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研究生:楊亦平
研究生(外文):YANG I PING
論文名稱:台灣老人心血管疾病與代謝症候群相關性之探究
論文名稱(外文):A STUDY ON THE RELATIONSHIP BETWEEN CARDIOVASCULAR DISEASE AND METABOLIC SYNDROME IN THE ELDERS IN TAIWAN
指導教授:李世代教授+黃國晉副
指導教授(外文):Shyh-Dye Lee+kuo-Chin Huang
學位類別:碩士
校院名稱:國立台北護理學院
系所名稱:長期照護研究所
學門:醫藥衛生學門
學類:護理學類
論文種類:學術論文
論文出版年:2007
畢業學年度:95
語文別:中文
論文頁數:85
中文關鍵詞:老人+心血管疾病+代謝症候群+NAHSIT+台灣
外文關鍵詞:elderly+cardiovascular disease+metabolic syndrome+NAHSIT+Taiwan
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本研究旨在探討台灣地區老人代謝症候群組成因子與心血管疾病之間的相關性,以「第二次國民營養健康狀況變遷調查(NAHSIT Ⅱ)」為資料庫來源,排除無其他相關健康篩檢資料者後計1,543名(男性790人、女性753人)之65歲以上老年人為研究對象,進行斷面調查資料之分析。代謝症候群依定義之不同,分為代謝症候群Ⅰ及代謝症候群Ⅱ來探討檢視,代謝症候群Ⅰ依據美國國家膽固醇教育計劃(NECP ATP Ⅲ)之定義,代謝症候群Ⅱ依據國際糖尿病基金會(IDF) 之定義。
研究結果顯示:本研究樣本之心血管疾病盛行率為21.6%(其中女性佔11.6%、男性10.0%),女性心血管疾病盛行率高於男性(p <.05);代謝症候群Ⅰ之盛行率高達47.3%(其中女性佔26.1%、男性21.2%),女性代謝症候群Ⅰ盛行率亦高於男性(p <.001);代謝症候群Ⅱ之盛行率為32.1%(其中女性佔20.2%、男性11.9%),女性代謝症候群Ⅱ盛行率亦是高於男性(p <.001)。在控制其他變項後,女性相對於男性,發生心血管疾病之危險性較大(p <.01);75-79歲者相對於65-69歲者,發生心血管疾病之危險性也較大(p <.01);有接受教育者相對於無接受教育者,發生心血管疾病之危險性較大(p <.01);高密度脂蛋白膽固醇(HDL-C)數值較低者相對HDL-C數值高者,發生心血管疾病之危險性較大(p <.05);有代謝症候群Ⅰ者相對於無代謝症候群Ⅰ者,發生心血管疾病之危險性亦較大(p <.05)。
結論:本研究探討代謝症候群組成因子與心血管疾病相關性,結果顯示代謝症候群與心血管疾病是存有高度相關之危險性,部分統計則顯示兩者間之關係,其明顯性並非一致。
The purpose of this study is to explore the relationship between cardiovascular disease and metabolic syndrome in the elders in Taiwan. This study design was cross-sectional and utilized database of Nutrition and Health Survey in Taiwan II (NAHSIT II) for analysis. We collected 1,543 elderly (790 men,753 women) aged 65 y/o and above. Those who did not have relevant data in health screening were excluded. The definition of metabolic syndrome type I was defined by the NCEP ATP Ⅲ criteria, and metabolic syndrome type II was defined by the IDF criteria.
The results showed that the prevalence of cardiovascular disease in our sample is 21.6 %, and amongst 11.6 % in females, and 10.0 % in males. The prevalence of cardiovascular disease is higher in female than in male (p<0.05). The prevalence of metabolic syndrome type 1 in general are 47.3 %, and 26.1 % for females, and 21.2 % for males respectively;and it is higher in females than in males (p<0.001). The prevalence of metabolic syndrome type II in general are 32.1%, and 20.2 % for females, 11.9 % for males respectively. It is also higher in females than in males (p<0.001). In univariant analysis, the higher risks in the incidence of cardiovascular disease included : female v.s. male (p<0.01), 75-79 y/o v.s. 65-69 y/o (p<0.01), educated v.s. uneducated (p<0.01), low HDL-C value v.s. high HDL-C value (p<0.05), and metabolic syndrome type I v.s. non-metabolic syndrome type I (p<0.05).
In conclusion, this study was to explore the relationship between the components of metabolic syndrome and cardiovascular disease. The results showed that those risk factors were associated highly between metabolic syndrome and cardiovascular disease. However, the significance was not uniformly evident.
