用身體質量指數預測代謝症侯群──以中部某醫院員工為例

Optimal BMI Cutoffs to Predict Metabolic Syndrome among the Employees in a Hospital of Middle Taiwan

目的：以中部某醫院員工為例，評估國內中年人口中，用身體質量指數預測代謝症侯群（包括中心肥胖、高血糖、高血壓、血脂異常）的理想值。並討論在此一族群中，腰圍與其他代謝危險因子的相關性。方法：於2004至2006年間，共收集886名參與健檢的中部某醫學中心員工資料，計男性262名，女性624名，年齡39至63歲。統計代謝症候群的人數及比例，並以敏感度和特異度，以及receiver operating characteristic（ROC） curve方法找出最能預測有無罹患代謝症候群危險的身體質量數值。結果：在886名受試人口中，共107位（12.1%）符合國內代謝症候群的診斷，男性有60位（22.9%），女性有47位（7.5%）。使用身體質量指數來預測是否有代謝症候群存在，男性以25.6 kg/m2為界，敏感度及特異度為74.3%及70.0%（p<0.001）。女性則為24.7 kg/m2，敏感度及特異度為79.2%及79.7%（p<0.001）。在預測兩個以上代謝危險因子的腰圍評估，男性人口以83公分為界，敏感度及特異度為71.5%及72%（p<0.001）。女性人口以74.5公分為界，敏感度及特異度各為75.7%及75.2%（p<0.001）。以上身體質量指數結果低於目前國內肥胖定義，而腰圍亦低於代謝症侯群的標準。結論：關於台灣區的中年人口的身體質量指數及腰圍與代謝症侯群之相關性，本研究之結果較目前國內頒布標準為低。可供基層醫師參考，以期能早期發現代謝危險因子存在，預防代謝症候群的發生。

Objectives: We evaluated the body mass index (BMI) cutoffs for predicting metabolic syndrome and the association between waist circumference and metabolic factor accumulation in the employees in a hospital of middle Taiwan. Methods: We collected data of 886 Taiwanese, who worked in a medical center in middle Taiwan, including 262 men and 624 women, aged 39-63 years (with a mean age of 47.7±5.7 years in men, women 44.4±4 years in women). A BMI cutoff point as a predictor for 3 or more criterion of metabolic syndrome was evaluated by sensitivity/specificity and a receiver operating characteristic (ROC) curve. In addition to, we analyzed the association between waist circumference cutoff point and other metabolic risk factor accumulation. Conclusion: We evaluated BMI and waist circumference for predicting metabolic risk factors in the employees in a medical center in middle Taiwan. The result may offer a reference for the primary physician in screening metabolic risk for the middle-aged population in Taiwan. Results: The optimal point was estimated as being 25.6kg/m2 of BMI in men and 24.7kg/m2 in women for predicting metabolic syndrome. A waist circumference cutoff 83cm in men and 74.5cm in women was an optimal value for predicting metabolic risk factor accumulation.