公共運輸使用頻率與代謝症候群檢查結果異常相關性之多層次分析

Correlation between frequency of public transportation use and abnormal metabolic syndrome screening results: a multilevel analysis

目標：使用公共運輸需步行或騎車往返車站，可增加身體活動量，但其與代謝症候群之關聯仍未明。本研究探討台灣40歲以上成人公共運輸使用頻率與代謝症候群檢查異常的關聯。方法：本研究採橫斷性研究設計，結合2022年成人預防保健服務1,146,485筆健檢結果與交通部日常運具調查作為研究材料。自變項每人每週公共運輸使用時間，依五分位數分為五組。依變項為代謝症候群檢查是否異常。採二元邏輯斯迴歸分析並且結合隨機截距，調整個人層級與區位層級潛在干擾因子，並計算勝算比與95%信賴區間。結果：研究樣本中共335,187人（29.24%）檢查結果異常。與每週公共運輸使用時間極少相比，使用時間最長者代謝症候群異常勝算比顯著較低（adjusted odds ratio（aOR）= 0.98，95% confidence interval（CI）: 0.96-0.99）。以每週使用時間增加10分鐘分析，檢查結果異常勝算比下降1%（aOR= 0.99，95% CI: 0.99–0.99）。結論：經常使用公共運輸者之代謝症候群異常風險較低，顯示公共運輸可能透過增加身體活動量具健康效益。未來可以縱貫性研究與客觀測量進一步驗證。

Objectives: Using public transportation frequently involves physical activity such as walking or cycling to and from stations. However, the association between using public transportation and metabolic syndrome remains unclear. The present study examined the association between public transportation use and abnormal metabolic syndrome screening results in adults aged≥40 years in Taiwan. Methods: This cross-sectional study evaluated 1,146,485 health examination records from the 2022 Adult Preventive Health Services Survey and data from the Ministry of Transportation’s Daily Transport Survey. The independent variable in this study was average time spent using public transportation per week per person, categorized into quintiles. The dependent variable was metabolic syndrome screening results. A binary logistic regression with random intercept was conducted to adjust for individual-level and area-level confounders, and adjusted odds ratios (aORs) with 95% confidence intervals (CIs) were calculated. Results: In the study population, 335,187 individuals (29.24%) received a routine screening for metabolic syndrome that revealed abnormal results. Compared with the individuals who minimally used public transportation, those who frequently used it had significantly lower odds of abnormal screening results (aOR = 0.98, 95% CI: 0.96–0.99). Furthermore, each additional 10 min of weekly public transportation use was associated with a 1% reduction in the odds of abnormal screening results (aOR = 0.99, 95% CI: 0.99–0.99). Conclusions: Frequent public transportation use is associated with a substantially reduced risk of abnormal metabolic syndrome screening results, and those who use public transportation frequently likely achieve this health benefit through increased physical activity. Future longitudinal studies using objective activity-level measurements are required to validate these results.