Have library access?
IP:3.236.143.154
  • Theses

台灣成年婦女肥胖指標與代謝症候群及三高疾病之系列研究

The series study of obesity indicators and metabolic syndrome, hypertension, diabetes mellitus and hyperlipidemia of Taiwanese adult women.

Advisor : 鄭綺

Abstracts


台灣婦女肥胖率日益增加,年齡及停經是造成女性肥胖率增加及肥胖型態改變的重要因素。肥胖及肥胖型態與代謝症候群及高血壓、糖尿病、高血脂三高疾病有相當程度關連,目前使用的肥胖指標(切點)是對所有婦女的肥胖控制建議,並未針對不同年齡及停經狀態女性設立標準。 本研究目的為運用國民健康署提供的「2002年台灣地區高血壓、高血糖、高血脂盛行率調查」,以及衛生福利部健康資料加值應用協作中心提供之「2007年台灣地區高血壓、高血糖、高血脂盛行率調查」資料庫,探討在不同年齡及停經狀態的成年婦女,腰高比( Waist-to-height ratio, WHtR)、腰圍(Waist Circumference ,WC) 、腰臀圍比( Waist-to-hip ratio, WHR)及身體質量指數( Body Mass Index, BMI)等肥胖指標診斷及預測婦女代謝症候群及三高疾病的適合度,並找出適合不同年齡及停經狀態婦女預防代謝症候群及三高疾病的最佳肥胖切點,期望提供台灣成年婦女肥胖控制的健康指引。 結果顯示,肥胖指標診斷65歲以下未停經婦女代謝症候群發生數目大於等於二及三項,以及高血壓、糖尿病的能力良好,且本研究切點在預測65歲以下未停經婦女五年發生代謝症候群數目大於等於二及三項,以及高血壓方面優於目前肥胖指標切點。相較於目前肥胖指標切點,四項指標的切點都應下降,建議預防65歲以下未停經婦女發生代謝症候群二項及三項以上的肥胖切點分別為WHtR 0.47、0.49,WC 74.7cm及78cm,WHR分別為 0.78及0.79,BMI 22.3及24.0 kg/m2。預防65歲以下未停經婦女發生高血壓及糖尿病的切點分別為WHtR 0.49,WC 74.7cm,WHR 0.79,BMI 22.3 kg/m2。WHtR及WC是預測未停經婦女代謝症候群及高血壓、糖尿病的較佳肥胖指標。肥胖指標診斷65歲以上婦女代謝症候群及三高疾病的能力都不好,表示肥胖並非老年婦女罹患代謝症候群及三高疾病的主要因素。肥胖指標在所有婦女診斷高血脂的能力不佳,肥胖並非診斷成年婦女發生高血脂的主要指標。 本研究結果建議,預防代謝症候群及高血壓、糖尿病的發生,未停經婦女肥胖指標切點應再下降。肥胖並非婦女發生高血脂及老年婦女發生代謝症候群及三高疾病的主要因素,未來研究可再深入探討相關因素與尋找最佳診斷工具。

Parallel abstracts


The obesity rate of Taiwanese adult women is increasing, with age and menopause considered important factors causing this rise and a change in obesity type. Obesity and obesity type are significantly related to metabolic syndrome (MS) and hypertension (HT), diabetes mellitus (DM), and hyperlipidemia. Currently, obesity indicators (cut-off points) are typically used in obesity control for all adult women but have not been to account for women in different ages and menopause statuses. The goal of this study was to discuss the feasibility of predicting and diagnosing MS, HT, DM, and hyperlipidemia for adult women in different ages and menopause statuses using the obesity indicators (cut-off points) of waist-to-height ratio (WHtR), waist circumference (WC), waist-to-hip ratio (WHR), and body mass index (BMI). The study using the database of the “2002 Survey on the Prevalence of Hypertension, Hyperglycemia and Hyperlipidemia in Taiwan” and the “2007 Survey on the Prevalence of Hypertension, Hyperglycemia and Hyperlipidemia in Taiwan” provided by the Ministry of Health and Welfare. The results showed that the obesity indicators could reliably diagnose two-or-more and three-or-more components of MS, HT, and DM for pre-menopausal women under 65 years old. Additionally, we were able to reliably predict these diseases by using our new cut-off points within five years. Accordingly, compared with current cut-off points used, the diagnostic cut-off points of four obesity indicators should decrease. In order to prevent the prevalence of two or three components of MS, we suggested that the cut-off points of obesity indicators should be, respectively: WHtR, 0.47 and 0.49; WC, 74.7 and 78 cm; WHR, 0.78 and 0.79; and BMI, 22.3 and 24.0 kg/m2. The cut-off points to prevent HT and DM should be: WHtR, 0.49; WC, 74.7cm; WHR, 0.79; and BMI, 22.3 kg/m2. Both WHtR and WC are better obesity indicators for predicting MS, HT, and DM in pre-menopausal women. On the other hand, the diagnostic ability of obesity indicators is poor for MS, HT, DM, and hyperlipidemia for women above 65 years old, and hyperlipidemia specifically is poorly predicted by obesity indicators for all women, indicating that obesity is not a major factor for these diseases. The results of this study suggest that the cut-off points of obesity indicators should be decreased in order to prevent the occurrence of MS, HT, and DM in pre-menopausal women. Furthermore, obesity is not a major predictor of hyperlipidemia for women generally, or of MS, HT, DM, and hyperlipidemia for elderly women. Future research can discuss related factors in more detail and further calibrate the best diagnostic tools.

References


王麗雲, 曾泓富, 玉慧卿, & 張玉珍 (2003) .成人肥胖、肥胖型態與血脂、血糖及血壓之相關研究. 長庚護理,14(3), 217-225.
黃伯超、游秦玲(2004).你的體重理想嗎?健康世界.224,45-54。
葉慶輝、葉鑑毅、葉淑娟 (2007) .四十歲以上成年人之肥胖與共病相關性之探討.中華職業醫學雜誌, 14(3), 171-189.
劉家鴻、吳岱穎、郭冠良、陳健志、林光洋、黃惠娟(2005) .過重與肥胖.基層醫學.20(9),219-222。
Yao, C. A., Lee, L. T., Chen, C. Y., & Huang, K. C. (2006). The Study of Metabolic Syndrome in Elderly Receiving Health Check-Up. Taiwan Geriatrics & Gerontology, 1(1), 18-26.

Read-around