探討台灣北部某地區不同行業別工作者代謝症候群之發生率及其危險因子

A Study of the Incidence Rate and Risk Factors of Metabolic Syndrome among Workers of Different Job Categories in Northern Taiwan

陳怡君(I-Chun Chen) ； 吳欣謙(Hsin-Chien Wu) ； 楊振昌(Chen-Chang Yang) ； 陳聲平(Sheng-Pyng Chen)

《中華職業醫學雜誌》 27卷3期 (2020/07) Pp. 177-184

摘要

前言：台灣20歲以上民眾罹患代謝症候群盛行率高達19.7%；45～65歲民眾有代謝症候群問題的比例更超過3成。台灣較少研究以長期追蹤方式，觀察各行業別代謝症候群發生率及危險因素，希望藉由此研究探討工作者中代謝症候群之人口學特性、發生率以及危險因子，並針對國內工作者代謝症候群提出預防對策。方法：本研究採回溯性世代研究，以2006年至2017年受邀參與社區健檢並同意加入世代研究者，且5年相同行業的人為研究對象，並去除進入世代前有代謝症候群之樣本，最終5年世代的研究對象共有1283名，擷取其資料進行分析。代謝症候群的診斷標準是使用美國國家膽固醇教育計畫（NCEPATPIII）的診斷標準，計算各行業別代謝症候群發生率，並以factor analysis及二元邏輯式回歸找出代謝症候群的危險因子。結果與討論：研究結果顯示代謝症候群發生率以批發及零售業、住宿及餐飲業、運輸倉儲及通信業、金融及保險業、不動產及租賃業、其他服務業組成的第三產業之發病率最高。男女性之標準化發生率則分別為（千分之13.29）及（千分之11.47），男性高於女性。年齡之標準化發生率以65歲以上的（千分之61.25）高於15－64歲的（千分之14.51）。危險因子方面，性別與停經、年齡、行業別、抽菸習慣為危險因素。結論：根據本研究的結果，我們建議雇主對高代謝症候群風險的員工進行健康管理，及支持推廣職場健康促進活動，以確保員工擁有良好的健康狀況。

關鍵字

代謝症候群 ； 回溯性世代研究 ； 職場健康促進 ； 各行業工作者

並列摘要

Background: In Taiwan, the prevalence of metabolic syndrome among people over the age of 20 years is 19.7%. The prevalence was more than 30% among those aged 45-65 years. Very limited follow-up studies have examined the incidence and risk factors of metabolic syndrome among workers of different job categories in Taiwan. Therefore, we conducted a study to explore the demographic characteristics, incidence rate, and risk factors of metabolic syndrome among domestic workers in an attempt to provide preventive measures of workers' metabolic syndrome. Materials and methods: A retrospective cohort study design was adopted. The subjects were participants in a community health examination who agreed to join the cohort study and had worked in the same industry for 5 years during 2006~2017. Excluding those who were previously diagnosed with metabolic syndrome before entering the cohort, the final sample consisted of 1283 persons. We use the Adult Treatment Panel III guidelines published by the US National Cholesterol Education Program (NCEP ATP III) to identify the metabolic syndrome. Factor analysis and logistic regression were then used to identify the risk factors of metabolic syndrome. Results: The incidence rate of metabolic syndrome was highest in the third-category industry consisting of wholesale and retail industry, hotel and lodging service industry, transportation, warehousing, communication industry, financial and insurance industry, real estate and rental industry, and other services industries. The standardized incidence rates in men and women were (13.29 per mille) and (11.47 per mille) respectively, suggesting that the rate was higher in men than in women. In terms of the age-standardized incidence rate, the rate among workers aged between 15~64 years was (14.51 per mille), which was lower than (61.25 per mille) found among workers aged 65 or over. The risk factors of metabolic syndrome identifiedinclude gender, menopausal statuse, age, industry type, and smoking habit. Conclusion: Our study findings suggest that the employers should implement a health manage program on their employees who are at higher risk of metabolic syndrome, and support worksite health promotion activities to ensure the employees' better health.

並列關鍵字

metabolic syndrome ； retrospective cohort study ； worksite health promotion ； workers in all industries