台灣民眾血脂肪濃度與罹患膽結石症之相關性研究

The Relationship of Serum Lipid Profiles and Risk of Gallstone Disease in Taiwanese Subjects

游凈惠(Ching-Hui You) ； 黃鈞源(Chun-Yuan Huang) ； 胡敏冰(Shiau-Ping Ow) ； 鍾昀志(Yun-Chih Chung) ； 黃麗卿(Lee-Ching Hwang)

《台灣家庭醫學雜誌》 25卷2期 (2015/06) Pp. 129-137

https://doi.org/10.3966/168232812015062502003

摘要

背景及目的：膽結石症盛行率頗高，然而高膽固醇血症和罹患膽結石症的關聯性仍未定論，本研究的目的在探討台灣民眾的血中膽固醇數值與其罹患膽結石症的盛行率分析，期望能對台灣民眾預防膽結石症有所貢獻。方法：收集10年來北部某健康檢查中心受檢者年齡20至75歲，且執行腹部超音波與空腹抽血為分析對象。登錄資料並測量身高、體重、血壓，血脂檢查與腹部超音波結果等。將資料依性別分層分析，以多變項邏輯迴歸模式進行檢定。結果：151,639名健康檢查受試者，其中79,052名男性，72,587名女性。經由隔夜空腹之後腹部超音波檢查結果，全體受檢者膽結石症盛行率為5.9%，其中男性膽結石症盛行率為6.4%，女性為5.3%。身體質量指數大於27 kg/m^2之體重肥胖者對膽結石症風險增加約有5成，在控制年齡、身體質量指數、高血壓與糖尿病病史之後，發現男性高密度脂蛋白膽固醇值低於40 mg/dL的受檢者罹患膽結石症的危險性較高，勝算比為1.14（95%信賴區間為1.08-1.21）；而女性受檢者總膽固醇大於240 mg/dL的勝算比為1.13（95% CI, 1.02-1.25），低密度脂蛋白膽固醇值高於130 mg/dL的勝算比為1.16（95% CI, 1.06-1.27），高密度脂蛋白膽固醇值低於50mg/dL的勝算比為1.28（95% CI, 1.17-1.48）。結論：本研究發現此健檢族群罹患膽結石症盛行率為5.9%，男性略高於女性。控制年齡與體重之後，高密度脂蛋白膽固醇值低於標準值的受檢者在男性會增加14%罹患膽結石症的機率、在女性則會增加28%。此外，女性族群的高膽固醇血症與低密度脂蛋白膽固醇過高皆為罹患膽石症的危險因子。

關鍵字

膽結石症 ； 高膽固醇血症 ； 低密度脂蛋白膽固醇 ； 高密度脂蛋白膽固醇

並列摘要

Background and Purpose: Gallstone disease is a health problem frequently encountered in family medicine clinics in Taiwan. However, whether the levels of serum total cholesterol, triglyceride, low density lipoprotein cholesterol (LDL-C), and high-density lipoprotein cholesterol (HDL-C) predict risks of gallstone disease remains unclear. The study accordingly aims at investigating the relationship of lipid profiles and the risk of gallstone disease in Taiwanese patients.Methods: This retrospective study recruited 151,639 health examination recipients divided into two groups (the group with and the group without gallstone disease) based on the results of abdominal sonography. Basic characteristics of the subjects and related data, incluidng the results of blood and fasting lipid profile tests, were collected. Multivariate logistic regression analysis was performed to examine the relationship between lipid profiles and gallstone disease in men or women.Results: A total of 79,052 men and 72,587 women were enrolled. The prevalence of gallstone disease read respectively 5.9% overall, 6.4% in male subjects, and 5.3% in female subjects. Overweight and obesity increased the risk of gallstone disease by nearly 50%. In multivariate analysis controlled by age, body mass index, history of hypertension and diabetes, lower HDL-C emerged to be positively associated with gallstone disease in both genders, adjusted OR1.14 (1.08-1.21) in men and adjusted OR 1.28 (1.17-1.48) in women. Moreover, hypercholesterolemia (OR 1.13 [1.02-1.25]) and high LDL-C (OR 1.1 [1.06-1.27]) were further identified as the risk factors for gallstone disease in women.Conclusions: In the examined Taiwanese population, the prevalence of gallstone disease was 5.9% and appeared to be slightly higher in men than in women. Low HDL-C is a risk factor in both genders, while hypercholesterolemia and high LDL-C predict a higher risk of gallstone disease only in women.

並列關鍵字

gallstone disease ； HDL-C ； hypercholesterolemia ； LDL-C

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