The problem of overweight and obesity has become increasingly prominent in recent years and has become a major global public health problem. China has also launched the "Weight Management Year" campaign, hoping to prevent and control chronic diseases related to overweight and obesity from the source. However, due to differences in economic and geographical conditions, the prevalence of overweight and obesity varies in different regions. What is the trend of overweight and obesity prevalence in Hebei Province in recent years, and where are the key points for prevention and control? This problem urgently needs to be solved.

To grasp the trend and change of overweight and obesity prevalence among residents aged 18-44 in Hebei Province between 2013 (from May to September) and 2020 (from April to December). Dynamically analyse the influencing factors and provide an objective basis for prevention and treatment strategies and measures for healthy Hebei and weight management.

We collected data from the 2013 Hebei Provincial Cardiovascular Disease Epidemiological Survey and the 2020 Hebei Provincial Residents' Cardiovascular Disease and Risk Factor Surveillance Project cross-sectional survey, and used different obesity indicators to comprehensively measure the prevalence of overweight and obesity among residents aged 18-44 years. The influencing factors and the interaction between each factor of overweight and obesity were explored by using the multifactorial Logistic regression model, and the changing situation was analyzed.

In 2020, the detection rates of standardised overweight, obesity, body fat percentage obesity, abdominal obesity and high waist-to-height ratio (WHtR) of Hebei residents aged 18-44 years will be higher than those in 2013 (the number of individuals detected with overweight, obesity, high body fat percentage, abdominal obesity and high waist-to-height ratio after standardization based on the 2010 national census population / the standard population count of individuals aged 18-44 from the 2010 national census), which were 32.24%, 11.49%, 24.86%, 27.03% and 45.01%, respectively; and in 2020, 32.85%, 25.75%, 57.93%, 40.77% and 59.73%, respectively. Multivariate Logistic regression analyses of the factors affecting different types of obesity in the adult population of China showed that men, older age groups (compared with the 18-20 groups), married and hypertensive individuals had a higher risk of various types of obesity. In addition to the above factors, insufficient physical activity, educational level of junior high school and below, occupation as self-employed and agricultural workers, high-fat diet, intake of fish and eggs >1 000 g/week, and sleep <6 h/d also increased the risk of different types of obesity. The results of the multiplicative interaction analysis showed that the risk of obesity, body fat percentage obesity, and high waist-to-hip ratio in married hypertensive patients was 1.551 (95%CI=1.400-1.758, P<0.05), 1.418 (95%CI=1.170-1.720, P<0.05), and 1.652 (95%CI=1.454-1.935, P<0.05) times that of the reference group, respectively; the risk of abdominal obesity was higher in people with short sleep duration and a high-fat diet (OR=1.428, 95%CI=1.075-1.897, P<0.05); the risk of high waist-to-hip ratio in self-employed or agricultural workers with hypertension was 3.248 (95%CI=1.418-7.44, P<0.05) and 3.100 (95%CI=1.606-5.984, P<0.05) times that of the reference group, respectively. Compared to 2013, in 2020, among the common influencing factors of various obesity types, the proportion of males in the overweight and body fat percentage obesity groups slightly decreased, while in other obesity types, the proportion increased; the proportion of people in different obesity types in the age groups of 31-35 and 36-40 reached over 20%; the proportion of married individuals in the two types of generalized obesity groups slightly decreased, while in the two types of central obesity groups, the proportion slightly increased; the proportion of hypertensive patients in various obesity types significantly increased, more than doubling compared to 2013.

In 2020, the detection rate of all types of obesity among residents aged 18-44 years in Hebei Province will be significantly higher than that in 2013, and attention should be paid to the dynamic trends of risk factors related to overweight/obesity in young and middle-aged populations in Hebei Province, so as to take targeted preventive measures, enhance the health awareness of the residents, and do a good job of weight management.

近年来超重和肥胖问题日益凸显，已成为全球重大公共卫生问题。我国也启动了"体重管理年"活动，旨在从源头上预防和控制与超重/肥胖相关的慢性病。但由于不同地域经济发展水平、地理条件存在差异，各地超重、肥胖流行情况也有所不同。其中，河北省近年来超重、肥胖流行趋势如何？防控工作应聚焦哪些重点？亟待明确。

分析2013年与2020年河北省18~44岁居民超重、肥胖流行趋势及变化情况，动态分析其影响因素，为"健康河北"建设及体重管理防治策略和措施制订提供依据。

收集2013年5—9月河北省心血管疾病流行调查与2020年4—12月河北省居民心血管病及其危险因素监测项目的调查数据，采用不同肥胖指标全面衡量18~44岁居民超重、肥胖流行变化情况。采用多因素Logistic回归模型探讨超重、肥胖的影响因素和各因素间的交互作用，并对其变化情况进行分析。

2020年河北省18~44岁居民的超重、肥胖、体脂率肥胖、腹型肥胖、高腰高比（WHtR）标化检出率均高于2013年，2013年居民的各项检出率依次为32.24%、11.49%、24.86%、27.03%、45.01%，2020年的各项检出率依次为32.85%、25.75%、57.93%、40.77%、59.73%。多因素Logistic回归分析结果显示：总体上，高年龄段（与18~20岁人群相比）、男性、在婚、患高血压者的各类型肥胖检出风险更大（P<0.05）；除此以外，文化程度为初中及以下、在婚、职业为个体工商户和农业劳动者、身体活动不充足、高脂饮食、鱼类和蛋类摄入量>1 000 g/周、睡眠时长<6 h/d、患高血压也会增加不同类型肥胖的患病风险（P<0.05）。相乘交互作用分析结果显示：在婚的高血压患者发生肥胖、体脂率肥胖、高WHtR的风险分别是参照组的1.551倍（95%CI=1.400~1.758，P<0.05）、1.418倍（95%CI=1.170~1.720，P<0.05）和1.652倍（95%CI=1.454~1.935，P<0.05）；与参照组相比，睡眠时长<6 h/d且高脂饮食者发生腹型肥胖的风险更高（OR=1.428，95%CI=1.075~1.897，P<0.05）；职业为个体工商户和农业劳动者的高血压患者发生高WHtR的风险分别是参照组的3.248倍（95%CI=1.418~7.44，P<0.05）和3.100倍（95%CI=1.606~5.984，P<0.05）。与2013年相比，2020年各肥胖类型共同的影响因素中，男性在超重、体脂率肥胖人群中的占比略有降低（P<0.05），在腹型肥胖人群中占比增加（P<0.05）；不同肥胖类型人群在31~35、36~40岁年龄段中的占比均达到20%以上；在婚者在全身性肥胖的两类人群中占比略有降低（P<0.05），在中心性肥胖的两类人群中占比略有增加（P<0.05）；高血压患者在各肥胖类型人群中占比明显升高，超过2013年的2倍（P<0.05）。

2020年河北省18~44岁居民各类型肥胖检出率明显高于2013年，应关注河北省中青年人群超重、肥胖的影响因素动态变化趋势，采取针对性预防措施，提升居民健康意识，做好体重管理。