OBESITY IN RUSSIAN POPULATION — PREVALENCE AND ASSOCIATION WITH THE NON-COMMUNICABLE DISEASES RISK FACTORS

Aim. Evaluation of the prevalence of obesity and association with the risk factors of chronic non-communicable diseases of the inhabitants of selected regions of Russia, by the data from ESSE-RF study.

Material and methods. Representative selections investigated, of the inhabitants of 13 regions of Russia, totally 21768 participants, males n=8 304, females n=13 464, age 25-64 y. o., under the circumstances of the study “Epidemiology of cardiovascular diseases (ESSE-RF)”, with response ~80%. Standard questionnaire, consisting 12 modules, was developed based upon adapted international methods. For the risk factors prevalence assessment, the standard epidemiological methods were applied. Body mass (BM) was evaluated in the categories of body mass index (BMI) (Ketle index: BMI — Body mass, kg / height, m²). BM as BMI was evaluated as insufficient (BMI <18,5), normal (18,5≤ BMI ≤24,9), overweight (25,0≤ BMI ≤29,9), obesity grade I (30,0 ≤BMI ≤34,9), obesity grade II (35,0 ≤BMI ≤39,9) and obesity grade III (BMI ≥40,0). Abdominal obesity (AO) was assessed with the criteria: for males waist circumference (WC) ≥102 cm and for females ≥88 cm.

Results. Mean BMI value among the participants was 27,6 kg/m², with no gender difference. BMI increases with the age only in women. WC — 87,8 cm ±0,1, among males it was significantly higher than in females (92,9 cm vs 84,1 cm, p<0,001), increasing with age. The prevalence of obesity was higher among females comparing to males: by BMI — 30,8% vs 26,9%, p<0,001; by AO — 38,4% vs 24,3%, p<0,001. The prevalence of obesity in female inhabitants of rural regions was significantly higher comparing to citizens (p<0,001), and in the group of higher education, there was no difference among males wither by BMI (p<0,005), or by AO (p<0,001). There was no clear geographic gradient of the risk factors. The prevalence of obesity increases linearly with the age, in males from 14,3% to 36,3%, p<0,001, and in females from 10,7% to 52,3%, p<0,001. AO was more prevalent in women comparing to men in every of analyzed age group, and with the age this difference gets more profound. In the multifactorial model the associations of risk factors were analyzed, with any type of obesity. Close relation was found for obesity and raised levels of glucose and triglycerides, with alcohol overconsumption. Most significant associations were found for obesity and AH in both genders — OR: 2,71 and 2,52 in men and women, respectively. There was linear increase of AH prevalence with mean SBP and DBP, together with BM.

Conclusion. In Russian population, obesity is associated most closely with alcohol overconsumption, increased glucose level, lipid disorders and especially strongly — with systemic hypertension, the factors that increase prevalence with age. Burden of this closely interrelated factors on healthcare system will increase with the portion of elderly inhabitants of the country. State of affairs demand for a complex approach based on the governmental politics on the control of populational levels of bodyweight, beginning at elementary school, with mass-media involvement, as the groceries manufacturers, regional governments.

1. Lim SS, Vos T, Flaxman AD, et al. A comparative risk assessment of burden of disease and injury attributable to 67 risk factors and risk factor clusters in 21 regions, 1990-2010: a systematic analysis for the Global Burden of Disease Study 2010. The Lancet 2012; 380 (9859): 2224-60. DOI: 10.1016/S0140-6736(12)61766-8.

2. Ng M, Fleming T, Robinson M, et al. Global, regional, and national prevalence of overweight and obesity in children and adults during 1980-2013: a systematic analysis for the Global Burden of Disease Study 2013. The Lancet. Elsevier; 2014; 384 (9945): 766-81. DOI: 10.1016/S0140-6736(14)60460-8.

3. Roberto CA, Swinburn B, Hawkes C, et al. Patchy progress on obesity prevention: emerging examples, entrenched barriers, and new thinking. Lancet. Elsevier 2015; 385, 9985: 2400-9. DOI: 10.1016/S0140-6736(14)61744-X.

