非肥胖者之代謝症候群盛行率：某醫院健檢資料分析

Metabolic Syndrome in Non-Obese Individuals Seeking Health Examinations

具正常身體質量指數（body mass index; BMI）者亦常有第二型糖尿病、高血壓及高三酸甘油酯血症等代謝性相關疾患，因此本研究擬評估正常體重及過重者（BMI介於18.5-26.9 kg/m2）之代謝症候群及其組成因子的盛行率。從2004年4 月到2005年7 月，以橫斷面研究，分析675位到台中某區域醫院做健康檢查之民眾，平均年齡為48.4±12.0歲，男性佔60.6%，女性佔39.4%。代謝症候群以美國心臟協會／國家心臟、肺臟及血液學會（2006）及亞太修訂版之腰圍為診斷標準。BMI以2.0至2.5增加單位分成4 組，分析其代謝症候群之盛行情形及勝算比。結果顯示，不同性別在4 種BMI類別變項之代謝症候群盛行率為BMI 18.5-20.9 kg/m2者2.4-3.4%、BMI 25.0-26.9 kg/m2者47.6-49.2%。以BMI 18.5-20.9 kg/m2為參考組，男性有代謝症候群之勝算比在BMI21.0-22.9 kg/m2組為4.2（95% CI 0.9-20.1），BMI 23.0-24.9 kg/m2組為9.0（95% CI 2.0-40.4），BMI 25.0-26.9 kg/m2組為22.1（95% CI 4.9-99.4）。在女性方面，勝算比依序為2.3（95% CI 0.5-12.2）、8.0 （95%CI 1.7-38.1）及18.9（95% CI 3.9-90.8）。在健康檢查之正常體重及過重者之代謝症候群盛行率從2.4%至49.2%，且有隨BMI愈大，代謝症候群盛行率愈高之現象，從預防醫學角度而言，家庭醫學科醫師應重視非肥胖者之代謝症候群，為第二型糖尿病及早發性心臟血管疾病的預防做把關。

Diabetes mellitus type 2, hypertension, and hypertriglyceridemia occasionally affect individuals of normal weight. Therefore, the aim of this study was to determine the prevalence of metabolic syndrome and its components in normal-weight or slightly overweight individuals (body mass index [BMI] 18.5-26.9kg/m2). From April 2004 to July 2005, we conducted a cross-sectional study of 409 men and 266 women (mean age±SD 48.4±12.0 years) who underwent a health examination at our general hospital in Taichung, Taiwan. We analyzed the prevalence and odds ratios of metabolic syndrome, as defined by the American Heart Association and the National Heart, Lung, and Blood Institute in 2006. We also measured waist circumferences, as defined in the Asia-Pacific guidelines. The findings were stratified according to BMI and statistically analyzed. The prevalence of metabolic syndrome increased in a graded, sex-dependent fashion from 2.4-3.4% at a BMI of 18.5-20.9kg/m2 to 47.6-49.2% at a BMI of 25.0-26.9kg/m2. After we controlled for age and smoking status, odd ratios for metabolic syndrome were 4.2 (95% CI 0.9-20.1) for men with a BMI of 21.0-22.9kg/m2, 9.0 (95% CI 2.0-40.4) for men with a BMI of 23.0-24.9kg/m2, and 22.1 (95% CI 4.9-99.4) for men with a BMI of 25-26.9kg/m2 compared with men whose BMI was 18.5-20.9kg/m2. Corresponding ORs in women were 2.3 (95% CI 0.5-12.2), 8.0 (95% CI 1.7-38.1), and 18.9 (95% CI 3.9-90.8), respectively. Individuals in the upper normal-weight and overweight ranges of BMI have a relatively high prevalence (2.4-49.2%) and an increased risk of metabolic syndrome. Therefore, family physicians should screen individuals with normal or slightly elevated BMI to help prevent diabetes and cardiovascular disease.