臺灣大數據的公衛應用：探討有氧運動對血中高密度膽固醇與脂蛋白酵素基因多態性在罹患代謝症候群風險的相關性

Association of Aerobic Exercise with High-Density Lipoprotein Cholesterol Levels and Lipoprotein Lipase rs3779788 Polymorphism on Risk of Metabolic Syndrome: Application of Big Healthcare Data in Taiwan

許群昇(Chun-Sheng Hsu)

指導教授 ： 廖勇柏

共同指導教授 ： 李宣信(Shiuan-Shinn Lee)

中山醫學大學/健康管理學院/公共衛生學系/博士(2022年)

https://doi.org/10.6834/csmu202100316

摘要

背景：
運動習慣可以改善罹患心血疾病的機會及改善相關的風險因子，包含血中高密度膽固醇濃度。但是在台灣族群中，目前仍無相關研究探討不同種類的運動習慣與高密度膽固醇濃度的相關性。因此利用大數據分析台灣族群中，不同種類的運動習慣與高密度膽固醇的相關性。
脂蛋白酵素基因(Lipoprotein lipase, LPL)的表現跟高膽固醇血症及代謝症候群有關，而有氧運動會改善代謝症候群中的膽固醇濃度，因此利用大數據分析台灣族群中，不同的LPL單核甘酸多態性表現和有氧運動，在導致代謝症候群風險的相關性。
方法：
本研究利用臺灣人體生物資料庫進行分析，將運動習慣分成有氧運動及非有氧運動(包含重訓、球類運動、混和)。使用多變量線性迴歸模式計算β-coefficient與p值，探討不同運動習慣與血液中HDL-C的相關性。另外，使用多元線性迴歸分析，探討LPL中rs3779788基因不同單核甘酸表現和有氧運動交互作用，在罹患代謝症候群風險之相關性。
結果：
經分析後發現，HDL-C與有氧運動(β= 1.33748, p<0.0001)及非有氧運動(β= 2.56210, p<0.0001)皆有正相關，其中HDL-C與重訓(β= 4.01828, p=0.0020)、球類運動(β= 2.43815, p=0.0001)、混和組(β= 2.47021, p<0.0001)皆有正相關。在罹患代謝症候群風險方面，有氧運動具有保護作用(OR, 0.858; 95% C.I., 0.743-0.991)；rs3779788基因的不同單核甘酸表現和有氧運動在罹患代謝症候群風險有顯著交互作用，進一步和無運動組比較，有氧運動且CC/CT基因組罹患代謝症候群風險為0.841(95% C.I., 0.727-0.974)，TT組的風險為4.076 (95% C.I., 1.158-14.346)。
結論：
在台灣族群中，有氧運動及非有氧運動對於血液中高密度膽固醇皆有正向影響，其中在非有氧運動族群中，阻力訓練對於高密度膽固醇之正向影響最大。有氧運動在rs3779788 CC/CT型相較於TT型，對於改善代謝症候群風險影響較大。

關鍵字

高密度膽固醇 ； 有氧運動 ； 阻力運動 ； 代謝症候群 ； 脂蛋白酵素基因 ； 台灣

並列摘要

Purpose:
Physical activity can help to reduce cardiovascular risks and mortality, such as increasing levels of high-density lipoprotein cholesterol (HDL-C) and preventing metabolic syndrome (MetS). Evidence has been provided on the association between HDL-C and exercise modalities. However, there is the absence of studies investigating this association in Taiwan. We assessed the relationship between exercise types and HDL-C among Taiwanese adults.
The Lipoprotein lipase (LPL) gene is a significant contributor to dyslipidemia and is associated with MetS. We evaluated the interactive association between MetS and rs3779788 of the LPL gene based on aerobic exercise.
Materials and Methods:
Data were collected from Taiwan Biobank (TWB), a national biomedical research database that contains the genetic information of ethnic Taiwanese residents gathered from 2008 to 2016. Regular exercise was categorized as non-aerobic exercise (separated as weight training, ball game, and mixed exercise) and strict aerobic exercise. Linear regression models were used to assess the effects of exercise in a questionnaire-based manner. Multiple logistic regression was used to determine the odds ratios (OR) for MetS and their 95% confident intervals (C.I.). Potential variables included LPL rs3779788, aerobic exercise, sex, age, education level, marital status, body mass index (BMI), smoking, alcohol consumption, midnight snacking, coffee, and tea drinking.
Results:
After multivariate adjustments, HDL-C was positively associated with aerobic (β=1.33748, p<0.0001) and non-aerobic (β=2.56210; p<0.0001) exercise. Positive associations were also found for resistance training (β=4.01828, p=0.0020), ballgame (β=2.43815, p=0.0001), and mixed exercise (β=2.47021, p<0.0001). Aerobic exercise was protective against MetS (OR, 0.858; 95% C.I., 0.743-0.991). Compared to CC/CT genotype, the OR for developing MetS was 0.875, (95% C.I., 0.571-1.341) in TT individuals. The test for interaction was significant for the rs3779788 variant and aerobic exercise (p = 0.0484). In our group analyses, the OR for MetS was 0.841 (95% C.I., 0.727-0.974) in CC/CT and 4.076 (95% C.I., 1.158-14.346) in TT individuals who did aerobic exercise compared to those who did not.
Conclusion:
In conclusion of our study, both aerobic and non-aerobic exercise have positive effects on HDL-C among Taiwanese adults. Among the non-aerobic exercise groups, resistance training had the greatest effect. Additionally, aerobic exercise improved metabolic syndrome in Taiwanese adults with rs3779788 CC/CT genotype relative to those with TT genotype.

並列關鍵字

HDL ； aerobic exercise ； resistance training ； metabolic syndrome ； Lipoprotein lipase ； Taiwan

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