4. WHO. Global action plan for the prevention and control of noncommunicable diseases 2013-2020 [Electronic resource]. URL: http://www.who.int/nmh/events/ncd_action_plan/en/#ВОЗ. (In Russ.) ВОЗ, Женева, Швейцария; 2013: 107с.

5. Obesity and overweight. Fact sheet. Updated June 2016 [Electronic resource]. URL: Key facts Worldwide obesity has more than doubled since 1980.

6. Dzhumagaziev AA, Bezrukova DA, Bogdanyants MV, et al. Obesity in Children in the Modern World: Realities and Possible Solutions. Curr. Pediatr. 2016, 15, 3: 250-6. (In Russ.) DOI: 10.15690/vsp.v15i3.1561.

7. Nguyen T, Lau DC. The Obesity Epidemic and Its Impact on Hypertension. Can. J. Cardiol. Elsevier Inc., 2012, 28, 3: 326-33. DOI: 10.1016/j.cjca.2012.01.001.

8. Landsberg L, Aronne LJ, Beilin L, et al. Obesity‐related hypertension: Pathogenesis, cardiovascular risk, and treatment–A position paper of the The Obesity Society and the American Society of Hypertension. 2013, Obesity, 21, 1: 8-24. DOI: 10.1002/oby.20181.

9. Lehnert T, Sonntag D, Konnopka A, et al. Economic costs of overweight and obesity. Best Pract. Res. Clin. Endocrinol. Metab. 2013. 27, 2: 105-15. DOI: 10.1016/j.beem.2013.01.002.

10. Wang YC, McPherson K, Marsh T, et al. Health and economic burden of the projected obesity trends in the USA and the UK. Lancet. Elsevier Ltd, 2011, 378, 9793: 815-25. DOI: 10.1016/S0140-6736(11)60814-3.

11. Withrow D, Alter DA. The economic burden of obesity worldwide: A systematic review of the direct costs of obesity. Obesity reviews, 2011 12, 2: 131-41. DOI: 10.1111/j.1467789X.2009.00712.x.

12. Drapkina OM, Eliashevich SO, Shepel RN. Obesity as a risk factor for chronic noncommunicable diseases Russ J Cardiol 2016, 6, 134: 73-9. (In Russ.) DOI: 10.15829/1560-4071-2016-6-73-79.

13. Romero-Corral A, Montori VM, Somers VK, et al. Association of bodyweight with total mortality and with cardiovascular events in coronary artery disease: a systematic review of cohort studies. The Lancet, 2006, 368 (9536): 666-78.

14. Shalnova SA, Deev AD, Kapustina AV, et al. Body weight and its impact on all-cause and cardiovascular mortality in Russia. Cardiovascular Therapy and Prevention. 2014; 13 (1): 44-8. (In Russ.)

15. Nguyen NT, Magno CP, Lane K, et al. Association of Hypertension, Diabetes, Dyslipidemia, and Metabolic Syndrome with Obesity: Findings from the National Health and Nutrition Examination Survey, 1999 to 2004. J. Am. Coll. Surg. 2008, 207 (6): 928-34. DOI: 10.1016/j.jamcollsurg.2008.08.022.

16. Kish L. Survey Sampling, New York: John Wiley and Sons, 1965.

17. Research organizing committee of the ESSE-RF project. Epidemiology of cardiovascular diseases in different regions of Russia (ESSE-RF). The rationale for and design of the study J. Profilakticheskaya meditsina. 2013, 6: 25-34. (In Russ.)

18. Balanova YuA, Kontsevaya AV, Shalnova SA. Smoking prevalence in Russia. What has changed over 20 years? Profilakticheskaya Meditsina Journal, 2015, 18 (6): 47-52. (In Russ.)

19. Boytsov SA, Balanova YuA, Shalnova SA, et al. Arterial hypertension among individuals of 25–64 years old: prevalence, awareness, treatment and control. By the data from ECCD. Cardiovascular Therapy and Prevention, 2014; 14 (4): 4-14. (In Russ.)

20. Muromtseva GA, Kontsevaya AV, Konstantinov VV, et al. The prevalence of non-infectious diseases risk factors in Russian population in 2012-2013 years. The results of ECVD-RF. Cardiovascular Therapy and Prevention. 2014; 13 (6): 4-11. (In Russ.)

