| 摘要: | 代謝症候群（Metabolic syndrome）與心血管疾病及其他多種慢性病況之危險性有極密切的關係，過去研究指出代謝症候群會增加心血管疾病、糖尿病、高血壓、腦中風等疾病的發生率及死亡率，對於民眾健康產生很大的危害。台灣地區隨著飲食習慣與生活型態日漸西化，使得代謝症候群的盛行率有逐年攀升的趨勢，分析造成的原因，除個人的遺傳因素外，以不當飲食(unhealthy diet)及缺乏運動(physical inactivity)造成的中心型肥胖體質(central obesity)最為重要。在國內有關代謝症候群的研究對象中，主要係針對40歲以上成人尤其是老年人族群為主，較缺乏對於40歲以下族群有關代謝性症候群盛行率及其相關風險因子之探討。
本研究主要調查對象為設籍於宜蘭縣30~43歲的年輕成年人，於98年5月10日至98年10月25日為止，自由參加由宜蘭縣政府衛生局免費提供之健康篩檢計畫，期間共有11,108位縣民（平均年齡36.09±4.13歲）接受該項檢查。檢查的項目包括血壓、腰圍、體重、空腹血糖、總膽固醇、三酸甘油酯、高密度膽固醇等。本研究採用行政院衛生署於2007年所修正美國國家膽固醇教育計畫成人治療指引第三版（National Cholesterol Education Program-Adult Treatment PanelⅢ，NCEP ATPⅢ ）為標準定義代謝症候群，至於有關代謝症候群的相關風險因子包括有性別、年齡、婚姻狀態、教育程度、家庭收入、飲食攝取習慣（醣類、油類、蔬菜水果類等）、運動習慣(International Physical Activity Questionairre；IPAQ)、吸菸習慣、飲酒習慣、嚼食檳榔習慣、糖尿病等慢性病家族史與心理因素(Brief Symptom Rating Scale；BSRS-5)等資料，則以民眾自填結構式問卷的方式取得。在統計方法上，本研究使用卡方檢定及邏輯式迴歸分析以比較各種風險因子與代謝症候群盛行率之差異，並預測罹患代謝症候群的危險性。
結果發現該年齡層符合代謝症候群標準共有1,960位(17.7%)，年齡愈高及教育程度愈低者其盛行率愈高。在代謝症候群指數異常中，高密度膽固醇最高(50.3%)，其次是血糖(21.8%)以及三酸甘油酯 (20.6%)。有關運動量方面，針對身體活動量部份顯示參與檢查者有58.7%運動量不足；有關飲食習慣方面，過去一週中每天吃3碟蔬菜僅占10.4%、過去一週中每天吃2份水果僅有6 %；顯示宜蘭地區年輕成人的族群完全不運動比例過高，蔬果攝取量不足。有代謝症候群的個案吸菸率有26.9%顯著高於不吸菸個案13.8%；有代謝症候群的個案經常飲酒率有30.0%顯著高於無飲酒個案的13.8%；有代謝症候群個案有嚼食檳榔的比率33.9%，顯著高於無嚼食檳榔個案的15.3%。在生活型態方面，有吸菸、喝酒或嚼檳榔習慣項目與代謝症候群達顯著相關；不同種族的代謝症候群盛行率有所差異，但未達顯著相關。男性、高年齡層、低教育程度、高身體質量指數、吸菸者、飲酒者、嚼檳榔者、活動量不足者、有糖尿病家族史以及肥胖家族史者，會增加得到代謝症候群的風險，而教育程度以及高身體活動量為保護因子。上述結果可提供醫療機構及當地衛生局未來衛生醫療政策及相關研究學者之參考。
Metabolic syndrome (MS) is the major risk factors for the development of type 2 diabetes and cardiovascular diseases (CVD). The purpose of this study was to assess the prevalence of MS and its components among young adults in YiLan County, Taiwan. Moreover, factors associated with MS were also assessed.
Data from a cross-sectional community-based survey of 11,077 participants averaged 30 to 43 years who lived in a rural city (5,203 men, 5,874 women; age range, 36.09±4.13 years) in 2009 were analyzed. Data were collected by interviewer-administered questionnaire, biophysical assessment, and biochemical examination. The prevalence of MS was estimated using the definitions of the MS criteria for Taiwanese (MS-TW).
The prevalence of MS was 17.7% by the MS-TW criteria. The prevalence of MS significantly increased with age ( p＝0.001) in men and women. Elevated high-density lipoprotein cholesterol was the most prevalent component of MS (50.3%), followed by elevated fasting sugar (21.8%) and elevated triglyceride (20.6%).According to lifestyle habit, 58.7% of the participants are inactive；The individuals with MS had more high percentage of smoking (26.9% vs 13.7%), drinking (30.0% vs 13.8%) and betal nut chewing (33.9% vs 15.3%) than individuals without MS.
Logistic regression analysis revealed that men had significantly higher risk of MS than women (odds ratio＝2.68, p<.001).Older age, aboriginal, family history of diabetes, and family history of obesity higher body mass index, current smoking, current alcohol consumption, betal nuts chewing, were positively associated with increased odds of MS. However, higher education and high physical activity were found to be negatively associated with MS (p<.05). |
