台灣老人身體質量指數與存活情形之研究

Body Mass Index and Survival Status among The Elderly in Taiwan

林豐釜(Lin Feng-Fu.)

指導教授 ： 董和銳

亞洲大學/健康學院/健康產業管理學系健康管理組/碩士(2010年)

摘要

研究背景與目的：
過去幾十年來，已經有非常多的研究證實肥胖會導致較高的死亡率。肥胖也是一些慢性疾病，例如心臟血管疾病、心臟病等的主要危險因子；在台灣，心臟血管疾病與心臟病更是名列十大死因。然而老人的身體質量指數（Body Mass Index, BMI）與死亡率的相關性卻是相對的薄弱。本研究目的主要在探討台灣老人的身體質量指數與全死因、心臟血管疾病相關死因的關聯性。
研究方法：
本研究利用1989年到2003年行政院衛生署國民健康局與美國密西根大學合作之「臺灣地區老人保健與生活長期追蹤調查」資料，將這15年期間年齡60歲以上的台灣老人共有2,185個樣本，利用Cox比例風險模式（Cox proportional hazards model）來進行身體質量指數與存活之分析。
研究結果：
在台灣老人肥胖問題並不嚴重，僅佔11.5％。在全死因的單一身體質量指數變項分析，發現體重過輕（BMI＜18.5 ㎏/㎡）者有較高的死亡率。可是當性別、社經狀況等控制變項加入後，發現肥胖（BMI≧27 ㎏/㎡）者有較高的死亡率，而且是可以被慢性病所解釋的，可能是肥胖者比較容易引發一些慢性疾病。利用相同模式來進行身體質量指數與心臟血管疾病相關死因的分析中，發現身體質量指數與心臟血管疾病相關死因有非常明顯的關聯性。

關鍵字

台灣老人 ； 身體質量指數 ； 存活分析 ； 肥胖

並列摘要

Over the past decades, studies have confirmed that obesity is related to higher mortality. Moreover, obesity is also a major risk factor for a variety of chronic diseases, such as cardiovascular and heart diseases that are among the top leading causes of death in Taiwan. At the same time, there are also debates arguing that the effect of BMI status on mortality would be weaker among older populations. In this study, we examined the effect of BMI status on both the all-cause mortality and death causes related to cardiovascular and heart diseases.

Data were taken from the Survey of Health and Living Status of the Middle Aged and Elderly in Taiwan, which followed a representative sample of elders (N=2185), aged 60 and over in1989, until 2003. Cox regressions were used to investigate the relationship between their BMI status and survival over the 15-year period.

Results showed that obesity might not be a serious problem among this cohort of elders in Taiwan. Only 11.5% of the elders were considered as overweight (BMI≧27). Plus, a somewhat surprised finding was revealed from our uni-variate analysis. That is, instead of being overweight, being underweight (BMI≦18.5) was associated with higher mortality over the study period. However, when gender, age, and socioeconomic status measures were controlled for, those overweight (BMI≧27) were more likely to died and this effect of overweight on mortality could be explained away by the fact that those overweight elders were also more likely to have chronic diseases. A similar pattern was observed from our Cox models analyzing the effect of BMI status on cardiovascular-and-heart-diseases-related causes of deaths. However, we did find a stronger association between BMI status and the causes of deaths related to cardiovascular and heart diseases.

並列關鍵字

Body mass index ； obesity ； the elderly ； survival analysis ； Taiwan

參考文獻

陳惠真＆王香蘋(2005)：台灣老人健康狀況初探：1989年至1999年。台灣家醫誌；14：25-35。

熊曉芳&蔡素珍（2008）：美國密西根州長期照護機構參訪心得與省思。長庚科技學刊，9：17-28

董和銳（2004）：族群與台灣老人之日常生活障礙與功能限制。身心障礙研究，12（3）：160-175

鄒孟婷&鄒孟文（2009）：臺灣成人肥胖因素之分析：2001年「國民健康訪問調查」。台灣家醫誌，2009; 19: 13-23

李志偉＆吳英黛＆施教諭＆王志鴻＆王豊裕＆謝仁哲（2008）：東台灣男性急性心肌梗塞患者之危險因子。臺灣醫學Formosan J Med;12:143-51