高雄縣居民高血糖高血脂高血壓盛行率及城鄉差異之探討

The differences of prevalences of hyperglycemia, hyperlipidemia and hypertension between urban and rural area in Kaohsiung County

謝米枝(Mi -Chih Hsieh)

指導教授 ： 莊弘毅

共同指導教授 ： 邱亨嘉

高雄醫學大學/健康科學院/醫務管理學研究所碩士在職專班/碩士(2006年)

摘要

摘 要
本研究目的旨在探討高雄縣城鄉地區性別、年齡別高血糖高血脂高血壓盛行率、運動、飲食情形、預測影響該縣城鄉地區高血糖高血脂高血壓危險因子，作為日後衛生政策訂定、健康管理者執行之參考。
本研究對象採用行政院衛生署國民健康局91年「台灣地區高血糖高血脂高血壓盛行率調查」資料，研究樣本取樣採多段分層系統抽樣設計，將台灣地區359個鄉鎮市區依地理位置和都市生活圈分為七層，每層內採用抽取率與單位大小成比例方式（Probability Proportional to Size, PPS）抽出鄉鎮市區，再隨機選取二分之一鄉、鎮、市區，被抽到的鄉鎮市區內再抽出鄰，最後每鄰抽出四戶，本次研究取自該次抽樣的縣市—高雄縣，有鳳山市、湖內鄉、大寮鄉等三個鄉市，獲得完成問卷517份、抽血樣本469支，進行資料分析。
研究結果高雄縣鳳山市、湖內鄉、大寮鄉三個鄉市之高血糖盛行率分別為24.0％、11.9％、18.6％，高血脂盛行率分別為30.4％、27.2％、31.3％，高血壓盛行率分別為20.4％、17.3％、28.3％，除高血糖三個鄉鎮有顯著差異（都市比鄉村高），其餘無顯著差異。男性高血糖盛行率在鳳山市、湖內鄉、大寮鄉分別為22.4％、9.4％、20.4％、女性高血糖盛行率分別為25.3％、14.3％、17.0％，男性高血脂盛行率在鳳山市、湖內鄉、大寮鄉分別為40.3％、27.1％、42.9％、女性高血脂盛行率分別為22.3％、27.4％、20.0％，男性高血壓盛行率在鳳山市、湖內鄉、大寮鄉分別為22.1％、15.6％、33.9％、女性高血壓盛行率分別為19.0％、18.9％、22.8％，三鄉市性別盛行率除了男性高血糖及高血壓盛行率有顯著差異（男性高血糖盛行率是都市比鄉村高、男性高血壓盛行率是半都市比鄉村高），其餘皆無顯著差異；影響高血糖的危險因子為都市地區、腰臀圍比高、年齡越大、女性比男性危險性高；高血脂的危險因子為腰臀圍比高、年齡越大、母親有高血脂病史；高血壓的危險因子腰臀圍比高、年齡越大、母親有高血壓病史。
三鄉市高血糖盛行率為都市比鄉村高、男性高血糖盛行率是都市比鄉村高、男性高血壓盛行率是鄉村比都市高。而腰臀圍比是高血糖、高血脂、高血壓共同顯著的危險因子，故本研究建議針對盛行率高地區及腰臀圍比高的族群訂定相關預防保健政策，加強推動工作重點、利用明確方法及資訊提供給居民，以加強自我保健，例如，在平常的健康促進活動中加入腰圍及臀圍的測量，並教導民眾腰臀圍比高的健康危險。

關鍵字

高血糖 ； 高血壓 ； 高血脂 ； 盛行率 ； 城鄉差異 ； 腰臀圍比

並列摘要

Abstract
The objective of this study is to analyze the variation of hyperglycemia, hyperlipidemia, and hypertension prevalences in different gender and ages, and between urban and rural in Kaohsiung County. Furthermore, the study endeavors to determine the influence of exercise and eating habits on the prevalences. The study results might be used as a reference for the health department’s policy making in the future.
This study is based on the results of the survey of hyperglycemia, yperlipidemia, and hypertension in Taiwan, 2002. The sampling method employd a multi-layer system which divides 359 cities and townships and villages in Taiwan into seven levels according to geographical characteristics. The method of probability proportional to size (PPS) was used to draw the samples from each level. Finally , Fongshan City ,Hunei Township and Daliao Township of Kaohsiung County were selected . Totally, 517 residents completed the questionaire, and of them, 469 recevied blood tests.
In the study result , we found the hyperglycemia prevalences of Fongshan City, Hunei Township and Daliao Township were 24.0%, 11.9% and 18.6% respectively; the hyperlipidemia prevalences were 30.4%, 27.2%, and 31.3%, and the hypertension prevalences were 20.4%, 17.3%, and 28.3% respectively. Only hyperglycemia prevalences among the three areas were significantly different. The hyperglycemia prevalences among Fongshan City, Hunei Township and Daliao Township in male were 22.4%, 9.4%, and 20.4%, while 25.3%, 14.3%, and 17.0% in female respectively. The hyperlipidemia prevalences among Fongshan City, Hunei Township and Daliao Township in male were 40.3%, 27.1%, and 42.9%, while 22.3%, 27.4%, and 20.0% in female respectively. The hypertension prevalences among Fongshan City, Hunei Township and Daliao Township in male were 22.1%, 15.6%, and 33.9%, while 19.0%, 18.9%, and 22.8% in female respectively. Only hyperglycemia and hypertension prevalences in males were significantly different between urban and rural. ( Hyperglycemia prevalence in males of urban was higher than those of rural, while hypertension prevalence in males of suburban was higher than those of rural.) Furthermore, we found a positive relationship between hyperglycemia prevalence and the factors of urban, waist-to-hip ratio, age, and female . Hyperlipidemia prevalence positively correlated to waist-to-hip ratio, age, and family history of mother with the same disease. Hypertension prevalence was higher in the group with higher waist-to-hip ratio, age, and family history of mother with hypertension .
In conclusion, the hyperglycemia prevalence was higher in urban than that in rural and also higher in male than that female in all three towns and city, while the hypertention prevalence was higher in rural than that in urban. High waist-to-hip ratio was an indicator for hyperglycemia , hypertension , and hyperlipidemia. Therefore, the study suggested health departments to set up some related prevention policies and campaign to reinforce the work focus. Use of clear methods and provide helpful information for the residents to improve their self-health awareness and disease preventions , such as suggestion of measuring waist and hip circumference in the usual activities of health promotion.

並列關鍵字

hyperglycemia ； hyperlipidemia ； hypertention ； prevalence ； urban and rural difference ； waist-to-hip ratio

參考文獻

參考文獻

（1）英文部分

Arvind G , Rajeev G, et al.：Prevalence of diabetes,impaired fasting glucose and insulin resistance syndrome in an urban Indian population.Diabetes Research And Clinical Practice 2003,61,69-76

Assmann G, Schulte H. Relation of high-density lipoprotein cholesterol and triglycerides to incidence of atherosclerotic coronary artery disease (the PROCAM experience).Am J Cardiol 1992;70 733-737

Blair SN, Kohl HW, Paffenbarger RS, Clark DG, Cooper KH, Gibbons LW, Physical fitness and all-cause mortality：A prospective study of healthy men and women. JAMA 1989；262：2395-2401