護理仁淵之代謝症候群盛行率及其相關因素探討

Prevalence and Associated Factors of Metabolic Syndrome in Nurses

護理人員是醫院中人數最多之專業人員，更位居病人照護第一線，但其生理健康卻少受重視，故本文旨在探討護理人員之代謝症候群盛行率及其相關因素，以作為未來擬定職場健康促進方案參考。本文彩橫斷性研究設計。其中代謝症候群乃參酌行政院國民健康局2007年訂定之標準，且以向前逐步邏輯斯回歸評值相關因素之勝算比（ODDS Ratio）。共591名護理人員納入分析，男性12人（2%），女性579人（98%），平均年零為31.0歲（正負5.9），整體代謝症候群盛行率為4.6％。結果發現，年齡每年長一歲就多出12%的罹病風險（95%CI：1.05－1.22），肝功能指數的值每GPT每增加一單位也高出3%的罹病風險（95%CI：1.02－1.06）。進一步檢視發現，51歲以上女性患有此症候群之勝算比為50歲以下者的5.0倍（95%CI：1.55－8.17），推估應與更年期有關。且若將GPT值定於16IU/L，可得敏感度與特意度總數為最大，受試者特徵曲線（Receiver Operating Characteristic Curve）下面積為0.85（p<.001）。跟具本文研究結果，建議未來可將GPT直列為代謝症候群篩檢指標，並推廣至其他研究族群，尤對50歲以上之護理人員，更應積極介入，以維護其健康並降低罹病風險。

Nurses possess the most proportion of employees in hospitals and play important roles in patient care; however, their healths have not been taken more attention until now. The aims of our study were to investigate the prevalence and associated factors of the metabolic syndrome (MS) in nurses. This is a cross-sectional hospital-based survey. The last health examination results of nurses at a medical center in Taiwan were analyzed. The MS was defined according to the criteria proposed by Bureau of Heath Promotion, Taiwan. Logistic regression with forward selection was applied to investigate the odds ratio (OR) of associated factors of the MS. 591 nurses were enrolled in this study, including 12 males (2%) and 579 females (98%). The mean age were 31.0 (. 5.9). Overall, the prevalence of the MS was 4.6%. Our study revealed that GPT value (OR. 1.03È 95%CI. 1.02-1.06) and age (OR. 1.12È 95%CI. 1.05-1.22) were significantly associated with the development of the MS. Nurses, after 51 years old in particular, were 5.0 times more susceptible to develop the MS compared with who were under 50 years old (95%CI. 1.55-8.17), and this effect might be attributed to menopause. The optimal cut-off value of GPT, 16 IU/L, would yield a sensitivity of 84% and a specificity of 61% (area under ROC curve= 0.85) (p < .001). GPT could be regarded as a clinical screen indicator to detect the MS in different population. Hospital managers could design in-service educations and health-promotion programs that were related to the MS prevention to strengthen the ability of self-care among nurses.