某榮民安養機構老年男性代謝症候群之盛行率及其與亡率的關係

The Prevalence of Metabolic Syndrome and Its Relationship to Mortality in Male Elderly of a Veteran Home in Central Taiwan

張明毅(Ming-Yi Chang) ； 林鉅勝(Chu-Sheng Lin) ； 唐憶淨(Yih-Jing Tang)

《台灣老年醫學暨老年學雜誌》 4卷2期 (2009/05) Pp. 130-142

https://doi.org/10.29461/TGG.200905.0005

摘要

目的：本研究嘗試以既有資料基礎探討安養機構老年男性代謝症候群之盛行率，及其與心血管疾病和全死因死亡率之間的關係。
方法：以居住於某安養中心的住民爲對象，共收案369位65歲以上老年男性，平均年齡爲78.8歲，於2002年7-8月接受檢查。代謝症候群的定義主要是根據美國心臟學會／美國國家衛生院心肺及血液研究所(AHA/NHLBI)，另外在分析盛行率時加入美國國家膽固醇教育計畫成人治療指引第三版(NCEP-ATP Ⅲ)的診斷標準。以Cox相對風險迴歸的統計方法來分析追蹤5.5年後，代謝症候群對於心血管疾病與全死因死亡率的相對危險性。
結果：代謝症候群的盛行率根據NCEP-ATP Ⅲ的標準爲28.5%，但是若根據新的AHA/NHLBI標準則增加爲41.5%，而代謝症候群之各組成成份的盛行率則以血壓過高的比率最高。追蹤期間共有126人死亡，其中有30人是死於心血管疾病。校正可能造成干擾的多重因子影響後，有代謝症候群者其心血管疾病死亡率的相對危險性爲2.33（95%信賴區間1.10~4.97），而全死因死亡率的相對危險性爲1.23（95%信賴區間0.86~1.77）。
結論：榮民安養機構老年男性代謝症候群的盛行率相當高，依登錄的主要死因統計資料顯示有代謝症候群的人似有較高的心血管疾病死亡率，但是對於全死因死亡率則似難以顯示其相關性，惟此仍舊無法作爲最終之結論。

關鍵字

代謝症候群 ； 死亡率 ； 老年人 ； 男性 ； 榮民安養機構

並列摘要

Background: The purpose of this study was to explore the prevalence of metabolic syndrome (MetS) and its relationship to mortality among institutionalized elderly males.
Methods: The subjects included 369 elderly men (78.8±4.1 yrs old) residing in a veterans' nursing center from July 2002 to August 2002. The MetS was defined based on the AHN/NHLBI (American Heart Association/National Heart, Lung Blood Institute) criteria while the diagnosis standards stipulated in the National Cholesterol Education Program-Adult Treatment Panel Ⅲ (NCEP-ATP Ⅲ) was also consulted. Multivariate Cox proportional hazards regression analysis was used to estimate the relative risks (RRs) of cardiovascular disease (CVD) and all-cause mortality for those with MetS after a follow-up of 5.5 years.
Results: The prevalence of MetS was 28.5% by the NCEP-ATP Ⅲ criteria but read significantly higher at 41.5% by the AHN/NHLBI definition. Of the five components of MetS, the prevalence of high blood pressure appeared to be the highest. After 5.5 years of follow-up, 126 deaths occurred, and 30 of them died from CVD. After multivariable adjustment, the RRs for CVD and all-cause mortality among participants with MetS were 2.33 (95% confidence interval=1.10-4.97) and 1.23 (0.86-1.77), respectively, when compared to those without MetS.
Conclusion: The prevalence of MetS is relatively high among institutionalized male elderly. The elderly with MetS had a higher risk for CVD mortality, but not for all-cause mortality.

並列關鍵字

metabolic syndrome ； mortality ； elderly ； institutionalized male elderly