以不同身體質量指數評估偏遠社區老年肥胖盛行率及相關因子

Prevalence and Associated Factors of Obesity Defined by Different Body Mass Index Cutoffs in Old People Living in Rural Community

白千慧(Chien-Hui Pai) ； 張秦松(Chin-Sung Chang) ； 邱靜如(Ching-Ju Chiu) ； 范聖育(Sheng-Yu Fan) ； 吳幸娟(Hsin-Chuan Wu) ； 張尹凡(Yin-Fan Chang) ； 劉秉彥(Ping-Yen Liu) ； 陳全裕(Chuan-Yu Chen) ； 許永河(Yuan-Ho Hsu) ； 吳至行(Chih-Hsing Wu)

《台灣老年醫學暨老年學雜誌》 11卷1期 (2016/02) Pp. 31-49

https://doi.org/10.29461/TGG.201602_11(1).0003

摘要

背景：台灣人口老化快速，近年來老化與肥胖健康相關問題逐漸受到重視。研究顯示，肥胖主要會與下列疾病有關，如代謝症候群、心血管疾病、糖尿病、癌症等。本研究以不同身體質量指數評估偏遠社區老年肥胖盛行率及相關危險因子。方法：2012年於高雄市田寮區進行全鄉老年居民抽樣調查，排除空戶、拒訪、死亡及資料嚴重不全後，總共545位(含)65歲以上男女老年人參與資料分析。受試者均接受結構式問卷訪談，並於隔夜空腹接受身體測量學檢查及血液生化檢查。計算身體質量指數並採亞太共識及台灣診斷標準評估肥胖程度。結果：老年居民肥胖盛行率以亞太標準為41.1%，台灣標準為21.3%。肥胖及體脂率過高程度均隨著年齡增加而逐漸下降。單變項分析發現，依序取不同身體質量指數於23至28公斤/公尺2為肥胖切點下，年齡、慢性疾病與病史、營養狀況、代謝症候群、身體活動量於肥胖與非肥胖兩組之間達統計差異。分別以身體質量指數25或27公斤/公尺2為肥胖切點，經複邏輯斯迴歸分析發現，教育程度、營養狀態、高血壓、糖尿病、高尿酸血症、代謝症候群為老年肥胖之獨立正相關因子，年齡與身體活動量則為負相關因子。結論：台灣偏遠地區老年居民整體肥胖盛行率呈現偏高，但有隨著年齡增加而逐漸下降的趨勢。年齡越低、教育程度越高、高血壓、糖尿病、高尿酸血症、代謝症候群、身體活動量高及營養狀況良好者易有肥胖的問題。以身體質量指數介於25至27公斤/公尺2為老年肥胖切點時，更能區別出肥胖與非肥胖老年人於代謝症候群等慢性疾病。若從疾病預防之觀點，則宜以亞太共識肥胖切點於25公斤/公尺2較為適當。

關鍵字

老年人 ； 肥胖 ； 身體質量指數 ； 腰圍 ； 體脂率 ； 偏遠社區

並列摘要

Background/Purpose: With the increase of the elderly population in Taiwan, aging and obesity-related health risks have received more and more attention in recent years. Studies have shown that obesity highly correlates with health problems, notably metabolic syndrome, cardiovascular disease, diabetes, and cancer. This study aims to investigate the prevalence of obesity defined by different body mass index (BMI) cutoffs and identify possible risks related to obesity by examining obese elderly residents in remote communities. Method: Subjects were recruited from elderly residents in Tianliao Township of Kaohsiung County and sampled by the whole-community screening method in 2012. With subjects excluded due to factors like empty household, declined interview, death, and incomplete data, a total of 545 men and women aged 65 and over participated in this research. In addition to a face-to-face interview by a well-trained staff member utilizing a structured questionnaire, each subject received a physical examination and laboratory tests. Obesity was defined by either Asia Pacific consensus or Taiwan BMI cutoffs. Results: The prevalence of elderly obesity in total were 41.1% and 21.3% by Asia and Taiwan BMI cutoffs, respectively. The levels of obesity and high percent body fat were observed to decline with age. Results of univariate analysis using 6 different BMI cutoffs for obesity (between 23 and 28 kg/m^2) indicated statistically significant differences between non-obese and obese subjects in terms of age, weight, body mass index, waist circumference, chronic diseases or history and nutritional status. were statistically significant differences between non-obese and obese old people. Results of binary logistic regression analysis, on the other hand, identified educational level, nutritional status, hypertension, diabetes, hyperuricemia, and metabolic syndrome as positively independent factors, while age and physical activity were negatively independent factors for elderly obesity. Conclusions: High prevalence of obesity in the elderly is noted in rural Taiwan, but the prevalence appears to decline with age. Younger age, hypertension, diabetes, hyperuricemia, metabolic syndrome, higher level of physical activity, and good nutritional status are associated with greater susceptibility to obesity. The BMI cutoffs between 25 and 27 kg/m^2 show better statistical significance in discriminating the metabolic syndrome or chronic disease between non-obese and obese older people. From the viewpoint of disease prevention, the BMI cutoff based on the Asia Pacific consensus (at 25 kg/m^2) is more appropriate in defining obesity in older people.

並列關鍵字

elderly ； obesity ； body mass index ； waist circumference ； percent body fat ； rural community