社區性糖尿病流行病學及其相關因素探討

A Community-based Epidemiological Study on Diabetes Mellitus and the Related Factors

陳孟皓(Meng-Hao Chen)

指導教授 ： 廖宏昌

中山醫學大學/健康管理學院/醫療產業科技管理學系碩士班/碩士(2013年)

https://doi.org/10.6834/CSMU.2013.00161

摘要

近年糖尿病已經高居我國國人十大死因前四名而患病人口也已達百萬之譜；其可怕之處在於症狀常是緩慢發生使患者不容易察覺。據研究顯示糖尿病的產生除了和個人生活習慣、家族病史有關之外，居住環境特性亦為重要影響因子之一。因此若能針對個人生活習慣及其環境特性進行研究，及早發現地區糖尿病的誘發因子進而提出應對的健康促進與照護政策定能有效減緩該疾病的發生。
本研究以桃園縣某地區30歲以上居民作為研究對象，針對其中18個里別採取等比概似抽樣方式，於15000位民眾中隨機抽取進行2006年至2011年共計六年之世代資料進行橫斷面研究，經過資料篩選最終針對5,886名當地民眾之糖尿病患病情形與人口統計變項、健康檢查變項、健康行為變項、環境變項等進行敘述性分析、卡方分析與羅吉斯迴歸分析之關聯性研究。
結果發現本研究地區無論從整體觀察或是個別從男、女性族群觀察，其糖尿病粗發生率與粗盛行率皆有逐年上升的趨勢但亦有上升幅度逐漸趨緩的現象，整體族群之糖尿病粗發生率由最初4.18‰上升至5.8‰，而粗盛行率方面至2011年全體為11.47%、男性為12.39%而女性為10.7%，明顯男性高於女性；而相關因素分析顯示，人口統計變項中年齡、教育程度與是否有工作會明顯影響糖尿病患病之風險，此外家庭收入亦會對糖尿病患病有關聯性但關聯強度較小：健康檢查變項的部分皆與糖尿病患病有顯著的關聯性，因此避免過重或肥胖以及高血壓的預防可以有效降低糖尿病患病的風險；健康行為的部分，本研究認為維持好的運動習慣可以有效降低糖尿病患病的可能性，特別是對於本研究地區的女性而言助益更大，此外抽菸亦會影響糖尿病患病的風險，抽菸者患病風險相對較高，特別是本地區的男性需要特別注意抽菸的問題；最後本研究亦發現二手菸暴露對於糖尿病患病有明顯的影響性，因此非抽菸者若能遠離二手菸環境將能有助於避免提升糖尿病患病風險的可能。

關鍵字

糖尿病 ； 發生率 ； 盛行率 ； 二手菸危害

並列摘要

Diabetes Mellitus is the fourth leading cause of death in Taiwan, and there are more than million people with diabetes recently. It’s difficult to detect the disease because the early symptoms are not clear. Therefore, it is often overlooked because it is unconsciously found. In addition to the effects of personal living habits and family medical history arising out of these disease, living environment is also one of important impact factors. Therefore, if could explored people’s health status and the living environment to construct the heath promotion and healthcare policy to meet regional needs and then early detection and prevention may be done, it can effectively reduce the incidence of diabetes.
These study is a prime study on diabetes mellitus socio-epidemiological analysis of a city of Taoyuan cohort study since 2006 to 2011. Target group of this study consist of the residents aged 30 years and over who still have domiciliated in a city of Taoyuan at the end of 2005, drawing 18 li from 46 li (neighborhood) of the city as the selected regions. Taking population distribution and structure of Taoyuan County as the basis, geometric and likelihood sampling was used in this project to randomly select 15000 subjects. The selected participants will be invited to participate in this research each year. Finally, there’re 5,886 subjects in these study. Based on analysis of the relationship of diabetes mellitus and demographic variables, health variables, health behavior variables and environment variables. Through statistical software, descriptive analysis, chi-square analysis and logistic regression analysis were conducted in this study.
After analysis, both of the incidence and prevalence rate of DM were increased annually, the incidence rate from 2007 to 2011 was 4.18‰ to 5.8‰ and the prevalence rate from 2006 to 2011 was 5.17% to 11.47%. After separated from gender, the incidence rate of male from 2007 to 2011 was 5.05‰ to 5.8‰ and the prevalence rate from 2006 to 2011 was 5.63% to 12.39%, while the incidence rate of female from 2007 to 2011 was 3.46‰ to 5.8‰ and the prevalence rate from 2006 to 2011 was 4.8% to 10.7%. The other hand, the study also showed that age, education, employment, household income, obesity, hypertension, physical activity, active smoking and passive smoking were correlated with diabetes.

並列關鍵字

Diabetes Mellitus ； Incidence rate ； Prevalence rate ； Passive smoking

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