以體位測量指標預測中年婦女罹患冠狀動脈疾病之研究

Anthropometric Indicators as Predictors of Coronary Artery Disease among Middle Aged Women

背景：女性心血管疾病的死亡率逐年上升，近十年來，心臟病一直是女性國人死因的第二位。先前研究結果顯示，體位測量指標：包括身體質量指數（body mass index, BMI）、腰圍（waist circumference, WC）、腰臀比（waistto hip ratio, WHR）、腰高比（waist to height ratio, WHtR）、體脂肪率（body fat percentage, BF％）可有效的預測冠狀動脈疾病（coronary artery disease, CAD）的發生，但因研究的年齡族群不同，其預測因子不盡相同，國內至今並無研究針對中年婦女進行探討。目的：本研究目的在探討預測中年婦女罹患CAD之體位測量指標。方法：本研究選取台北某醫學中心接受心導管檢查之中年婦女為受試對象，經心導管檢查證實冠狀動脈血管有一條（含一條以上）阻塞大於或等於50％以上則定義為CAD，未達以上標準者則歸為non CAD，此外並收集非住院之健檢部門個案為健檢組。共選取符合收案條件且接受心導管檢查之94位中年婦女為受試對象，並依心導管檢查結果將個案分為CAD組（n=52）和non CAD組（n=42）。另收取非住院之健檢個案為健檢組（n=41）。分別進行五項體位指標的測量，包括BMI、WC、WHR、WHtR、BF%。以One way ANOVA、邏輯斯迴歸分析等進行資料分析。結果：本研究個案平均年齡為54.3±6.9歲，體位測量指標數值平均值BMI 25.6 ±4.6 kg/m2，WC為79.8±11.3公分，WHR為0.84±0.08，WHtR為0.51 ±0.08，BF%為32.5±5.8％。CAD組與non CAD組在WC、WHR、WHtR皆顯著高於健檢組（p<0.0001），在校正干擾變項後，WHR是發生CAD的主要預測因子。結論：WHR是預測中年婦女罹患CAD的重要體位測量指標之一，這個測量方式經濟、簡單又方便，值得推廣並應用於臨床。

Background: The mortality rate of cardiovascular disease in females are rising every year, and has been thesecond leading cause of death in the female population. Previous studies report that body mass index (BMI), waistcircumference (WC), waist to hip ratio (WHR), waist to height ratio (WHtR), and body fat percentage (BF%) mayeffectively predict the incidence of CAD. However, due to different age, gender and race, the predictors of CAD weredifferent. So far, no study discusses the topic on the middle aged women in Taiwan.Purpose: The aim of this study was to examine the anthropometric indicators that may predict CAD amongmiddle aged women.Methods: Ninety-four middle-aged women who had undergone cardiac catheterization examinations and met theselection criteria were chosen. Based on the examination results, subjects were divided into CAD group (n = 52) andnon-CAD group (n = 42). Forty-one healthy subjects who received health examination were invited to participate in thisstudy. Five anthropometric indicators, including BMI, WC, WHR, WHtR, and BF% were measured. One way ANOVAand logistic regressions were used for data analysis.Results: The mean age of the subjects was 54.3±6.9 years old, with BMI 25.6 ±4.6 kg/m2, WC 79.8±11.3 cm,WHR 0.84±0.08, WHtR 0.51 ±0.08, and BF% 32.5±5.8%. The values of WC, WHR and WHtR were significantlyhigher in both CAD and non CAD groups than the healthy group. WHR was a significant predictor of CAD after theconfounding factors were adjusted.Conclusion: WHR was a significant anthropometric predictor of CAD in middle aged women. The measurementof WHR is economical, simple and convenient, and worth recommending for clinical use.