以病例對照研究探討大台北地區痛風飲食及非飲食危險因子

To explore the dietary and lifestyle risk factors associated with gout by caes-control study.

徐繼蔭(CHI-YIN SHU)

指導教授 ： 盧立卿

國立臺灣師範大學/教育學院/家政教育學系/碩士(1999年)

摘要

摘要
本研究以病例對照研究法探討大台北地區痛風男性其飲食及非飲食危險因子。自民國八十七年七月至八十八年八月於台北市立和平醫院痛風門診及痛風患者工作場所之同事，選取年齡介於20-70歲、家中有電話可連絡且居住於大台北地區的男性236位，以自行發展的結構式問卷與受訪個案進行面對面的訪談以收集資料。經由查閱病歷後，選取92位初診痛風男性與92位非痛風男性問卷資料進行統計分析。結果顯示，病例組之收縮壓、舒張壓、腰圍、臀圍、三頭肌皮層厚度、每月應酬頻率次數(p=0.043)、家族痛風史與家族糖尿病史均高於對照組且達顯著差異。對照組之每月食用蔬菜次數與每月食用水果次數高於病例組且達顯著差異(p=0.0174，p=0.0350)。分析飲食及營養素相關指標後發現，對照組之鈣、鐵、葉酸、維生素C攝取量均高於病例組，而病例組的酒精攝取量顯著高於對照組(p=0.0216)。對數迴歸分析於控制年齡、家族痛風史、家族糖尿病史、教育程度、收縮壓後，結果指出高腰圍組(>84公分)比低腰圍組得痛風危險性提高1.4倍(OR=2.414)。此外，飲食中富含鐵、葉酸及總膳食纖維的食物來源為痛風可能的保護因子(OR=0.003，OR=0.0024，OR=0.0193)。本研究的結論包括酒精為痛風最主要的危險因子;富含總膳食纖維與葉酸的食物可能為痛風的保護因子;並發現腰圍與罹患痛風比體重、三頭肌皮層厚度及身體質量指數的相關性更為顯著。

關鍵字

痛風 ； 病例對照研究 ； 二十四小時飲食回憶問卷 ； 半定量飲食頻率問卷 ； 腰圍 ； 飲食

並列摘要

Abstract
The purpose of this case-control study was to explore potential dietary and lifestyle risk factors associated with gout. Between 1998-1999, we contacted 236 volunteers from the Gout Clinic in Taipei Municipal Ho-Ping Hospital and volunteers’ coworkers for this study. We conducted face-to-face interviews to collect dietary and lifestyle information by structured questionnaires. Final 92 male patients with gout and 92 controls without gout were included in the analysis.
The results showed that systolic blood pressure, diastolic blood pressure, waist girth, hip girth , triceps skinfold, the times of social dinner events after work were significantly higher in cases than controls. Family history of gout and diabetes mellitus were positively correlated with gout. Consumption of vegetables and fruits were significantly lower in cases than controls. Calcium, iron , folic acid and vitamin C intakes were lower in cases than controls. However, alcohol consumption was significantly higher in cases than controls.
Logistic regression analyses showed that hip girth, waist-hip ratio and systolic blood pressure increased risks for gout. The food sources rich in iron, vitamin B2 , vitamin C and folic acid may be protective for gout .After controlling for covariates including age, family history of gout and diabetes mellitus , education level and systolic blood pressure , we found high waist girth group (>84cm) showed an OR=2.414 compare to the lower group(<84cm). In addition, we found total dietary fiber, iron and folic acid may be protective.
In conclusion, this case-control study in Taiwan confirm that alcohol is the most significant risk for gout. Dietary factors such as total dietary fiber and folic acid may be protective. Waist girth shows a more significant effect than body weight, triceps skinfold and body mass index with gout occurrence .

並列關鍵字

gout ； case-control study ； twenty-four hours dietary recall questionnaire ； semi-quantitative frequency questionnaire ； waist girth ； diet

參考文獻

ARRAY(0x9fa68ec)