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某鄉村社區老年居民代謝症候群盛行率及相關危險因子之探討

Prevalence and Associated Risk Factors of Metabolic Syndrome in Old People Living in a Rural Community

摘要


背景:代謝症候群為第二型糖尿病、心血管疾病及整體死亡率的危險因子之一,其盛行率隨著年齡增加而增高。目前台灣已經邁入高齡化社會,因此代謝症候群的預防將是老人照護的一個重要議題。本研究之目的為評估老化鄉村社區的代謝症候群盛行率及相關危險因子,以供未來臨床照護參考。方法:2012年於高雄市田寮區對老年居民進行全區隨機抽樣調查,總計有549位65歲以上老年男女接受調查,粗回覆率為50% (549/1,098)。每位受檢者均經隔夜空腹抽血檢查生化指標並量測右上臂血壓值及接受測量腹部中線腰圍。以面對面的方式及結構式問卷調查個案基本資料、生活習慣、身體活動量、營養評估、認知功能及疾病史等。採用2007年國民健康署公佈標準判定代謝症候群,最終以527位資料完整者進行統計分析。結果:於527位老人中(男性273人,女性254人),年齡平均76.0±6.2歲(65至102歲),代謝症候群的盛行率為46.7% (男性36.6%,女性57.5%)。經過邏輯斯迴歸分析發現,和代謝症候群顯著相關的危險因子包含女性、較高身體質量指數、有高尿酸血症以及較低的活動量。進一步將身體質量指數分為正常、過重、肥胖三組,再度以邏輯斯迴歸分析發現,和正常組比較起來,過重組代謝症候群之勝算比為4.577(95%信賴區間2.868-7.305) ; 肥胖組之勝算比則為8.092 (95% 信賴區間 4.625-14.156)。結論:本研究發現老化鄉村社區之代謝症候群盛行率偏高。女性、高尿酸血症與身體活動量低皆為代謝症候群的危險因子之一,尤其是身體質量指數對於代謝症候群的影響最為顯著。然而因肥胖矛盾的存在,老人身體質量指數的控制標準則須更多研究探討。

並列摘要


Background/Purpose: Metabolic syndrome (MetS), increasing its prevalence with age, is one of the risk factors for type 2 diabetes mellitus, cardiovascular disease and all-cause mortality. As Taiwan is now an aged society, the prevention of metabolic syndrome becomes an important issue in health care. This study investigates the prevalence and associated risk factors of MetS in the elderly residents living in a rural community. Method: In 2012, the cross-sectional survey was conducted with whole district random sampling of 1,966 community-dwelling old people in Tian-Liao district, Kaohsiung city. The response rate was 50% (549/1098). A structurized questionnaires including basic characteristics, life style, medical history along with non-invasive assessment tool including International Physical Activity Questionnaires, mini-nutrition assessment and mini-mental status examination were interviewed face-to-face by well-trained staffs individually. Totally, 527 subjects (273 males, 254 females) with complete data were enrolled for final statistical analysis. Results: Of the 527 subjects (mean age=76.0±6.2 y/o, range=65-102 y/o), prevalence of MetS is 46.7% (male=33.6%, female=57.5%). The logistic regression model showed that female, higher body mass index (BMI), hyperuricemia, and lower physical activity were positive independent risk factors of MetS. After dividing subjects into normal BMI, overweight and obesity, the logistic regression analysis revealed that overweight (OR=4.577, 95%CI=2.868-7.305, p<0.001) and obesity (OR=8.092, 95%CI=4.625-14.156, p<0.001) were significant risk factor of MetS. Conclusions: The prevalence of MetS in old people living in this remote, rural community was relatively high. Female, low physical activity and hyperuricemia were risk factors of MetS. BMI is the most predominant risk factor of MetS in this rural community. However, due to obesity paradox, further research and discussion were needed for setting the goal of BMI control in old people.

被引用紀錄


黃雪清(2017)。新北市老年農民健康狀況與城鄉發展之關聯性探討〔碩士論文,國立臺灣大學〕。華藝線上圖書館。https://doi.org/10.6342%2fNTU201703432

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