题名

某電子工廠員工中央型肥胖與心血管代謝相關因子間的關聯性研究

并列篇名

Correlation between Central Obesity and Cardio-Metabolic Ciated Factors at an Electronic Factory

DOI

10.7023/TJFM.200806.0100

作者

陳昭源(Jau-Yuan Chen);林忠順(Chung-Shiang Lin);羅錦泉(Jiin-Chyuan Luo)

关键词

central obesity ; waist circumference ; high sensitivity C-reactive protein ; homocysteine ; lipoprotein a

期刊名称

台灣家庭醫學雜誌

卷期/出版年月

18卷2期(2008 / 06 / 01)

页次

100 - 110

内容语文

繁體中文

中文摘要

本研究目的在瞭解中央型肥胖與新陳代謝之相關因子以及心血管疾病獨立預測因子(同半胱胺酸、脂蛋白(a)、高敏感度C-反應蛋白)間的相關性。肥胖是很普遍的健康問題,肥胖易引發高血壓、糖尿病、高血脂症、胰島素阻抗⋯等新陳代謝性疾病,這些不良影響,使其易造成動脈硬化,因而更容易罹患心血管疾病,尤其是中央型肥胖的人,不但因肥胖引起併發症的比率更高,更是罹患心血管疾病的高危險群。我們以某年度某電子工廠中35歲以上的作業員工爲研究的對象,共計有1,202位員工,其中男性員工有584位,女性員工有618位,平均年齡爲39.9±4.0歲。本研究爲橫斷性研究,研究樣本中中央型肥胖者有223人,其中男性員工中有23.8%是中央型肥胖者,女性員工中有13.6%是中央型肥胖者,男性及女性平均腰圍分別爲83.9±7.9公分及71.8±7.9公分。分析結果發現,不論是單變項分析或是多變項迴歸分析,腰圍過粗者在新陳代謝相關因子如血壓,膽固醇,三酸甘油酯,空腹血糖,高密度脂蛋白膽固醇,以及尿酸等皆達統計上之顯著相關,而在與心血管疾病獨立預測因子間的相關性中,則腰圍過粗者亦較腰圍正常者有較高之高敏感度C-反應蛋白異常率,而且危險對比值高達4.5倍。因爲腰圍能反映出代謝異常及心血管疾病的危險程度,所以家庭醫師於執行健康檢查時,除了身高體重等基本項目,應測量腰圍,讓民眾能及早預防,遠離代謝性疾病及心血管疾病之威脅。

英文摘要

The aim of this study was to determine the correlation between central obesity and related metabolic factors, such as the current independent predictors of cardiovascular disease (high sensitivity C-reactive protein, homocysteine, and lipoprotein-a). Obesity is a common health problem and its harmful effects promote metabolic diseases, such as hypertension, diabetes, hyperlipidemia, and insulin resistance. Obesity also has a critical effect on atherosclerosis that exacerbates cardiovascular disease, especially in those patients who have central obesity. Five hundred eighty-four male and six hundred aighteen female operators who were above 35 years of age were selected from an electronic factory to participate in the study. The total study population was 1,202 operators and the average age was 39.9±4.0 years. This was a cross-section study. Two hundred twenty-three subjects had central obesity (23.8% of the males and 13.6% of the females). The average waist circumference in males and females were 83.9± 7.9 and 71.8±7.9 cm, respectively. Whether univariate or multiple logistic regression analysis was used for statistical analyses, metabolic factors (blood pressure, fasting plasma glucose, cholesterol, triglycerides, HDL, and uric acid) had a significant positive correlation with waist circumference. The correlation with current independent predictors for cardiovascular disease revealed that operators with larger waist circumferences had higher high sensitivity C-reactive protein levels than operators with a normal waist circumference, and the odds ratio was up to 4.5 times. Since waist circumference can reflect the degree of risk for cardiovascular disease and metabolic dysfunction, family physicians performing physical examinations should not only measure heights and weights, but also the waist circumference. In so doing, metabolic disorders and cardiovascular disease can be prevented.

