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醫療從業人員代謝症候群調查暨相關危險因子之探討

Prevalence of metabolic syndrome in hospital employees and Related Risk Factors

摘要


目的:代謝症候群的組成包含了許多相關因子,例如高血壓、高血糖、血脂異常、與肥胖等。而醫療從業人員,因其特殊的高工時及高壓的工作型態,以致可能導致不良的健康情形及生活型態。本篇希望以醫院員工健檢的資料,分析醫療從業人員代謝症候群的盛行率與其相關危險因子方法:本研究為橫斷式研究,收集北部某醫院醫療從業人員的年度健檢報告。從民國103年到107年共收錄1312位員工,依ATP III診斷標準分為正常組及代謝症候群組。以單變項分析包括獨立樣本t檢定(two-sample independent t test)及卡方檢定(chi-square test)對於是否有代謝症侯族群進行相關變項之分析。再以邏輯斯迴歸分析(logistic regression analysis)多變項分析代謝症候群相關的危險因子。最後以ROC曲線比較各種危險因子預測代謝症候群的敏感性及特異性。結果:本研究共有1312人納入分析,其中包含501位男性(38.19%)與811位女性(61.81%)。平均年齡為42.39±8.9歲。所有研究群體中,223人(16.99%)符合代謝症候群的標準。我們將員工依代謝症候群的有無分成兩組,結果發現年齡、體重、收縮壓、舒張壓、腰圍、三酸甘油脂、腰圍、總膽固醇、高密度膽固醇、尿酸、空腹血糖、血清麩胺酸丙酮酸轉氨基酵素、性別、高血壓病史、糖尿病病史、高血脂病史在兩組均有顯著差異(p<0.05)。經邏輯斯迴歸分析(logistic regression analysis)多變項分析後,發現BMI、收縮壓、空腹血糖、尿酸達統計上意義BMI(OR=1.31, 95% CI 1.23-1.39, p<0.001), SBP(OR=1.04,95% CI 1.03-1.06, p<0.001), FPG(OR=1.06, 95% CI 1.04-1.07, p<0.001), and uric acid (OR=1.35,95% CI 1.12-1.63, p=0.002)最後,我們針對BMI、收縮壓、空腹血糖、總膽固醇、肝指數(血清麩胺酸丙酮酸轉氨基酵素)與尿酸繪製ROC曲線由表三可知,當BMI為26.27(kg/m2);收縮壓為129.50(mmHg);空腹血糖為91.50(mg/dL);總膽固醇為196.50(mg/dL);肝指數為26.50(mg/dL);尿酸為5.950(U/dL)時,分別可作為預測代謝症候群相關指標的最佳切點。結論:本研究顯示此族群中代謝症候群的危險因子為身體質量指數、收縮壓、空腹血糖與血中尿酸值。對於醫療從業人員,需控制相關危險因子,以避免代謝症候群的產生。

並列摘要


Background: Metabolic syndrome is comprised of a clustering of various metabolic abnormalities including hypertension, hyperglycemia, dyslipidemia and obesity. This study analyzes the health check-up data of hospital employees to find out the prevalence of metabolic syndrome and related risk factors. Methods: This is a cross-sectional study, with enrollment of hospital employees in northern Taiwan and collection of their health check-up data. Metabolic syndrome was defined by the revised NCEP/ATPIII criteria from Taiwan Health Promotion Administration. , and all subjects were divided into 2 groups, the normal and metabolic group. T-test and Chi-Square analysis were used to compare the continuous and categorical variables between 2 groups. Multivariate logistic regression analysis was used to establish the relationship between cardiometabolic risk factors and metabolic syndrome Results: Total 1312 hospital employees were included with average age of 42.39 years old. Metabolic syndrome is noted in 223 employees (16.99%). The results showed that Age, body mass index (BMI), blood pressure (BP), waist circumferences(WC),total cholesterol,triglyceride(TG), fasting plasma glucose (FPG), uric acid, Alanine Aminotransferase(ALT), male gender, underlying disease of hypertension, diabetes and hyperlipidemia were significantly higher in the metabolic syndrome group (p<0.05). After adjusting confounding risk factors, multivariate logistic regression analysis revealed that BMI (OR=1.31, 95% CI 1.23-1.39, p<0.001) , SBP (OR=1.04, 95% CI 1.03-1.06, p<0.001), FPG (OR=1.06, 95% CI 1.04-1.07, p<0.001), and uric acid (OR=1.35, 95% CI 1.12-1.63, p=0.002) were independent risk factors for metabolic syndrome. Conclusion: This study showed that in hospital employees, metabolic syndrome is associated with BMI, SBP, FPG and uric acid. For employees with metabolic syndrome, physician should encourage their lifestyle modification and control these risk factors intensively to reduce further cardiovascular events.

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