成人期體重增加與代謝症候群之相關性

Association of Weight Gain in Adulthood and Metabolic Syndrome

洪瑞麟(Rui-Lin Hong) ； 黃偉新(Wei-Hsin Huang) ； 詹欣隆(Hsin-Lung Chan) ； 黃麗卿(Lee-Ching Hwang)

《台灣家庭醫學雜誌》 23卷2期 (2013/06) Pp. 83-92

摘要

背景及目的：肥胖與高血壓、心血管疾病、代謝症候群、糖尿病及血脂肪異常等慢性疾病的發生關係密切，本研究目的在探討成人期體重增加對代謝症候群及心血管疾病的危險因子的關連性。方法：收集30歲以上體重過重的331位員工參與本研究，以問卷登錄個案基本資料，包括個人疾病史，個人生活習慣史及成人初期（20歲）體重，並測量身高、體重、腰圍與血壓，血液檢查包含空腹血糖值、總膽固醇、三酸甘油酯、高密度脂蛋白膽固醇與空腹血清胰島素值。成人期體重增加定義為測量體重減成人初期體重。結果：趨勢檢定分析顯示成人期體重增加組別越高與代謝症候群及各心血管疾病危險因子上升有統計上顯著相關。使用偏相關分析，控制年齡，性別影響後，發現成人期體重增加與各種肥胖指標（身體質量指數，腰圍，體脂肪百分比）和血壓呈現顯著的相關性，並與胰島素阻抗呈現正相關性；多變項分析結果顯示即使控制成人初期體重，成人期間體重每增加一公斤，得到代謝症候群的風險增加15%，胰島素阻抗的風險增加13%。結論：成人期體重增加和肥胖指標及各種代謝危險因子呈現正相關性，可能罹患代謝症候群和心血管疾病風險增加，此結果提供衛生政策應加強民眾在成人期初期時應重視體重管理的證據，以期達到預防勝於治療的目標。

並列摘要

Background: Obesity is closely related to chronic diseases such as hypertension, cardiovascular diseases, metabolic syndrome, diabetes mellitus, and dyslipidemia. This study discussed the relationship between cardiovascular risk factors with adult weight gain and metabolic syndrome.Methods: There were 331 overweight employees over 30 years of age who were recruited into the study. Each subject profile was obtained via questionnaires, consisting of questions related to personal medical history, dietary habits and early adult weight (at 20 years of age). Weight gain in adulthood was defined as the difference between measured weight and weight in early adulthood.Results: According to the trend test analysis, weight gain in adulthood is significantly related to both metabolic syndrome and cardiovascular disease. After applying Pearson's correlation coefficient and adjustments for age and sex, the results revealed that weight gain in adulthood was significantly related to body mass index, abdominal circumference, percentage of body fat and insulin resistance. Multivariate analysis showed that even with well-controlled early adulthood weight, the risk of acquiring metabolic syndrome and insulin resistance increased significantly.Conclusion: Weight gain in adulthood positively correlated with multiple metabolic risk factors, possibly resulting in increased risks of acquiring metabolic syndrome and cardiovascular disease. This study pointed out the importance of weight management in early adulthood and serves as evidence for preventive medicine-focused health policies.

並列關鍵字

weight gain ； metabolic syndrome ； cardiovascular diseases

參考文獻

Hankey, GJ,Jamrozik, K,Broadhurst, RJ(1998).Long-term risk of first recurrent stroke in the Perth Community Stroke Study.Stroke.29,2491-500.

Lin, LY,Kuo, HK,Li, HY,Hwang, JJ,Lin, JW(2008).Confirming a biological pathway in the metabolic syndrome-insight from the NHANES 1999-2002.Obesity.16,2676-81.

Expert Panel on Detection, Evaluation,Treatment of High Blood Cholesterol in Adults(2001).Executive Summary of The Third Report of The National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, And Treatment of High Blood Cholesterol In Adults (Adult Treatment Panel III).JAMA.285,2486-97.

World Health Organization(1999).Definition, Diagnosis and Classification of Diabetes Mellitus and Its Complication. Pt I : diagnosis and Classification of Diabetes Mellitus.consultation.(consultation).,::World Health Organization.

Foreyt, JP(2005).Need for lifestyle intervention: how to begin.Am J Cardiol.96,11-4.