內臟脂肪分析與勞動部法規健康檢查項目之關聯性-以北部某區域為例

內臟脂肪的危害併發症是從頭到腳，由腦血管、甲狀腺、心血管、腹部肥胖、腎上腺、乳房、卵巢、內分泌、深層靜脈血栓、糖尿病、高血壓、慢性肝病、慢性腎臟病。利用勞工健康檢查中勞動部法規檢查項目，篩選出與慢性病較為相關之15個自變數及健康檢查紀錄問卷內容，問卷包含作業經歷(每週工時)、生活習慣(睡眠品質、吸菸、喝酒、嚼食檳榔)，找出控制依變數內臟脂肪相關因子做探討分析。以多元迴歸統計並經過檢定分析，共10項具顯著性的自變數；推論身體各系統相互關聯，不是單一自變數能決定造成內臟脂肪之重要性。利用主成分分析找出貢獻度最大的特徵類別指標，來預測內臟脂肪正相關性，影響力最大為質量類(體重、腰圍、身體質量指數)，造成腹部內臟脂肪推積。血壓類(舒張壓、收縮壓)當肥胖造成內臟脂肪推積，分泌許多脂肪細胞素，造成慢性發炎、易導致血壓高、血管彈性硬化。次要為壞脂類(低密度脂蛋白膽固醇、總膽固醇、三酸甘油酯)，皆與肥胖、內臟脂肪推積具顯著相關性。控制壞脂類即可控制其他相關變數(血清丙酮酸轉移酶、空腹血糖、肌酸酐)，減少身體各器官功能彼此受損影響。生活習慣研究其吸菸對內臟脂肪具有正向影響，有吸菸習慣者比較無吸菸者增加約12.72 cm²內臟脂肪面積。本研究結果可運用於民眾對內臟脂肪控制與認識，落實於日常生活健康促進，定期量腰圍、血壓、控制三高；可善用國健署成人預防保健，預防新陳代謝疾病、心血管慢性病等健康問題。

關鍵字

內臟脂肪分析；體重；腰圍；身體質量指數；吸菸

並列摘要

Visceral fat accumulation is a significant risk factor for cardiovascular diseases and various metabolic complications affecting multiple organs, including the thyroid, adrenal glands, kidneys, liver, breasts, and ovaries. Using data from the workers’health examination required by Ministry of Labor consisting of a detailed questionnaire (on weekly working hours and lifestyle habits), we selected 15 independent variables related to chronic diseases. We aimed to determine and analyze the control dependent variable factors of visceral fat. Based on multiple regression statistics and test analysis, we found ten significant independent variables. No single independent variable contributed to the overall effect and importance of visceral fat, considering the complex pathophysiology of visceral fat involved in metabolic disorders. We used principal component analysis (PCA) to identify the best predictive disease group to identify a positive correlation with visceral fat accumulation. The most significant group was the “Body mass group”, including weight, waist circumference, and body mass index that were resulted from the accumulation of abdominal fat. “Blood pressure group”, including systolic and diastolic blood pressure, was also strongly associated due to the increased arterial stiffness and other direct effects from visceral fat secretion adipokines. The second group is the “Lipid group”: consisting of low-density lipoprotein cholesterol, total cholesterol and triglycerides. All had a strong association with obesity and visceral fat accumulation. Improving these lipid profiles can help control other related variables such as SGPT, fasting glucose, and creatinine since visceral fat's impact was reduced. We also found that smokers had increased visceral fat 12.72 cm² accumulation compared to non-smokers. This study provides insights into the impact of visceral fat accumulation and helps understand and manage visceral fat. Frequent monitoring of waist circumference, blood pressure, fasting glucose, and lipid profiles by performing regular health examinations in adults will prevent metabolic diseases and future cardiovascular diseases.