityNational Institute for Nutrition and Health, Chinese Center for Disease Control and PreventionDepartment of Biostatistics, School of Public Health, Key Laboratory of Public Health Safety and Collaborative Innovation Center of Social Risks Governance in Health, Fudan UniversityAbstract Background Little is known about the long-term shifts in distributions of three abdominal-obesity-related indicators, waist circumference (WC), waist-to-hip ratio (WHpR) and waist-to-height ratio (WHtR) among Chinese adults. Traditional mean regression models used in the previous analyses were limited in their ability to capture cross-distribution among effects. The current study aims to describe the shift in distribution of WC, WHpR, and WHtR over a period of 18 years (1993–2011) in China, and to reveal quantile-specific associations of the three indicators with key covariates. Methods Longitudinal data from seven waves of the China Health and Nutrition Surveys (CHNS) in 1993, 1997, 2000, 2004, 2006, 2009 and 2011 were analyzed. The LMS method was used to illustrate the gender-specific quantile curves of WC, WHtR and WHpR over age. Separate gender-stratified longitudinal quantile regressions were employed to investigate the effect of important factors on the trends of the three indicators. Results A total of 11,923 participants aged 18–65 years with 49,507 observations were included in the analysis. The density curves of WC, WHtR and WHpR shifted to right and became wider. The three outcomes all increased with age and increased more at upper percentiles. From the multivariate quantile regression, physical activity was negatively associated in both genders; smoking only had a negative effect on male indicators. Education and drinking behavior both had opposite effects on the three indicators between men and women. Marital status and income were positively associated with the shifts in WC, WHtR and WHpR in male and female WC, while urbanicity index had a positive effect on three outcomes in men but inconsistent effect among female outcomes. Conclusions The abdominal-obesity related indicators of the Chinese adults experienced rapid growth according to our population-based, age- and gender-specific analyses. Over the 18-year study period, major increases in WC, WHtR and WHpR were observed among Chinese adults. Specifically, these increases were greater at upper percentiles and in men. Age, physical activity, energy intake, drinking, smoking, education, income and urbanicity index were associated with elevated abdominal obesity indicators, and the effects differed among percentiles and between genders.http://link.springer.com/article/10.1186/s12889-019-6927-6Waist circumferenceWaist-to-hip ratioWaist-to-height ratioAbdominal obesityQuantile regression |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Xiwen Qian Chang Su Bing Zhang Guoyou Qin Huijun Wang Zhenyu Wu |
spellingShingle |
Xiwen Qian Chang Su Bing Zhang Guoyou Qin Huijun Wang Zhenyu Wu Changes in distributions of waist circumference, waist-to-hip ratio and waist-to-height ratio over an 18-year period among Chinese adults: a longitudinal study using quantile regression BMC Public Health Waist circumference Waist-to-hip ratio Waist-to-height ratio Abdominal obesity Quantile regression |
author_facet |
Xiwen Qian Chang Su Bing Zhang Guoyou Qin Huijun Wang Zhenyu Wu |
author_sort |
Xiwen Qian |
title |
Changes in distributions of waist circumference, waist-to-hip ratio and waist-to-height ratio over an 18-year period among Chinese adults: a longitudinal study using quantile regression |
title_short |
Changes in distributions of waist circumference, waist-to-hip ratio and waist-to-height ratio over an 18-year period among Chinese adults: a longitudinal study using quantile regression |
title_full |
Changes in distributions of waist circumference, waist-to-hip ratio and waist-to-height ratio over an 18-year period among Chinese adults: a longitudinal study using quantile regression |
title_fullStr |
Changes in distributions of waist circumference, waist-to-hip ratio and waist-to-height ratio over an 18-year period among Chinese adults: a longitudinal study using quantile regression |
title_full_unstemmed |
Changes in distributions of waist circumference, waist-to-hip ratio and waist-to-height ratio over an 18-year period among Chinese adults: a longitudinal study using quantile regression |
title_sort |
changes in distributions of waist circumference, waist-to-hip ratio and waist-to-height ratio over an 18-year period among chinese adults: a longitudinal study using quantile regression |
publisher |
BMC |
series |
BMC Public Health |
issn |
1471-2458 |
publishDate |
2019-06-01 |
description |
Abstract Background Little is known about the long-term shifts in distributions of three abdominal-obesity-related indicators, waist circumference (WC), waist-to-hip ratio (WHpR) and waist-to-height ratio (WHtR) among Chinese adults. Traditional mean regression models used in the previous analyses were limited in their ability to capture cross-distribution among effects. The current study aims to describe the shift in distribution of WC, WHpR, and WHtR over a period of 18 years (1993–2011) in China, and to reveal quantile-specific associations of the three indicators with key covariates. Methods Longitudinal data from seven waves of the China Health and Nutrition Surveys (CHNS) in 1993, 1997, 2000, 2004, 2006, 2009 and 2011 were analyzed. The LMS method was used to illustrate the gender-specific quantile curves of WC, WHtR and WHpR over age. Separate gender-stratified longitudinal quantile regressions were employed to investigate the effect of important factors on the trends of the three indicators. Results A total of 11,923 participants aged 18–65 years with 49,507 observations were included in the analysis. The density curves of WC, WHtR and WHpR shifted to right and became wider. The three outcomes all increased with age and increased more at upper percentiles. From the multivariate quantile regression, physical activity was negatively associated in both genders; smoking only had a negative effect on male indicators. Education and drinking behavior both had opposite effects on the three indicators between men and women. Marital status and income were positively associated with the shifts in WC, WHtR and WHpR in male and female WC, while urbanicity index had a positive effect on three outcomes in men but inconsistent effect among female outcomes. Conclusions The abdominal-obesity related indicators of the Chinese adults experienced rapid growth according to our population-based, age- and gender-specific analyses. Over the 18-year study period, major increases in WC, WHtR and WHpR were observed among Chinese adults. Specifically, these increases were greater at upper percentiles and in men. Age, physical activity, energy intake, drinking, smoking, education, income and urbanicity index were associated with elevated abdominal obesity indicators, and the effects differed among percentiles and between genders. |
topic |
Waist circumference Waist-to-hip ratio Waist-to-height ratio Abdominal obesity Quantile regression |
url |
http://link.springer.com/article/10.1186/s12889-019-6927-6 |
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