21. Webber L, Divajeva D, Marsh T, et al. The future burden of obesity-related diseases in the 53 WHO European-Region countries and the impact of effective interventions: a modelling study. BMJ Open. 2014. 4 (7), e004787. DOI: 10.1136/bmjopen-2014-004787.

22. Tutelyan VA, Baturin AK, Kon IYa, et al. Russian Prevalence of obesity and overweight among the Russian children’s population: a multicentre study. Pediatria. Journal named after G. N. Speransky. 2014, 5, 93: 28-31. (In Russ.)

23. Shalnova SA, Deev AD. Body mass in men and women: the Russian national representative sample data. Cardiovascular Therapy and Prevention. 2008, 7 (6): 60-3. (In Russ.)

24. Shalnova SA, Deev AD, Balanova YuA, et al. Twenty years trends of obesity and arterial hypertension and their association in Russia. Cardiovascular Therapy and Prevention 2017; 16 (4): 4-10, (In Russ.)

25. Bayram F, Koce D, Gundoga K, et al. Prevalence of dyslipidemia and associated risk factors in Turkish adults. J. Clin. Lipidol. 2014. 8, 2: 206-16. DOI: 10.1016/j.jacl.2013.12.011.

26. Bastien M, Poirier P, Lemieux I, et al. Overview of epidemiology and contribution of obesity to cardiovascular disease. Prog. Cardiovasc. Dis. Elsevier Inc., 2014. 56, 4: 369-81. DOI: 10.1016/j.pcad.2013.10.016.

27. Stamler J. Epidemic Obesity in the United States. Arch Intern Med. 1993. 153, 9: 1040-4.

28. Chandra A, Neeland IJ, Berry JD, et al. The relationship of body mass and fat distribution with incident hypertension: Observations from the dallas heart study. J. Am. Coll. Cardiol. 2014. 64, 10: 997-1002. DOI: 10.1016/j.jacc.2014.05.057.

29. Hall JE, Silva AD, Carmo JD, et al. Obesity-induced hypertension: Role of sympathetic nervous system, leptin, and melanocortins. Journal of Biological Chemistry. 2010. 285 (23), 17271-6. DOI: 10.1074/jbc.R110.113175.

30. Lim K, Jackson KL, Sata Y, et al. Factors Responsible for Obesity-Related Hypertension. Curr. Hypertens. Rep. Current Hypertension Reports, 2017. 19, 7: 53. DOI: 10.1007/s11906-017-0750-1.

31. Konstantinov VV, Deyev AD, Balanova YuA, et al. The cardiovascular risk profile and its contribution to survival in Moscow men and women aged 35-64 years Profilakticheskaya Meditsina Journal 2013, 1: 3-7. (In Russ.)

32. Booth HP, Prevost AT, Gulliford MC. Severity of obesity and management of hypertension, hypercholesterolaemia and smoking in primary care: population-based cohort study. J. Hum. Hypertens. 2016. 30: 40-5. DOI: 10.1038/jhh.2015.23.

33. Wofford MR, Smith G, Minor DS, et al. The treatment of hypertension in obese patients. Curr. Hypertens. Rep. 2008. 10, 2: 143-50.

34. Ho A. K., Bartels C. M., Thorpe CT, et al. Achieving Weight Loss and Hypertension Control among Obese Adults: A US Multidisciplinary Group Practice Observational Study. Am. J. Hypertens. 2016. 29, 8: 984-91. DOI: 10.1093/ajh/hpw020.

35. Efremova YuE, Oshchepkova EV, Zhernakova YuV. Cardiovascular risk factors in people with high normal blood pressure in Russian population (based on data obtained in ESSE-RF epidemiological study). Systemic Hypertension 2017. 14, 1: 6-11. (In Russ.)

36. Shalnova SA, Deev AD, Vihireva OV, et al. The prevalence of hypertension in Russia. Awareness, treatment and control. Profilaktika zabolevanij i ukreplenie zdorov’ja 2001; 2: 3-7. (In Russ.)

37. Shalnova SA, Balanova YA, Konstantinov VV, et al. Hypertension prevalence, awareness, antihypertensive drugs and treatment efficacy among the population of the Russian Federation. Russian Journal of Cardiology. 2006; 4: 45-50. (In Russ.)