题名

代謝症候群與其相關因子之研究-健檢資料分析

并列篇名

A Study on Related Factors of the Metabolic Syndrome: Based on Health Screening Data

DOI

10.7023/TJFM.200606.0112

作者

蔡崇煌(Chung-Huang Tsai);黃素雲(Su-Yun Huang);林高德(Gau-De Lin)

关键词

metabolic syndrome ; alanine aminotransferase ; uric acid ; bilirubin ; body mass index

期刊名称

台灣家庭醫學雜誌

卷期/出版年月

16卷2期(2006 / 06 / 01)

页次

112 - 122

内容语文

繁體中文

中文摘要

代謝症候群的重要性是其可預測未來發生第二型糖尿病及心臟血管疾病,因此代謝症候群操作性定義之出現,對預防醫學而言,提供了一大利器。目前之研究發現有些實驗室檢查結果與胰島素阻抗性及慢性次臨床炎症有關,可見其可能亦與代謝症候群有相關。本研究從2004年3月至12月間,以台中市某區域醫院自費健康檢查之成人居民為對象,分析某些自費健康檢查常用的實驗室檢查結果與代謝症候群的關聯性,共收集有效樣本821人,其中男性有520人(63.3%)。結果顯示符合代謝症候群標準者有178人(21.7%),其中男生有118人(22.7%),女生有60人(19.9%)。基本資料及實驗室檢查與代謝症候群之關聯以卡方檢定,結果發現年齡、身體質量指數、腹部肥胖、肝膽功能、腎功能及尿酸指數與代謝症候群之相關達統計學上的意義,但總黃膽指數與代謝症候群呈負相關。進一步以逐步邏輯斯複迴歸分析,結果發現年齡越大、有抽菸習慣者、丙胺酸胺基轉化酶、高尿酸血症異常者、身體質量指數越大者與代謝症候群呈正相關,而總黃膽指數與其呈負相關。因此,在健檢中發現有抽菸習慣、年齡較大、身體質量指數較大者、或有丙胺酸胺基轉化酶及尿酸異常者,除了例行性處置外,建議應注意其是否有符合代謝症候群之危險指標。

英文摘要

The importance of the metabolic syndrome is to predict the intentioned development of type 2 diabetes mellitus and cardiovascular disease, so does its working definition to the career of prevention medicine. Some laboratory data revealed the association of insulin resistance and chronic subclinical inflammation with the metabolic syndrome, so they could be associated with the metabolic syndrome. The aim of the present study was to analyze the association of some common used laboratory data with the metabolic syndrome from March to December 2004 from the residents of health inspection of a regional hospital at Taichung. A total of 821 subjects with 63.3% male were analyzed. There were 178 subjects (21.7%) with 118 male (22.7%) and with 60 female (19.9%) matched the definition of the metabolic syndrome. Chi-square analyzed the association of demographic data with the metabolic syndrome, the result revealed age, body mass index, abdominal obesity, hepatobiliary enzyme, renal enzyme and uric acid being associated with the metabolic syndrome, but it was negative correlation of total bilirubin. Stepwise multiple logistic regression further analyzed age, body mass index, smoking, alcohol consumption and laboratory data with the metabolic syndrome, it revealed those who were elderly subjects, smoking, abnormal alanine aminotransferase, high uric acid, and increased body mass index were positive correlation with the metabolic syndrome, but total bilirubin was negative correlation with it. Besides normal treatment of the diseases, doctors should care more about the related markers of the metabolic syndrome, if they were the ones of above mentioned abnormal data found at health inspection department.

