台灣地區國中生面皰與飲食關係之橫斷面研究，台灣營養健康調查，2010-2011。

Facial inflammatory acne and diet, a cross-sectional study Nutrition and Healthy Survey in Taiwan Junior High School Student, 2010-2011.

馬欣怡(Hsin-Yi Ma)

指導教授 ： 潘文涵

國立臺灣大學/生命科學院/生化科技學系/碩士(2012年)

https://doi.org/10.6342/NTU.2012.03036

摘要

研究背景與目的：
面皰好發於青春期，各國青少年面皰盛行率高達四至九成，面皰被廣泛認為是多因性疾病，近年來學者逐漸注意到飲食與面皰之相關性，因此本研究目的為了解台灣地區國中生面皰盛行率，並且探討面皰與已知非飲食因素及飲食因素之關係。
材料與方法：
採用「台灣營養健康調查，2010-2011」之國中生問卷與身體檢查生化值資料，以SUDAAN 比較台灣地區各性別、地區別與年級別之國中生面皰盛行率。此外透過卡方檢定分析國中生發炎性面皰與已知非飲食因素之關係，並且利用減縮維度回歸分析(Reduced rank regression，RRR) 與邏輯式回歸分析探討國中生面皰嚴重性相關之飲食型態。
結果：
台灣地區國中生面皰總盛行率高達九成，而且面皰盛行率以及發炎性面皰盛行率隨著年級之增加而有增加之趨勢，但是無患有發炎性面皰者之未發炎性面皰盛行率以七年級最高；面皰盛行率於各地區之分佈無一定之規律，中、南部層發炎性面皰盛行率顯著高於山地層，然而無發炎性面皰者之未發炎性面皰盛行率於山地層顯著最高。國中女生皆已進入青春期，發炎性面皰與年齡、年級、嘗試減重顯著相關，並且此族群「含糖飲料類、家畜加工製品類、蛋糕、派類、蛋類、水果製品」之飲食頻率越高，則面皰患者之嚴重性越高，反之，「堅果類、豆漿類、新鮮水果或果汁、全穀、家禽肝臟與血類」之飲食頻率越高，則面皰患者之嚴重性越低，在調整了面皰之多種可能危險因子之後，面皰嚴重性之飲食型態與發炎性面皰之發生、面皰嚴重性增加一級之風險比維持正相關。國中男生發炎性面皰與年齡、年級、肥胖程度(BMI) 以及青春期發展程度顯著相關；且此族群平均分布在青春期發展之四個階段，其中，未進入青春期之國中男生「調味乳類、含糖果汁類、果凍、布丁類、冰淇淋類、冰棒類」之飲食頻率與面皰嚴重性有正相關；「豆漿以外之黃豆製品類、海產卵類」之飲食頻率與面皰嚴重性有負相關；然而，不論是青春期前期、中期或者是後期之國中男生之資料皆顯示保護性食物與風險性食物與面皰嚴重性可能有正相關亦可能有負相關的複雜現象；同時發現單一食物項中僅有「魚類與小魚類」攝食與面皰嚴重性有顯著正相關，即發炎性面皰患者攝取此類食品之頻率顯著高於未患有發炎性面皰者。
結論：
本研究之國中女生已經進入青春期階段，而且多數已發育完成，主要影響其發炎性面皰之因素可能為年齡、年級、嘗試減重與飲食因子，而且此族群之面皰之發生或面皰嚴重性與高醣、高脂之加工食品呈現正相關，相反地，與富含纖維、微量元素、礦物質、以及植化素之食物呈現負相關。然而，國中男生發炎性面皰可能與青春期發展程度、肥胖程度 (BMI)、年級、年齡有關，且青春期發展程度不一，可能因此導致面皰與飲食關係因果難分。

