生活型態因素與青少年代謝危險因子聚集消長之關係

The association between lifestyle factors and the change of the metabolic syndrome components clustering in adolescents

賴宜妏(Yi-Wen Lai)

指導教授 ： 李建宏

高雄醫學大學/健康科學院/公共衛生學系公共衛生學碩士班/碩士(2018年)

摘要

背景
許多研究指出兒童代謝症候群與增加成人時期第二型糖尿病、代謝症候群、心血管疾病的風險有關。而近年來亦有研究指出在青春時期有代謝症候群，若在進入成人時期前轉變成無代謝症候群，則得到第二型糖尿病和增加動脈內膜中層厚度的風險降至與青春期間無代謝症候群者的風險相同。然而雖然有許多文獻指出代謝症候群與生活型態因素的相關性，不過探討生活型態因素對於代謝症候群消長的相關性較缺乏。本研究目的為探討生活型態因素與代謝危險因子聚集消長的關係
材料與方法
本研究採用多階段分層叢集抽樣方法，隨機選取南台灣19間國中共1045位學童參與問卷及體位調查或血液生化檢驗，排除問卷資料不全或無問卷資料者，共有1031人參與問卷及體位調查，其中773位學童有完整血液生化檢驗和體位資料，追蹤後共有955位參與問卷及體位調查，其中有553在基線和追蹤皆有問卷及體位調查或血液生化檢驗。本研究使用ATP III定義代謝危險因子聚集，並用二項式和多項式邏輯氏迴歸分析模式分析結果，並校正潛在干擾變數。

結果
本研究結果顯示，從Model 1和Model 2可得知，每天一個小時以上
的閱讀時間比無閱讀者有較高代謝危險因子聚集持續存在的風險，其風險分別為4.2和4.5倍，每周攝取4份以上的乳製加工品與不吃或每周少於1份者相比有較高代謝症候群持續存在的風險(aOR=4.0倍)，每天攝取1瓶和2瓶以上的包裝或瓶裝飲料與未攝取者相比，有較高代謝危險因子聚集持續存在的風險，其風險分別為2.2、3.7倍，每天攝取2瓶以上的手搖杯飲料與未攝取者相比，有較高代謝危險因子聚集持續存在的風險(aOR=3.6倍)。每天3小時以上的屏幕時間與每天少於3小時者相比，有較高發生代謝危險因子聚集的風險(aOR=2.5倍)，每周攝取4次以上的肥肉和動物皮與不吃或每周少於1次者相比，有較高發生代謝危險因子聚集的風險(aOR=3.3倍)。
結論
本研究顯示代謝危險因子聚集持續存在可能與閱讀時間、乳製加工品攝取、包裝或瓶裝茶類飲料和手搖杯飲料攝取則有關；代謝危險因子聚集發生可能與屏幕時間和肥肉和動物皮攝取有關。

關鍵字

青少年代謝危險因子聚集 ； 生活型態因素

並列摘要

Pediatric metabolic syndrome (MetS) is a predictor of high carotid intima-media thickness, type 2 diabetes mellitus and cardiovascular disease in adults. Previous studies have reported that the resolution from MetS between youth and adult life could reduce the risk of diabetes and cardiometabolic disorders. The occurrence of MetS has been linked to lifestyle parameters, however, how lifestyle factors in childhood affect the resolution of adolescent MetS is not well understood. We used prospective study to investigate the effect of the change in lifestyle factors on the change of the metabolic syndrome components clustering. Participants were 553 adolescents aged 12 to 14 years who were randomly selected from 19 junior high schools in Taiwan, using a multistage stratified cluster selecting strategy. Comprehensive demographic factors, dietary, physical, anthropometric, and clinical parameters were collected. The criteria of NCEP/ATP-III for was used to determine metabolic syndrome components clustering. Adolescents with ≥2 risk components were defined as metabolic syndrome components clustering. The multivariable logistic regression models were used to evaluate the related effects after adjusted for covariates. We found that adolescents with high hand-shaken sugar-sweetened beverages consumption (≥2 bottles/day) had a 3.6-fold higher likelihood of metabolic syndrome components clustering persistence than nondrinker. And, adolescents with high package/bottled sugar-sweetened beverages consumption (1 bottle/day, ≥2 bottles/day) had higher likelihood of metabolic syndrome components clustering persistence than nondrinker. In addition, adolescents with high screen time (≥3 hr/day) had a 2.5-fold higher likelihood of metabolic syndrome components clustering incidence than low screen time (<3 hr/day). Our finding emphasizes the role of screen time on the incidence of metabolic syndrome components clustering among adolescents, and the role of hand-shake, package/bottled sugar-sweetened beverages consumption on the persistence of metabolic syndrome components clustering among adolescents.

並列關鍵字

adolescent ； metabolic syndrome components clustering ； lifestyle factors

參考文獻

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