主题分类 醫藥衛生 > 社會醫學
参考文献
  1. 謝俊德、林雅芬、陳民虹、楊日昇(2004)。七十歲以上老人新陳代謝症候群的相關指標及盛行狀況-健檢資料分析。台灣家醫誌,14,184-192。
    連結:
  2. Aengevaeren WR(1999).Beyond lipids-the role of the endothelium in coronary artery disease.Atherosclerosis,147,11-6.
  3. Anonymous(2001).Executive summary of the Third Report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III).JAMA,285,2486-2497.
  4. Becker BF(1993).Towards the physiological function of uric acid.Free Radio Biol Med,14,615-631.
  5. Chuang SY,Chen CH,Tsai ST,Chou P(2002).Clinica identification of the metabolic syndrome in Kinmen.Acta Caridol Sin,18,16-23.
  6. Dallongeville J,Cottel D,Ferrières J(2005).Household income is associated with the risk of metabolic syndrome in a sex-specific manner.Diabetes Care,28,409-415.
  7. Ford ES,Giles WH,Dietz WH(2002).Prevalence of the metabolic syndrome among US adults: findings from the third National Health and Nutrition Examination Survey.JAMA,287,356-359.
  8. Garcia Puig J,Mateos FA(1994).Clinical and biochemical aspects of uric acid overproduction.Pharm World Sci,16,40-54.
  9. Grundy SM,Brewer HB,Cleeman JI(2004).Definition of metabolic syndrome: Report of the National Heart, Lung, and Blood Institute/American Heart Association conference on scientific issues related to definition.Circulation,109,433-438.
  10. Hanley AJG,Williams K,Festa A(2004).Elevations in markers of liver injury and risk of type 2 diabetes: the insulin resistance atherosclerosis study.Diabetes,53,2623-2633.
  11. Inoue S,Zimmet P,Caterson I(2000).The Asia-Pacific perspective: redefining obesity and its treatment.Australia:Health Community Australia.
  12. Isomaa B,Lahti K,Almgren P(2001).Cardiovascular morbidity and mortality associated with the metabolic syndrome.Diabetes Care,24,683-689.
  13. Jonas MM(2004).Nonalcoholic fatty liver disease.Adolescent Medicine Clinics,15,159-173.
  14. Kaplan NM(1989).The deadly quartet: upper body obesity, glucose intolerance, hypertriglyceridemia, and hypertension.Arch intern Med,149,1541-20.
  15. Lakka HM,Laaksonen DE,Lakka TA(2002).The metabolic syndrome and total and cardiovascular disease mortality in middleaged men.JAMA,288,2709-2716.
  16. Lambert M,Delvin EE,Paradis G(2004).C-reactive protein and features of the metabolic syndrome in a population-based sample of children and adolescents.Clin Chem,50,1762-1769.
  17. Lindsay RS,Krakoff J,Hanson RL,Bennett PH,Knowler WC(2001).Gamma globulin levels predict type 2 diabetes in the Pima Indian population.Diabetes,50,1598-1603.
  18. Maison P,Day NE,Byrne CD(2001).Do difference dimensions of the metabolic syndrome change together over time?.Diabetes care,24,1758-1763.
  19. Marchesini G,Brizi M,Bianchi G(2001).Nonalcoholic fatty liver disease: A feature of the metabolic syndrome.Diabetes,50,1844-1850.
  20. Marette A(2002).Mediator of cytokine-induced insulin resistance in obesity and other inflammatory settings.Curr Opin Clin Nutr Metab Care,5,377-383.
  21. Maxwell AJ,Bruinsma KA(2001).Uric acid is closely linked to vascular nitric oxide activity: evidence for mechanism of association with cardiovascular disease.J Am Coll Cardiol,38,1850-1858.
  22. Nakanishi N,Suzuki K,Tatara K(2004).Serum [gamma]-Glutamyltransferase and risk of metabolic syndrome and type 2 Diabetes in middle-aged Japanese men.Diabetes Care,27,1427-1432.
  23. Niskanen LK,Laaksonen DE,Nyyssönen K(2004).Uric acid level as a risk factor for cardiovascular and all-cause mortality in middle-aged men: a prospective cohort study Arch Intern Med,164,1546-1552.
  24. Rana JS,Monraats PS,Zwinderman AH(2005).Metabolic Syndrome and Risk of Restenosis in Patients Undergoing Percutaneous Coronary Intervention.Diabetes Care,28,873-877.
  25. Reaven GM(1998).Role of insulin resistance in human disease.Diabetes,37,1595-1607.
  26. Reunanen A,Takkunen H,Knekt P(1982).Aromaa A: Hyperuricemia as a risk factor for cardiovascular mortality.Acta Med Scand Suppl,668,49-59.
  27. Ross R(1999).Atherosclerosis: an inflammatory disease.N Engl J Med,340,115-126.
  28. Sattar N,Scherbakova O,Ford I(2004).Elevated alanine aminotransferase predicts new-onset type 2 diabetes independently of classical risk factors, metabolic syndrome, and C-reactive protein in the west of Scotland coronary prevention study.Diabetes,53,2855-2860.
  29. Teli MR,James OF,Burt AD,Bennett MK,Day CP(1995).The natural history of non-alcoholic fatty liver: a follow-up study.Hepatology,22,1714-1719.
  30. Tong PC,Lee KF,So WY(2004).White blood cell count is associated with macroand microvascular complications in Chinese patients with type 2 diabetes.Diabetes Care,27,216.
  31. Unger RH(2003).Minireview: weapons of lean body mass destruction: the role of ectopic lipids in the metabolic syndrome.Endocrinology,144,5159-5165.
  32. Vozarova B,Stefan N,Lindsay RS(2002).High alanine aminotransferase is associated with decreased hepatic insulin sensitivity and predicts the development of type 2 diabetes.Diabetes,151,1889-1896.
  33. 行政院衛生署(2004)。成人健康體位挑戰1824。台北:行政院衛生署。