關鍵字

面皰 ； 飲食型態 ； 台灣國中生營養健康調查 ； 減縮維度回歸

並列摘要

Research background & Purpose:
Prevalence of facial acne is very high among teenagers. It is up to 40 to 90 percent in most countries. It is gradually recognized that acne is a multi-factorial disease and diet is one of the contributing factors. Therefore, the purpose of this research was to understand the prevalence of facial acne in Taiwan junior high school students and the associated non-dietary and dietary factors of acne.
Material & Method:
Use was made of questionnaire and physical examination data of junior high school students from Nutrition and Health Survey in Taiwan carried out from 2010 to 2011. SUDAAN was used to compare the facial acne prevalence rates between gender and among regions and different grades. Besides, we used Chi-square and t-test to compare various characteristic parameters between students with inflammatory facial acne and without. Furthermore, reduced rank regression and hierarchical logistic regression were used to examine the associations between acne or seriousness of acne with dietary and non-dietary factors.
Result:
The prevalence of facial acne of junior high school students in Taiwan was around 90% and both acne and inflammatory acne prevalence rose with age and with grade level; but for those without any inflammatory acne, the prevalence of non-inflammatory was the highest in the seventh grade.
There was no clear geographical pattern in facial acne’s prevalence. The southern stratum had higher prevalence rate of total facial acne than the northern counterpart, but the prevalence of non-inflammatory in those without inflammatory acne was the highest in the mountain strata.
Developmental changes have started in all junior high school girls and the presence of inflammatory acne in girls was associated with age, grade and attempt to lose weight. Those girls who tended to ingest higher frequency of “sugar containing beverage, red meat products, cakes, pies, eggs and processed fruits“ would tend to have higher rate of severe facial acne. On the contrary, the higher the frequency of “nuts, soybean milk, fresh fruits or juices, whole grains, livers, and blood cake of poultry”, the lower prevalence rate of severe acne. After adjusting multiple risk factors of acne, the positive association between risk of inflammatory acne and the dietary pattern remained .
The junior high school boys with inflammatory acne were positively associated with age, grade, the degree of obesity, and the developmental stage of adolescence. The boys were evenly distributed among four developmental stages. In those in the pre-pubertal stage, the frequency of “flavored milk, juices containing sugar syrup, fruit jelly, pudding, ice cream, and ice sticks” was positively associated, but that of “soy beans products (except soy bean milk), and non-fish sea foods” was negatively associated with the acne severity. However, in other adolescence stages, there was a mixed association with the risky and protective dietary factors. In the association with individual food items, we discover that the frequency of consuming “fish and small fish” was positively associated with the acne severity and those with inflammatory acne had higher frequency than those without inflammatory acne.
Conclusion:
In junior high school girls in Taiwan, the major risk factors of inflammatory acne were age, grade, attempt to lose weight, and poor diet. The presence of acne and the severity of acne were positively associated with high fat and sugar containing processed foods, but negatively correlated with foods rich in fiber, micronutrients, mineral, and phytochemicals. However, in junior high school boys with inflammatory acne, acne was related to age, grade, the developmental stage of adolescence, and body mass index. The different stages of puberty may have caused the highly complex relationship between facial acne and diet.

並列關鍵字

facial acne ； dietary pattern ； Nutrition and Healthy Survey in Taiwan, junior high school student, 2010-2011 ； reduced rank regression.

參考文獻

Mattes, R. D. (2008). The energetics of nut consumption. Asia Pac J Clin Nutr 17 Suppl 1: 337-339.

Hogewoning, A.A., et al..Prevalence and risk factors of inflammatory acne vulgaris in rural and urban Ghanaian schoolchildren. Br J Dermatol, 2009. 161(2): p. 475-7.

Abulnaja, K.O.. Changes in the hormone and lipid profile of obese adolescent Saudi females with acne vulgaris. Braz J Med Biol Res, 2009. 42(6): p. 501-5.

Bataille, V., et al.. The influence of genetics and environmental factors in the pathogenesis of acne: a twin study of acne in women. J Invest Dermatol, 2002. 119(6): p. 1317-22.

Uslu, G.Sendur, N.Uslu, M.Savk, E.Karaman, G.Eskin, M.. Acne: prevalence, perceptions and effects on psychological health among adolescents in Aydin, Turkey. 2008, J Eur Acad Dermatol Venereol,22(4),462-9.