臺南市老年人中心型肥胖的盛行率與相關因子之研究

Prevalence of Central Obesity and Associated Factors in Older Adults in Tainan City

目的：過去研究指出肥胖，尤其是中心型肥胖，對於人類的健康有明顯負面的影響，而中心型肥胖在預測疾病的罹患率以及全死因死亡率，都是較佳的預測指標。本研究的目的，在於瞭解台南市老年人中心型肥胖的盛行率，並探討其相關的影響因子。方法：利用分層集束取樣方法，邀請台南市65歲以上老年民眾參與研究。經隔夜空腹，依標準方法測量身高、體重、腰圍及身體脂肪比例。每位分析對象均填寫一份自填結構式問卷，內容包含個人基本資料、生活習慣、過去疾病史及簡式老年憂鬱量表等。男女性分別以腰圍90公分及80公分為切點，分為無中心型肥胖組及中心型肥胖二組。結果：總計1195位65歲以上老年民眾參與研究（男性634位，佔53.1%；女性561位，佔46.9%），平均年齡為72.0±4.9歲（男性：72.3±4.8歲、女性：71.6±4.9歲）。研究對象之中心型肥胖盛行率為58.6%（男性：46.4%、女性：72.4%），女性中心型肥胖之盛行率明顯高於男性（p<0.001）。多因子複邏輯回歸分析所有參與老人發現，年齡、性別、體重及身體脂肪比例（勝算比分別為1.067，54.890，1.554以及1.107，p<0.05）與中心型肥胖呈現有意義的正相關，但身高（勝算比為0.875，p<0.05）則呈現有意義的負相關。進一步分別檢視男女性，發現年齡、體重、身體脂肪比例及糖尿病病史（OR分別為1.100，1.547，1.186以及2.735，p<0.05）與老年女性中心型肥胖呈現有意義的正相關，身高（OR為0.899，p<0.05）則呈現有意義的負相關。體重及身體脂肪比例（OR分別為1.563及1.078，p<0.05）與老年男性中心型肥胖呈現有意義的正相關，身高（OR為0.876，p<0.001）則呈現有意義的負相關。結論：台南市老年人中心型肥胖的盛行率為58.6%，女性明顯多於男性。性別、年齡、身高、體重及身體脂肪比例為影響老年人中心型肥胖的獨立相關因子；影響老年人中心型肥胖的因子因性別不同而異。

Purposes: Previous studies have shown that obesity, especially central obesity, has a tremendous negative impact on human health. Central obesity is well known to be a good predictor for morbidity and mortality due to all causes. The aim of this study was to investigate the prevalence of central obesity and possible associated factors in older people in Tainan City. Methods: People aged 65 or older and living in Tainan City were invited into the study after selection by a stratified cluster sampling method. After the person fasted overnight, we measured body weight (BW), body height (BH), waist circumference (WC) and percent of body fat (BF %) using standard methods. We also obtained information about demographic characteristics, lifestyle, past medical history and the score on the short-form Geriatric Depression Scale (GDS-S) with a structured questionnaire. The subjects were divided into a non-central obesity group (WC<80 cm for women and WC<90cm for men) and a central obesity group (WC≥80 cm for women and WC≥90cm for men). Results: A total of 1195 elderly people aged 65 or over (males 53.1%, female 46.9%, mean age: 72.0±4.9 years) participated in this study. The prevalence of central obesity was 58.6% (46.4% of the men and 72.4% of the women). Multiple logistic regression analysis for all study subjects revealed significantly positive correlations with age, sex, BW and BF% (OR were 1.067, 54.890, 1.554 and 1.107, p<0.05), but a negative correlation with BH (OR was 0.875, p<0.05). Further analysis by gender found that men with central obesity had a higher level of WC, BH, BW and BF% and women with central obesity had a higher percentage of non-depressive tendency and a history of DM history as well as a higher level of WC, BH, BW and BF% than their non-central obesity counterparts. Multiple logistic regression analysis also revealed significantly positive correlations with age, BW, BF% and DM history (OR were 1.100, 1.547, 1.186 and 2.735 respectively, p<0.05), but a negative correlation with BH (OR was 0.899, p<0.05) for females with central obesity. For males with central obesity, this was significantly positively correlated with BW and BF% (OR were 1.563 and 1.078, p<0.05), but negatively correlated with BH (OR was 0.876, p<0.001). Conclusions: The prevalence of central obesity was 58.6% in our study sample and women had a higher prevalence rate of central obesity than did men. Female gender, age, BH, BW and BF % were independent risk factors for central obesity for older people in Tainan city; however, there were also different independent risk factors for each gender.