- 學位論文
腹部脂肪分佈與代謝症候群及腹主動脈鈣化之相關
Association between Abdominal Fat Distribution and Metabolic Syndrome and Abdominal Aortic Calcification
摘要
研究背景和目的：腹部肥胖會增加發生代謝症候群的風險，代謝症候群的發生又會提高將來發生動脈硬化、心血管疾病的風險。本研究的目的為研究腹部脂肪分佈與腹主動脈鈣化之相關性。 材料與方法：本研究為一橫斷性研究，調查於 2009年9月至2010年1月，在某家區域醫院接受腹部電腦斷層檢查之門診及健康檢查病人，為其測量身高、體重、腰圍，利用病歷回顧的方式，收集參與者之基本資料及臨床檢驗結果。我們採用2005年AHA/NHLBI所修訂的標準做為診斷代謝症候群的依據，腰圍則是採用亞洲人的標準。利用腹部電腦斷層資料分析所有參與者之內臟脂肪面積及皮下脂肪面積，及腹主動脈分叉往上4.5公分內的鈣化積分。 結果：我們一共收集了200位參與者腹部電腦斷層的資料，其平均年齡為50.8歲，其中47%為女性，40% 參與者有代謝症候群； 42.5% 參與者有腹主動脈鈣化的情形。而檢定內臟脂肪面積分層(三層)和腹主動脈鈣化之相關性，其勝算比(OR)分別為2.1及4.2(95%信賴區間為：1.0-4.5; 2.0-8.7; trend test, p <0.001)，在加入相關危險因子校正後，第三組比起第一組的勝算比為1.5 (95%信賴區間為0.6-3.6; trend test, p=0.33)，；而以Receiver operating characteristic (ROC) 曲線分析求得內臟脂肪面積診斷腹主動脈鈣化的切點為81.5cm2(敏感性為75.3%，特異性為51.3%)，所對應之腰圍分別為女性84cm，男性88cm。 結論：內臟脂肪面積與腹主動脈鈣化之相關性只有在單因子分析時存在，在校正相關危險因子後，此相關性即不具統計顯著意義。
並列摘要
Objectives: The relationship between visceral fat and abdominal aortic calcification among Taiwanese was still unclear. We investigated the association between visceral fat and abdominal aortic calcification in Taiwanese. Material and Methods: We conducted a cross-sectional study of 200 adult participants in a regional hospital during September 2009 to January 2010. Subcutaneous and visceral fat areas were measured on one cross-sectional abdominal CT scan and the calcium score of abdominal aorta were measured within a 4.5cm cylindrical section of abdominal aorta just above aortic bifurcation. Results: The mean age was 50.8 (standard deviation, 14.4) years and 47% were women; 40% had metabolic syndrome and 42.5% had abdominal aortic calcification. The odds ratios (ORs) of abdominal aortic calcification according to tertiles of visceral fat area were 2.1 and 4.2 (95% confidence interval (CI), 1.0-4.5, 2.0-8.7;trend test, p <0.001). After adjusting for age, gender, body mass index (BMI), the OR comparing the participants in the 3rd tertile of visceral fat area with those in the first tertile was 1.5 (95%CI, 0.6-3.6; trend test, p=0.33). We plotted the Receiver Operating Characteristic (ROC) curve of different fat measurements with association of abdominal aortic calcification. The cut-off point for visceral fat area to diagnose aortic calcification was 81.5cm2(sensitivity 75.3%，specificity 51.3%), and the corresponding waist circumference is 84cm in women and 88cm in men. Conclusions: The association between visceral fat area and abdominal aortic calcification were found only in univariate analysis, this association attenuated after multivariate adjustment.
參考文獻
延伸閱讀
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