The Prevalence of Metabolic Syndrome in a Group of Patients Receiving Long-Term Hemodialysis in Eastern Taiwan

東臺灣一家醫院的長期血液透析病人代謝症候群之盛行率

王智賢(Chih-Hsien Wang) ； 方德昭(Te-Chao Fang) ； 徐邦治(Bang-Gee Hsu) ； 林群晨(Chun-Chen Lin) ； 沈祖望(Tsu-Wang Shen)

《Acta Nephrologica》 21卷3期 (2007/10) Pp. 201-205

摘要

背景：尿毒症在台灣已成為公共衛生上之一大挑戰，台灣現有四萬多人因慢性尿毒症而需要接受透析治療，每年須花費兩佰億的健保費用，約佔總預算的六至七%。
「代謝症候群」，指的是五種危險因子集合、包括腹圍肥胖、血中三酸甘油酯(TG)偏高、血中高密度脂蛋白膽固醇(HDL-C)偏低、血壓偏高、空腹血糖偏高等五項指標中，具有三項或三項以上便符合代謝症候群，而此徵候群在已開發中國家可謂相當常見。目前已知「代謝徵候群」患者日後得心臟病、糖尿病為一般人之兩倍以上，此外死於心血管疾病之比例也跟著上升。在台灣造成尿毒症病人死亡的主要原因就是心血管疾病（約佔總死亡原因百分之四十）。但是「代謝症候群」和「尿毒症」兩者之間的關聯卻很少人去探討、尤其是本土的資料更是缺乏。此研究主要探討東台灣長期血液透析病人代謝症候群之盛行率。
方法：研究對象為146位血液透析病人、採用National Cholesterol Education Program Adult Treatment Panel Ⅲ in 2001(NCEP ATP Ⅲ)之標準，但腹圍採亞洲人標準，男生腹圍大於等於90公分，女生腹圍大於等於80公分。
結果：在146位血液透析病人中，代謝症候群佔了49.4%。血液透析病人併代謝症候群者比血液透析病人無代謝症候群者有較低的Kt/V和較短的透析年。其中男生在高三酸甘油酯、高血壓、空腹高血糖的百分比超過女性的百分比。女生在腹圍過大和低高密度膽固醇(HDL-C)的百分比超過男性的百分比。性別對血液透析病人的代謝症候群盛行率沒有影響。
結論：東台灣血液透析病人的代謝症候群的盛行率是49.4，我們應儘早診斷和積極的治療。血液透析病人併代謝症候群者比血液透析病人無代謝症候群者有較低的Kt/V和較短的透析年。

關鍵字

代謝症候群 ； 血液透析 ； 尿毒症 ； 盛行率

並列摘要

Background: Metabolic syndrome has been associated with an increased risk for diabetes mellitus and cardiovascular disease, as well as increased mortality from cardiovascular disease. The aim of this study is to examine the prevalence of metabolic syndrome in a group of patients receiving long-term hemodialysis in Eastern Taiwan.
Material and Method: End-stage renal disease patients on hemodialysis more than half year were enrolled. Metabolic syndrome was defined by the criteria proposed by National Cholesterol Education Program Adult Treatment Panel III in 2001 with the cut-off values of the waist circumference greater than or equal to either 90 cm for male or 80 cm for female.
Results: The results showed (1) the prevalence of the metabolic syndrome in uremic patients was 49.4%; (2) chronic uremic patients with metabolic syndrome had a lower Kt/V, and shorter dialysis duration than uremic patients without metabolic syndrome; (3) the prevalence of hypertension, hypertriglyceridemia and hyperglycemia in male uremic patients were significantly higher than those in female uremic patients; (4) female uremic patients had significant higher percentage of the components in abdominal obesity and low HDL-C than male uremic patients.
Conclusion: The prevalence of metabolic syndrome in a group of chronic hemodialysis patient in Eastern Taiwan is 49.4%. Chronic uremic patients with metabolic syndrome had significantly lower Kt/V, and shorter dialysis duration than chronic uremic patients without metabolic syndrome.

並列關鍵字

Prevalence ； metabolic syndrome ； uremia ； hemodialysis