不同年齡世代，肥胖與冠心症的相關性-某一台灣健檢中心橫斷面研究

The association of obesity and coronary heart disease in different age cohort-a cross-sectional study from one health examination center in Taiwan

黃鈞源(Chun-Yuan Huang)

指導教授 ： 季瑋珠

國立臺灣大學/公共衛生學院/公共衛生碩士學位學程/碩士(2013年)

https://doi.org/10.6342/NTU.2013.00679

摘要

背景: 在國外許多文獻已顯示，肥胖是冠心症危險因子之一，但在不同年齡層，兩者關係似乎有所不同。台灣在肥胖對冠心症的研究仍有限，且文獻上多以身體質量指數為主要肥胖指標，也缺乏不同年齡層的比較性。所以本研究是為了瞭解不同性別、年齡族群，肥胖與冠心症相關性是否一致?
研究方法:研究對象為20-80 歲不同性別、年齡層，在94-101年至台北某一健檢中心檢查的第一次健檢資料，在排除資料不全的參與者後，以身體質量指數分析的個案有40422位(男性:21404 女性:19018)，其中以腰圍分析的個案有36752位(男性:19289 女性:17463)。身體質量指數以亞太標準做區分，腰圍以國健署標準做區分，冠心症風險以佛萊明罕分數公式做預估。其他可能的干擾因子如：吸菸、飲酒、運動、教育程度等以問卷取得。將男女族群各別分開三個年齡族群(20-44歲、45-54歲和55-80歲)作邏輯式回歸分析。
結果：研究對象男性多於女性，分別有52.95%和47.05%，男性體重過重和肥胖比例是27.45%和41.19%，女性體重過重和肥胖比例是12.71%和12.86%
。由佛萊明罕公式所計算出的分數，和未來10年發生冠心症風險的機率，都是以男性較高。在男女分開的邏吉斯回歸分析中，發現身體質量指數與年齡、腰圍與年齡皆呈現交互作用的現象(P<.0001)，故進一步做不同年齡層的回歸分析時，發現身體質量指數愈高或腰圍異常，皆與冠心症風險正相關，但年齡層愈高，此相關性減弱；若身體質量指數與腰圍一同分析時，只有身體質量指數與年齡呈現交互作用，而腰圍未達顯著，顯示腰圍在年輕與老年族群對冠心症同等重要。另外，腰圍與冠心症的關係在老年男性比老年女性更顯重要。
結論：身體質量指數與腰圍對未來冠心症事件的關係會因年齡層不同而不同；55歲以下的族群，身體質量指數與腰圍對冠心症同是危險因子；55歲以上的族群，腰圍對冠心症風險大於身體質量指數，尤其在男性更明顯。

關鍵字

肥胖 ； 冠心症 ； 年齡

並列摘要

Background: Many studies has indicated obesity was one of the risk factors of coronary heart disease (CHD).The research about obesity and CHD is limited in Taiwan and body mass index(BMI) is often the measurement of obesity. So the objective of this article is to examine the association of obesity and CHD in different age group.
Methods: We investigated the association between BMI,WC (waist circumference) and CHD as estimated by Framingham risk score in a cross-sectional study. Data was collected from one health examination center in Taipei since 2005 to 2012 . In all, 21,404 men and 19,018 women with BMI information and 19,289 men and 17,463 women with WC information (age range, 20–80 years) were included.
Results: The prevalence of obesity was higher in men than in women(41.19% vs 12.86%).The interaction between BMI and age or WC and age showed significant when BMI or WC was analyzed alone(P<.0001).The positive association was observed between BMI and CHD or WC and CHD in every stratified age group, but decreased in older group. When BMI and WC were both analyzed in the model, no interaction was found between WC and age. The results suggest that the relationship of BMI and CHD is more important in younger group than the relationship in older group, but the relationship of WC and CHD is similar in younger or older groups. The association of WC and CHD is more obvious in men than in women.
Conclusion: Obesity was one of the risk factors in coronary heart disease. The association of obesity(BMI,WC) and CHD decreases with age, and WC is a better predictor than BMI in the age of 55-80, especially in men.

並列關鍵字

obesity ； coronary heart disease ； age

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