年輕肥胖男性心血管疾病危險因子聚集現象：以健康檢查族群為例

Aggregation of Cardiovascular Disease Risk Factors in Young Obese Men-An Example from Health check-up Population

吳德敏(Der-Min Wu) ； 申慕韓(Muh-Han Shen) ； 楊士賢(Shih-Hsien Yang) ； 王淑娟(Shu-Chuan Wang) ； 孫建安(Chien-An Sun) ； 楊燦(Tsan Yang) ； 祝年豐(Naim-Feng Chu)

《中華職業醫學雜誌》 12卷4期 (2005/10) Pp. 215-227

https://doi.org/10.30027/CJOM.200510.0002

摘要

目標：本研究目的為暸解參加健康檢查之年輕肥胖男性在血壓、血脂與血糖等異常之心血管疾病危險因子個人聚集現象。方法：研究族群為民國91年1月至12月前往北部某一醫療院所接受常規健康檢查之男性健康檢查民眾，共有3,149人。由自填式問卷收集健檢者之人口學資料；採用標準程序方法測量身體體位、血壓及血液生化等資料。血壓、血脂與血糖等異常之心血管疾病危險因子個人聚集分析，係以健檢者所具有前述三項異常之數目的實際觀察比率與其期望比率之比值(O/E ratio)及信賴區間來作比較分析。結果：男性肥胖(BMI≧27 kg/m^2)、高血壓(SBP≧130 or OBP≧85 mmHg)、血脂異常(cholesterol≧200 or triglyceride≧150 mg/dl)及高血糖(fasting glucose≧110 mg/dl)的盛行率分別為21.1、40.9、43.7及5.8%等。合併有三項心血管疾病危險因子(O/E ratio=2.78, 95%CI=2.22-3.34)之O/E ratio具有統計學上顯著意義。同時，年輕肥胖男性其心血管疾病危險因子有個人聚集現象(O/E ratio=6.11, 95%CI=3.10-12.74)。進一步多變項分析結果，在此一健檢族群中，影響前述三項血壓、血脂與血糖等異常心血管疾病危險因子產生個人聚集的統計學上顯著因素包括年齡及肥胖指標，且兩者間有交互作用。結論：血壓、血脂與血糖等這些異常之心血管疾病危險因子在健檢族群中有明顯的個人聚集現象，而且此一個人聚集現象與年齡及肥胖有關，且有交互作用。年齡較輕且肥胖健檢者有較高的心血管疾病危險因子聚集現象。因此，年輕肥胖個案為國人值得重視的族群，其與心血管疾病危險因子間的作用機轉有待日後進一步研究。

關鍵字

心血管疾病 ； 危險因子 ； 肥胖 ； 聚集現象

並列摘要

Objectives: To evaluate the aggregation of cardiovascular disease (CVD) risk factors, such as high blood pressure (BP), dyslipidemia, and high fasting glucose and other CVD risk factors, among young obese Taiwanese adults.
Methods: A total of 3,149 male, who attended a periodic health check-up program between Jan. and Dec. 2002, were enrolled for this analysis. Information on demographic characteristics was ascertained as part of self-administered questionnaire completed by examinees. Anthropometrics measures, blood pressure, and biochemical variables (including fasting serum total cholesterol, triglyceride, and glucose levels) were measured by standard methods. Aggregation of CVD risk factors was examined by comparing the observed and expected proportions (O/E ratio) and their 95% confidence intervals (Cl) for none, one, two, and three risk factors simultaneously occurring high levels.
Results: The prevalence of obesity (BM≧l27 kg/m^2), high BP (SBP≧130 or DBP≧85 mmHg), dyslipidemia (cholesterol≧200 or triglyceride≧150 mg/dl) and high glucose level (fasting glucose≧110 mg/dl) was 21.1, 40.9, 43.7 and 5.8%, respectively, among this study population. A significant clustering of CVD risk factors was noted among obese population. Among them, the observed numbers were more than expected in groups with three CVD risk factors (O/E ratio=2.78, 95% Cl=2.22-3.34). More interestingly, these characteristics were also significantly among young obese population (O/E ratio=6.11, 95% Cl=3.10-12.74). Factors associated with the clustering of CVD risk factors included age, body mass index (BMI), and their interation.
Conclusions: From this study, the significantly individual aggregation of CVD risk factors including high BP, dyslipidemia, and high fasting glucose levels in the young obese Taiwanese adults was noted. More interestingly, even the younger males with a higher BMI had an apparent tendency toward the aggregation of these CVD risk factors. From the public health point of view, we should pay attention to the younger obese population and their prevention of CVD risk factors in the future.

並列關鍵字

cardiovascular disease ； risk factors ； obesity ； aggregation