老年婦女高血壓及糖尿病之最適肥胖指標切點

The Optimal Cut-off Point of Obesity for Predicting Hypertension and Diabetes mellitus in Elderly Women

瞿馥苓(Fu-Ling Chu) ； 鄭綺(Chii Jeng)

《新臺北護理期刊》 16卷2期 (2014/09) Pp. 7-18

https://doi.org/10.6540/NTJN.2014.2.002

摘要

本研究旨在了解台灣老年婦女肥胖與三高疾病（高血壓、糖尿病及高血脂）之相關性。用身體質量指數（body mass index; BMI）、腰圍（waist circumference; WC）、腰臀圍比（waist-to-hip ratio; WHR）以及腰高比（waist-to-height ratio; WHtR）四項肥胖指標診斷及預測老年婦女罹患高血壓、糖尿病以及高血脂之適合度，以及找出預測老年 婦女三高疾病之最佳肥胖指標切點。研究個案為國民健康署「2002年台灣地區高血壓、高血糖、高血脂盛行率調查」資料庫中65歲以上共316位婦女，以ROC曲線（receiver operating characteristic curve）分析檢驗肥胖指標預測三高疾病之能力，以最短距離（Shortest Distance）計算出各肥胖指標之最佳切點，再以邏輯斯回歸（Logistic Regression）檢視此肥胖切點與現行使用的肥胖指標切點在預測三高疾病的能力何者較佳。結果顯示，肥胖指標對65歲以上婦女在高血壓（WHR除外）及糖尿病具診斷力（P＜0.5），但對高血脂的診斷力不佳。本研究肥胖切點相較於目前使用的切點有較佳的診斷力及預測力。建議預防老年婦女高血壓的肥胖指標切點WHtR為0.55、WC為84.9cm，BMI24.7kg/m2；預防糖尿病，WHtR為0.55、WC84.1cm、BMI24.4kg/m2、WHR則為0.86。肥胖並非預測65歲以上婦女罹患高血脂的良好指標，而預防高血壓及糖尿病之肥胖指標切點，應較目前使用的肥胖指標切點更為寬鬆。

關鍵字

老年婦女 ； 肥胖 ； 肥胖指標 ； 高血壓 ； 糖尿病

並列摘要

The purpose of this study is to examine the relationships among obesity and hypertension, diabetes mellitus, and hyperlipidemia in elderly women. The anthropometric indicators of obesity, including the body-mass index (BMI), waist circumference (WC), waist-to-hip ratio (WHR), and waist-to-height ratio (WHtR) were used to predict hypertension, diabetes mellitus and hyperlipidermia, and thus to calculate the optimal cut-off point for each indicators of obesity. The sample consisted of women over age of 65, as derived from data of the 2002 National Health ＂Taiwan Three High Prevalence Survey＂ database. Receiver-operating characteristic (ROC) curves were applied to the obesity indicators to ascertain their value in predicting hypertension, diabetes mellitus and hyperlipidemia. The ＂shortest-distance＂ was used to calculate individual cut-off points for each indicators of obesity, and using logistic regression analysis to investigate whether our proposed cutoff points of obesity indicators predict the occurrence of hypertension, diabetes mellitus and hyperlipidemia, compared to reference cutoff points of obesity that are currently used. The results revealed that four obesity indicators can be used to predict hypertension (except WHR) and diabetes mellitus in elderly women, but not hyperlipidemia. Our proposed cutoff points had greater predictability than did the reference cutoff points. The following as ideal cut-off values were demonstrated in elderly women: WHtR＜0.55, WC＜84.9 cm, and BMI＜24.7 kg/m2 to prevent hypertension as well as WHtR＜0.55, WC＜84.1 cm, BMI＜24.4 kg/m2, and WHR ＜0.86 to prevent diabetes mellitus. In conclusion, all four indicators of obesity are not reliable predicators of hyperlipidermia in women over the age of 65, and cut-off values for obesity indicators in predicting hypertension and diabetes mellitus need to be further loosened for the criterion in elderly women.

並列關鍵字

Elderly women ； Obesity ； Obesity indicators ； Hypertension ； Diabetes