代謝症候群盛行率的性別差異

Gender Differences in the Prevalence of Metabolic Syndrome

流行病學特徵，女性出現代謝症候群的年齡較晚。過去多數研究僅對40 歲以上民眾作篩檢，缺乏20-39歲成人資料。本研究以自2005 年至2007 年曾在林口長庚醫院健康檢查中心接受自費篩檢的受檢者為對象，年齡在20-95 歲間。目的是估計20 歲以上代謝症候群在一個大型健診族群的盛行率，分析性別及年齡差異。本研究納入33600 筆（92.8％）個案進行分析，平均年齡為50.4 ± 12.6 （20-95）歲。男性共19946 人，平均年齡49.9 ± 12.5 （20-95）歲。女性共13654 人，平均年齡51.1 ± 12.7 （20-90） 歲。共有4455 （13.3％）個案符合代謝症候群定義，分別佔男女性15.1％及10.6％。我們研究結果顯示，隨著年齡增加代謝症候群盛行率就越高。男性代謝症候群的盛行率高於女性，但此差異在60 歲有所轉變，女性代謝症候群的盛行率高於男性。這種性別的差異，可在代謝症候群之三個診斷項目（肥胖、三酸甘油酯偏高）的盛行率及代謝症候群符合診斷項目平均數看到。而高密度脂蛋白膽固醇偏低及高血壓，性別差異的轉變分別在40 歲及70歲。依本研究結果，我們建議成人全面篩檢代謝症候群，男性應於三十歲而女性於四十歲開始。又在健康檢查報告上，應加入代謝症候群的結果，屬多少項目異常，三項以上者應提醒要尋求醫療上的治療，已有兩項代謝症候群診斷項目的民眾也應定期追蹤，早期矯正這些心血管風險因子以改善長期預後。

Metabolic syndrome is a cluster of high cardiovascular risk factors. Gender differences are relevant in metabolic syndrome with females generally experiencing later onset of metabolic syndrome. Most literature has focused on middle to older age groups, but there is a lack of data from the younger adult population. Thus, this study focused on a wider population, ages 20-95. Subjects were those who participated in health examinations in the Chang Gung Memorial Hospital, Linkou Center from 2005 to 2007. The aim of this study was to estimate the age and sex specified rate of metabolic syndrome. A total of 33,600 records (92.8%) were eligible for analysis with a mean age of 50.4±12.6 (20-95) years old. There were 19,946 males with an average age of 49.9±12.5 (20-95) and 13,654 females with an average age of 51.1±12.7 (20-90) years old. A total of 4455 (13.3%) participants fulfilled the definitions of metabolic syndrome (male: 15.1%, female: 10.6%). Our findings show that the prevalence of metabolic syndrome rises with age. The prevalence of metabolic syndrome was higher among males than among females, but such gender differences switch at age 60. Similar gender differences in age-specific rates were seen in three individual components (obesity, elevated triglycerides) and the mean number of fulfilled components. The gender difference switches at age 40 for decreased HDL cholesterol and at age 70 for high blood pressure. Thus, we suggest that large-scale screening for metabolic syndrome should start at age 30 in males and at age 40 in female adults. To reduce the risk of cardiovascular disease, abnormal components of metabolic syndrome should be included in health examination reports. Treatment or lifestyle changes should be recommended for those who fulfill the criteria for metabolic syndrome. For those who have only two abnormal components of metabolic syndrome, periodic follow-up screenings are needed.