宜蘭地區中老年民衆身體質量指數與胰島素抗性相關性之探討

Correlation of Insulin Resistance and Body Mass Index in Middle-Aged and Elderly in Rural Communities of I-Lan

柳家勛(Chia-Hsun Liu) ； 陳亮恭(Liang-Kung Chen) ； 陳稚均(Zhi-Jun Chen) ； 陳振文(Tzen-Wen Chen) ； 黃信彰(Shinn-Jang Hwang) ； 邱淑媞(Shu-Ti Chiou)

《北市醫學雜誌》 2卷2期 (2005/02) Pp. 138-145

https://doi.org/10.6200/TCMJ.2005.2.2.03

摘要

Background: Obesity has become a global endemic in recent years, and the related health risks have been vividly identified. International Obesity Task Force of World Health Organization has proposed a definition of obesity for Asia-Pacific populations, which was different from the definition proposed by the Department of Health of Taiwan. The aim of this study is to compare the insulin resistance of the middle-aged and elderly in I-Lan by the two definitions to evaluate the appropriateness of cutoff values. Methods: We conducted a community-based study for metabolic disorders and insulin resistance among residents aged over 40 in I-Lan County, Taiwan. History taking, anthropometric measurements, and blood samplings were performed in detail by experienced research staff. Insulin resistance was measured and expressed by homeostasis model assessment (HOMA-IR). The threshold value for insulin resistance of these people was defined as the highest quartile of HOMA-IR. HOMA-IR of obesity statuses classified by both definitions were compared for clarifications. Results: A total of 1059 subjects (470 males and 589 females, mean age=64.4±11.4 years) participated the study, and insulin resistance was evaluated among 857 subjects. The mean body mass index (BMI) was 25.5±73.76Kg/m^2, and the proportion of obesity and overweight in our study was 43.0% and 22.6% by the cutoffs provided by WHO-IOTF definition. The proportion of obesity and overweight was 23.0%, and 30.3% by the DOH-Taiwan definition. The mean HOMA-IR of the body weight statuses classified by WHO-IOTF criteria was as follows: 1.77±3.58 for underweight, 1.22±2.66 for normal weight, 1.47±2.30 for overweight and 2.15±2.56 for obesity. The mean HOMA-IR of the body weight statuses classified by DOH-Taiwan criteria was as follows: 1.77±3.58 for underweight, 1.21±2.37 for normal weight, 1.72±2.71 for overweight and 2.49±2.48 for obesity. Conclusion: Insulin resistance was be clearly differentiated among the normal weight and overweight subjects by DOH-Taiwan criteria in our study, but WHOIOTF criteria can vividly demonstrated the co-morbidity of insulin resistance among obese subjects (65.1% obese subjects were insulin resistant). An ideal diagnostic criterion for obesity demands large-scaled cohord study to correlate the appropriate cutoff and clinical significance.

關鍵字

胰島素阻抗 ； 身體質量指數 ； 過重 ； 肥胖 ； 社區醫學

並列摘要

Background: Obesity has become a global endemic in recent years, and the related health risks have been vividly identified. International Obesity Task Force of World Health Organization has proposed a definition of obesity for Asia-Pacific populations, which was different from the definition proposed by the Department of Health of Taiwan. The aim of this study is to compare the insulin resistance of the middle-aged and elderly in I-Lan by the two definitions to evaluate the appropriateness of cutoff values. Methods: We conducted a community-based study for metabolic disorders and insulin resistance among residents aged over 40 in I-Lan County, Taiwan. History taking, anthropometric measurements, and blood samplings were performed in detail by experienced research staff. Insulin resistance was measured and expressed by homeostasis model assessment (HOMA-IR). The threshold value for insulin resistance of these people was defined as the highest quartile of HOMA-IR. HOMA-IR of obesity statuses classified by both definitions were compared for clarifications. Results: A total of 1059 subjects (470 males and 589 females, mean age=64.4±11.4 years) participated the study, and insulin resistance was evaluated among 857 subjects. The mean body mass index (BMI) was 25.5±73.76Kg/m^2, and the proportion of obesity and overweight in our study was 43.0% and 22.6% by the cutoffs provided by WHO-IOTF definition. The proportion of obesity and overweight was 23.0%, and 30.3% by the DOH-Taiwan definition. The mean HOMA-IR of the body weight statuses classified by WHO-IOTF criteria was as follows: 1.77±3.58 for underweight, 1.22±2.66 for normal weight, 1.47±2.30 for overweight and 2.15±2.56 for obesity. The mean HOMA-IR of the body weight statuses classified by DOH-Taiwan criteria was as follows: 1.77±3.58 for underweight, 1.21±2.37 for normal weight, 1.72±2.71 for overweight and 2.49±2.48 for obesity. Conclusion: Insulin resistance was be clearly differentiated among the normal weight and overweight subjects by DOH-Taiwan criteria in our study, but WHOIOTF criteria can vividly demonstrated the co-morbidity of insulin resistance among obese subjects (65.1% obese subjects were insulin resistant). An ideal diagnostic criterion for obesity demands large-scaled cohord study to correlate the appropriate cutoff and clinical significance.

並列關鍵字

body mass index ； community medicine ； insulin resistance ； obesity ； overweight