台北市高中生根據不同診斷標準下代謝症候群與其組成因子盛行率與關連性之探討

Investigating the Prevalence and Relevance of Metabolic Syndrome and its Components among High-school Students in Taipei City in Line with Different Diagnostic Criteria

目的：比較台北市高中生使用不同青少年代謝症候群定義對於代謝症候群及其組成因子的盛行率和關連性的影響。

方法：本研究使用台北市某醫院2011至2014年間，15至17歲青少年高中學健資料庫總共45,756筆。資料庫內收集資料，包括性別、年齡、身高、體重、腰圍、收縮壓及舒張壓、及生化檢查包括三酸甘油酯、高密度脂蛋白膽固醇、空腹血糖。青少年代謝症候群定義使用修正後美國國家膽固醇教育計畫成人治療專家組的第三次指南(modified NCEP ATP III)、國際糖尿病聯盟(IDF)及台灣兒科醫學會建議(TPA)標準。統計方法利用描述性統計分析代謝症候群及其組成因子的盛行率和男女差異；卡方檢定及多元迴歸分析來分析不同性別間代謝症候群與其組成因子的盛行率和關聯性差異。

結果：台北市高中生代謝症候群盛行率使用modified NCEP ATP III、IDF及TPA標準分別為2.2%、1.1%及1.8%，其中33.9%、28.1及33.7%有至少一項代謝症候群組成因子。代謝症候群因子中，在三種標準下，以腰圍及BMI關聯性最強。

結論：青少年代謝症候群目前未有統一標準，使用上需要注意各自標準的差異和限制性。在青少年代謝症候群與其因子之間，腰圍及BMI有較強的關聯性。目前仍需進一步研究了解不同青少年代謝症候群標準與未來成人心血管疾病和第二型糖尿病風險之間的關聯性。

 

Background: A comparison of the different definitions of metabolic syndrome (MetS) on the prevalence and relevance of MetS and its components among high-school students in Taipei City.

Methods: A data set incorporating the health checkup information of 45,756 Taipei City high-school students aged between 15 to 17 years during the period from 2011 to 2014 were examined. The health checkup information covered a student’s gender, age, height, weight, waist circumference (WC), systolic and diastolic blood pressures, and biochemical markers such as triglycerides, high-density lipoprotein cholesterol, and fasting glucose levels. The modified National Cholesterol Education Program Adult Treatment Panel III (NCEP ATP III), the International Diabetes Federation (IDF), and the Taiwan Pediatric Association (TPA) criteria were used as the MetS criteria for adolescents. Chi-squared test and multiple regression analysis were performed to analyze the prevalence and relevance of metabolic syndrome and its components between students of different genders.

Results: According to the modified NCEP ATP III, the IDF, and the TPA criteria, the prevalence of MetS among high-school students in Taipei City was 2.2%, 1.1% and 1.8% respectively, and about 33.9%, 28.1% and 33.7% of them had at least one MetS component. Of the examined MetS components, WC and body mass index (BMI) reported a stronger relevance based on all three criteria; diastolic blood pressure, on the other hand, showed a poor relevance by the IDF and TPA criteria in boys.

Conclusion: At present, there is no unified criterion of metabolic syndrome for adolescents, and we need to be careful at applying different criteria. Among metabolic syndrome and its components in adolescents, WC and BMI are marked with stronger relevances. Further studies are necessary to clarify the relationship between different criteria of metabolic syndrome in adolescents and future cardiovascular disease and type 2 diabetes mellitus in adulthood.