健康生活型態介入對於女性高膽固醇血症及其他代謝症候群風險因子之影響

The Effect of Lifestyle Modification on Hypercholesterolemia and Other Risk Factors for Metabolic Syndrome in Females

背景：高膽固醇血症以及代謝症候群對於台灣民眾的威脅日益增加，其第一線治療為健康生活型態介入，因此有需要探討介入措施對改善高膽固醇血症及其他代謝症候群風險因子的成效。目的：探討為期9個月的健康生活型態介入措施對高膽固醇血症及其他代謝症候群風險因子之影響。方法：本研究以前瞻性研究設計，從嘉義縣大林鎮衛生所於2005年1月舉辦之複合式篩檢資料篩選有高膽固醇血症或代謝症候群危險因子的女性成為研究樣本之母體。實驗組為27位完成為期9個月的健康生活型態介入措施「健康甘仔店」的女性，對照組則以年齡分層抽樣選取27位沒有參加「健康甘仔店」的女性。以無母數分析比較實驗組與對照組之前後健檢數據數值，健檢數據包括體重、身體質量指數、腰圍、代謝症候群指標數量、血壓、膽固醇、三酸甘油酯及血糖。結果：實驗組與對照組研究對象之膽固醇濃度及代謝症候群風險因子呈顯著差異，健康生活型態介入措施「健康甘仔店」顯著改善代謝症候群風險因子。其中，腰圍的前後差異的中位數在實驗組及對照組分別為-1cm及1 cm (p<0.001)，舒張壓的前後差異的中位數在實驗組及對照組分別為 -7 mmHg及2 mmHg (p=0.001)，總膽固醇的前後差異的中位數在實驗組及對照組分別為 -17 mg/dL及6 mg/dL (p=0.004) ，三酸甘油酯的前後差異的中位數在實驗組及對照組分別為2 mg/dL及24 mg/dL (p=0.040)，空腹血糖的前後差異的中位數在實驗組及對照組分別為 -9 mg/dL及4mg/dL (p=0.001)。結論：本研究之健康生活型態介入措施「健康甘仔店」顯著降低女性的總膽固醇水平及代謝症候群之風險因子。

Background: Hypercholesterolemia and metabolic syndrome are increasingly threatening to the health of the Taiwanese people. Lifestyle modification remains the primary treatment strategy for these conditions. We investigated the effect of lifestyle modification on hypercholesterolemia and other risk factors for metabolic syndrome by utilizing a nine-month lifestyle modification program. Methods: The present study used a prospective design. Female subjects afflicted with hypercholesterolemia or risk factors for metabolic syndrome were selected from among the participants in the January 2005 adult health examination in Dalin township of Chiayi county in Taiwan. The intervention group consisted of 27 females who completed the 9-month lifestyle modification program. The control group consisted of 27 age-matched (at 5-year intervals) females who did not participate. Non-parametric tests were used to compare the differences in adult health examination data between the intervention and control groups. This data included body weight, body mass index, waist circumference, number of risk factors for metabolic syndrome, blood pressure, and levels of blood cholesterol, blood triglycerides, and blood glucose. Results: Significant differences were observed in the pre- and post-intervention values between the intervention and control groups. Change in the median value of waist circumference was -1cm in the intervention group and +1cm in the control group (p<0.001). The median values of diastolic pressure decreased 7 mmHg in the intervention group but increased 2 mmHg in the control group (p=0.001). The median values of total cholesterol decreased 17 mg/dL in the intervention group but increased 6 mg/dL in the control group (p=0.004). The median values of triglycerides increased 2 mg/dL in the intervention group but increased 24 mg/dL in the control group (p=0.040). The median values of blood glucose decreased 9 mg/dL in the intervention group but increased 4 mg/dL in the control group (p=0.001). Conclusions: The lifestyle modification program significantly reduced the levels of cholesterol and other risk factors for metabolic syndrome in females.