勞工健檢中脂肪肝之相關因素探討

Evaluation the Related Factors of Fatty Liver in Labors Physical Examination

葉慶輝(Ching-Hui Yeh) ； 葉淑娟(Shu-Chuan Yeh)

《中華職業醫學雜誌》 11卷1期 (2004/01) Pp. 57-70

https://doi.org/10.30027/CJOM.200401.0007

摘要

目的：勞工健檢中肝功能指數異常比例約20%，其中異常原因以脂肪肝最多。從國內外流行病學統計資料得知，脂肪肝的盛行率由20%至63%皆有人報告，在台灣大部分報告指出脂肪肝的盛行率約21%至25%。以往除了酒精性脂肪肝，因其轉變成肝炎、肝硬化的比例高，較為人所重視外，對非酒精性脂肪肝並未受到關注。近來由於非酒精性脂肪肝轉變成肝炎、肝硬化的文章陸續發表，也引起醫界對其感到興趣。本研究乃針對勞工其健檢脂肪肝情形與相關因子做分析探討，以提供勞工對健康更進一步的認知。
研究方法：本研究為一實證性橫斷研究，研究對象為至國軍左營醫院體檢之勞工。樣本共收集了1379位勞工。研究方法主要針對不同勞工其脂肪肝情形與職業、性別、年齡、肥胖程度及其他檢驗項目等相關因子做描述性與推論性之統計分析探討。
研究結果與建議：本研究在1379位勞工中，脂肪肝比例為31.8%。脂肪肝與性別、年齡層、職業、身體質量指數（BMI肥胖程度）、肝功能指數異常（GOT、GPT、rGT）、高三酸甘油脂血症、高膽固醇血症、高尿酸血症、糖尿病、B、C型肝炎，在卡方分析皆達統計顯著性。若脂肪肝依超音波之判讀，將其嚴重程度分為正常、輕度、中度、重度，分別給與0分、1分、2分、3分，然後將脂肪肝嚴重度與性別、肥胖、貧血、肝功能指數（GOT、GPT、rGT）異常與否、腎功能指數（BUN、Crea）異常與否、高三酸甘油脂血症、高膽固醇血症、高尿酸血症、糖尿病、B、C型肝炎做獨立樣本T檢定，達統計顯著性。另外脂肪肝嚴重度與年齡層、職業、肥胖程度，在變異數分析只有肥胖程度達統計顯著性，且越胖者脂肪肝越明顯。由結果顯示，台灣因生活條件佳，脂肪肝比例日漸增加，提醒國人應注意日常的飲食與生活保健，尤其具有危險因子如肥胖、肝功能指數異常、高血脂症、糖尿病、高尿酸血症等更應注意自身的健康管理。

關鍵字

健康檢查 ； 脂肪肝

並列摘要

Object: The abnormal ratio of liver function index is about 20%, and most of the etiology of liver function impairment is fatty liver. According to the epidemiological reports, the prevalent rate of fatty liver is around 20% to 63% in the world. In Taiwan, however, most reports stated that the prevalent rate of fatty liver is around 21% to 25%. In the past, the clinician ignored the non-alcohol fatty liver, while the alcohol related fatty liver was emphasized that is easily transformed into the hepatitis and cirrhosis. Due to the reports of non-alcohol fatty liver which transformed into hepatitis and cirrhosis increased recently, the clinicians become more interested in this phenomenon. The study focuses on analyzing the labors’ health examination and the related factors of fatty liver. The result could offer labors and employers further insight into their health.
Research Method: The study was an experimental cross-section study. All the health examination reports came from Armed Forces Tsoying Hospital, where we collected 1379 cases for this research. The research method focuses on the relationship among the fatty liver severity, occupation, gender, age, obesity and other related health examination items. Furthermore, we did the descriptive and deductive statistic analysis of the study.
Research Result and suggestion: Among 1379 labors, the ratio of fatty liver is 31.8%. Factors such as gender, age level, occupation, obesity, liver function impairment, hyperlipidemia, hyperurecemia, DM, hepatitis Band C all achieve the statistic significance with the fatty liver in Chi-square analysis. If we sort the fatty liver by its severity score and do the student T-test with gender, obesity, liver function impairment, renal function impairment, hyperlipidemia, hyperurecemia, DM, hepatitis B and C and anemia, the result also achieve the statistic significance. Besides, we do the ANOVA analysis to compare the fatty liver severity with age level, occupation and obesity severity, only the obesity severity achieve the statistic significance. The result of this research implies that the comfortable living style in Taiwan keeps the fatty liver increasing. Therefore, it’s important to those highly risked patients, who have obesity, liver function impairment, hyperlipidemia, DM and hyperurecemia, to concern more about their food and health management in daily life.

並列關鍵字

Health Examination ； Fatty Liver