主题分类 醫藥衛生 > 社會醫學
参考文献
  1. 行政院衛生署國民健康局網站
  2. Boushey CJ,Beresford SA,Omenn GS(1995).A quantitative assessment of plasma homocysteine as a risk factor for vascular disease. Probable benefits of increasing folic acid intakes.JAMA,13,274.
  3. De Craen AJM,Stott DJ,Westendorp RGJ(2006).Homocysteine, B Vitamins, and Cardiovascular Disease.NEJM,355,205.
  4. Dobbelsteyn CJ,Joffres MR,MacLean DR,Flowerdew G(2001).A comparative evaluation of waist circumference, waist-to-hip ratio and body mass index as indicators of cardiovascular risk factors. The Canadian Heart Health Surveys.Int J Obes Relat Metab Disord,25,652-661.
  5. Doetsch K,Roheim PS,Thompson JJ(1991).Human lipoprotein (a) quantified by `capture` ELISA.Ann Clin Lab Sci,21,216-218.
  6. Dukat A,Lietava J,Krahulec B(2007).The prevalence of abdominal obesity in Slovakia.The IDEA Slovakia study Vnitr Lek,53,326-330.
  7. Erren M,Reinecke H,Junker R(1999).Systemic inflammatory parameters in patients with atherosclerosis of the coronary and peripheral arteries.Arterioscler Thromb Vasc Biol,19,2355-2363.
  8. Genest JJ,Jenner JL,McNamara JR(1991).Prevalence of lipoprotein(a) excess in coronary artery disease.Am J Cardiol,67,1039-1045.
  9. Haffner S(2006).Relationship of metabolic risk factors and development of cardiovascular disease and diabetes.Obesity,14,121-127.
  10. Himes CL(2000).Obesity, disease, and functional limitation in later life.Demography,37,73-82.
  11. Hu FB(2007).Obesity and mortality: watch your waist, not just your weight.Arch Intern Med,167,875-876.
  12. Jaar BG(2007).Novel and traditional cardiovascular risk factors for peripheral arterial disease in incident-dialysis patients.Adv Chronic Kidney Dis,14,304-313.
  13. James PT,Leach R,Kalamara E,Shayeghi M(2001).The worldwide obesity epidemic. Section I: Obesity, the major health issue of the 21st century.Obes Res.
  14. Kannel William B(2002).Coronary heart disease risk factors in the elderly.Am J Geriatric Cardiol,11,101-107.
  15. Kullo IJ,Ballantyne CM(2005).Conditional risk factors for atherosclerosis.Mayo Clin Proc,80,219-230.
  16. May J,Bucaman E(2007).The role of disease management in the treatment and prevention of obesity with associated co-morbidities.Dis Manag,10,156-163.
  17. Merz B(1989).Is it time to include lipoprotein analysis in cholesterol screening. Medical news and perspectives.JAMA,261,496-497.
  18. Musunuru K,Blumenthal RS,Ridker PM(2007).Biomarkers for Prediction of Cardiovascular Events.NEJM,356,1472-1475.
  19. Nash DT(2005).Relationship of C-reactive protein, metabolic syndrome and DM: potential role of statins.J Natl Med Assoc,97,1600-1607.
  20. R. Clarke,Collins, Lewington(2002).Homocysteine and Risk of Ischemic Heart Disease and Stroke.JAMA,288,2015-2022.
  21. Ridker PM(2007).C-reactive protein and the prediction of cardiovascular events among those at intermediate risk: moving an inflammatory hypothesis toward consensus.J Am Coll Cardiol,49,2129-2138.
  22. Ridker PM,Rifai N,Clearfield M(2001).Measurement of C-Reactive Protein for the Targeting of Statin Therapy in the Primary Prevention of Acute Coronary Events.NEJM,344,1019-1059.
  23. Ridker PM,Rifai N,Rose L(2002).Comparsion of C-Reactive Protein and lowdensity lipoprotein cholesterol levels in the prediction of first cardiovascular events.NEJM,347,1557-1565.
  24. Rosenbaum M,Leibel RL,Hirsch J(1997).Obesity.NEJM,337,396.
  25. Selhub J,Jacques PF,Bostom AG(1995).Association between Plasma Homocysteine Concentrations and Extracranial Carotid-Artery Stenosis.NEJM,332,286.
  26. Shah PK(1999).Plaque disruption and thrombosis: potential role of inflammation and infection.Cardiol Clin,17,271-281.
  27. Sowers JR.(2003).Obesity as a cardiovascular risk factor.Am J Med.,115,37-41.
  28. Stein JH(1997).Lp (a) excess and coronary heart disease.Arch Intern Med,157,1170-1176.
  29. Turcato E(1994).Waist circumference and abdominal sagittal diameter: best simple anthropometric indexes of abdominal visceral adipose tissue accumulation and related cardiovascular risk in men and women.Am J Cardiol,73,460-468.
  30. Urek R,Crncevin-Urek M,Cubrilo-Turek M(2007).Obesity, a global public health problem.Acta Med Croatica,61,161-164.
  31. World Health Organization(1997).Prevention and managing the Global Epidemic.Geneva:WHO Consultation On obesity.
  32. World Health Organization.The Asia-Pacific perspective: redefining obesity and its treatment 2000.
被引用次数
  1. 呂萬安、吳淑禎(2015)。大專青年腰圍與血脂肪、血液流體力學之相關性研究。中醫藥研究論叢,18(1),13-26。