某電子工廠員工中央型肥胖與心血管代謝相關因子間的關聯性研究

Correlation between Central Obesity and Cardio-Metabolic Ciated Factors at an Electronic Factory

本研究目的在瞭解中央型肥胖與新陳代謝之相關因子以及心血管疾病獨立預測因子（同半胱胺酸、脂蛋白(a)、高敏感度C-反應蛋白）間的相關性。肥胖是很普遍的健康問題，肥胖易引發高血壓、糖尿病、高血脂症、胰島素阻抗等新陳代謝性疾病，這些不良影響，使其易造成動脈硬化，因而更容易罹患心血管疾病，尤其是中央型肥胖的人，不但因肥胖引起併發症的比率更高，更是罹患心血管疾病的高危險群。我們以某年度某電子工廠中35歲以上的作業員工為研究的對象，共計有1,202位員工，其中男性員工有584位，女性員工有618位，平均年齡為39.9±4.0歲。本研究為橫斷性研究，研究樣本中中央型肥胖者有223人，其中男性員工中有23.8%是中央型肥胖者，女性員工中有13.6%是中央型肥胖者，男性及女性平均腰圍分別為83.9±7.9公分及71.8±7.9公分。分析結果發現，不論是單變項分析或是多變項迴歸分析，腰圍過粗者在新陳代謝相關因子如血壓，膽固醇，三酸甘油酯，空腹血糖，高密度脂蛋白膽固醇，以及尿酸等皆達統計上之顯著相關，而在與心血管疾病獨立預測因子間的相關性中，則腰圍過粗者亦較腰圍正常者有較高之高敏感度C-反應蛋白異常率，而且危險對比值高達4.5倍。因為腰圍能反映出代謝異常及心血管疾病的危險程度，所以家庭醫師於執行健康檢查時，除了身高體重等基本項目，應測量腰圍，讓民眾能及早預防，遠離代謝性疾病及心血管疾病之威脅。

The aim of this study was to determine the correlation between central obesity and related metabolic factors, such as the current independent predictors of cardiovascular disease (high sensitivity C-reactive protein, homocysteine, and lipoprotein-a). Obesity is a common health problem and its harmful effects promote metabolic diseases, such as hypertension, diabetes, hyperlipidemia, and insulin resistance. Obesity also has a critical effect on atherosclerosis that exacerbates cardiovascular disease, especially in those patients who have central obesity. Five hundred eighty-four male and six hundred aighteen female operators who were above 35 years of age were selected from an electronic factory to participate in the study. The total study population was 1,202 operators and the average age was 39.9±4.0 years. This was a cross-section study. Two hundred twenty-three subjects had central obesity (23.8% of the males and 13.6% of the females). The average waist circumference in males and females were 83.9± 7.9 and 71.8±7.9 cm, respectively. Whether univariate or multiple logistic regression analysis was used for statistical analyses, metabolic factors (blood pressure, fasting plasma glucose, cholesterol, triglycerides, HDL, and uric acid) had a significant positive correlation with waist circumference. The correlation with current independent predictors for cardiovascular disease revealed that operators with larger waist circumferences had higher high sensitivity C-reactive protein levels than operators with a normal waist circumference, and the odds ratio was up to 4.5 times. Since waist circumference can reflect the degree of risk for cardiovascular disease and metabolic dysfunction, family physicians performing physical examinations should not only measure heights and weights, but also the waist circumference. In so doing, metabolic disorders and cardiovascular disease can be prevented.