目 錄
誌 謝………………………………………………………………………………Ⅰ
中文摘要……………………………………………………………………………Ⅱ
英文摘要……………………………………………………………………………Ⅲ
圖表索引……………………………………………………………………………Ⅳ
第一章 續論………………………………………………………………………1
第一節 研究背景及研究動機……………………………………………………1
第二節 研究的重要性……………………………………………………………4
第三節 研究目的…………………………………………………………………5
第二章 文獻查證…………………………………………………………………7
第一節 心血管疾病的定義及盛行率……………………………………………7
第二節 代謝症候群的歷史沿革、定義及盛行率………………………………10
第三節 影響心血管疾病之因子…………………………………………………15
第四節 代謝症候群及心血管疾病之相關研究…………………………………19
第三章 研究方法學………………………………………………………………22
第一節 研究架構…………………………………………………………………22
第二節 名詞解釋…………………………………………………………………25
第三節 研究對象…………………………………………………………………27
第四節 研究工具…………………………………………………………………27
第五節 資料處理與分析的方法…………………………………………………29
第四章 研究結果…………………………………………………………………31
第一節 基本資料分佈……………………………………………………………31
第二節 不同性別發生心血管疾病及代謝症候群之情形………………………33
第三節 男性發生心血管疾病及心血管疾病危險因子之單變項分析…………34
第四節 女性發生心血管疾病與心血管疾病危險因子之單變項分析…………36
第五節 代謝症候群及其個別組成因子與心血管疾病之多變項分析…………37
第五章 討論………………………………………………………………………45
第一節 心血管疾病及心血管疾病危險因子之相關性…………………………45
第二節 代謝症候群及其個別組成因子與心血管疾病之相關性………………48
第三節 研究限制…………………………………………………………………50
第六章 結論與展望………………………………………………………………51
第七章 參考文獻…………………………………………………………………74
中文部分 ………………………………………………………………………74
英文部分 ………………………………………………………………………75
一、中文部分
中央健康保險局(2004年,4月26日)。2002年全民健康保險統計。台北: http://www.nhi.gov.tw/01intro/statistic/s91.htm
中央健康保險局(2007年,12月5日)。2001年ICD-9-CM疾病碼一覽表。台北: http://www.nhi.gov.tw/webdata/webdata.asp?menu=3&menu_id=56&webdata_id=1008
行政院衛生署國民健康局(2006年,8月21日)。台灣地區高血糖、高血脂、高血壓之盛行率調查。台北:http://www.bhp.doh.gov.tw/BHP/do/www/themeParkDocRead?themeParkDocumentId=2651&type=document&themeParkId=27
行政院衛生署(2006年,12月20日)。中老年病防治高血壓定義。台北: http://www.doh.gov.tw/cht/content.aspx?dept=R&class_no=41&now_fod_list_no=1162&array_fod_list_no=&level_no=2&doc_no=5247&show=
內政部(2007年,6月18日)。內政統計資訊服務網。台北:http:// http://www.moi.gov.tw/stat/

二、英文部分
Alford, F. P. (1996). Syndrome X(insulin resistance metabolic syndrome): a deadly quartet or an awesome foursome? Med J Aust, 164, 4-5.
Alberti, K. G. M. M., & Zimmet, P. Z. (1998). Definition, diagnosis, and classification of diabetes mellitus and its complications part 1: Diagnosis and classification of diabetes mellitus provisional report of a WHO consultation. Diabetic Medicine, 15, 539-553.
American Heart Association. 2001 Heart and Stroke Statistical Update. Dallas, Tex: American Heart Association, 2000.
Abbott, R. D., David, J., Rodriguez, B. L., Masaki, K. M., Yano, Katsuhiko., Schatz, I. J., et al. (2002). Age-related changes in risk factor effects on the incidence of coronary heart disease. Ann Epidemiol, 12, 173-181.
Alexander, C. M., Landsman, P. B., Teutsch, S. M., & Haffner, S. M. (2003). NCEP-defined metabolic syndrome, diabetes, and prevalence of coronary heart disease among NHANES Ⅲ participants age 50 years and older. Diabetes, 52, 1210-1214.
Asia Pacific Cohort Studies Collaboration (2003). Cholesterol, coronary heart disease, and stroke in the Asia Pacific region. International Journal of Epidemiology, 32, 563-572.
Beaglehole, R. (1992). Cardiovascular disease in developing countries. British Medical Journal, 305, 1170-1171.
Camargo, C. A. (1989). Moderate alcohol consumption and stroke. The epidemiologic evidence. Stroke, 20, 1611-1626.
Chuang, S. Y., Chen, C. H., Tsai, S. T., & Chou, P. (2002). Clinical identification of the metabolic syndrome in Kinmen. Acta Cardiol Sin, 18, 16-23.
CDC. (2002). Cigarette smoking among adults-United States, 2000. Morb Mortal Wkly Rep, 51, 642-645.
Curb, J. D., Abbott, R. D., Rodriguez, B. L., Masaki, K. H., Chen, R., Popper, J. S., et al. (2004). High density lipoprotein cholesterol and the risk of stroke in elderly men-the Honolulu heart program. American Journal Epidemiology, 160, 150-157.
Cankurtaran, M., Halil, M., Yavuz, B. B., Dagli, N., Oyan, B., & Ariogul, S. (2006). Prevalence and correlates of metabolic syndrome (MS) in older adults. Archives of Gerontology and Geriatrics, 42, 35-45.
Dawber, T. R., Moore, F. E., & Mann, G. V. (1957). Coronary heart disease in the Framingham Study. American Journal Preventive Medicine, 47, 4-23.
Feigin, V. L., Shishkin, S. V., Tzirkin, G. M., Vinogradova, T. E., Tarasov, A. V., Vinogradov, S. P. & Nikitin, Y. P. (2000). A population-based study of transient ischemic attack incidence in novosibirsk, Russia, 1987-1988 and 1966-1997. Stroke, 31, 9-13.
Ford, E. S., Giles, W. H., & Dietz, W. H. (2002). Prevalence of the metabolic syndrome among US adults: Findings from the Third National Health and Nutrition Examination Survey. JAMA, 287, 356-359.
Fair, J. M. (2003). Cardiovascular risk factor modification Is it effect in older adults? The Journal of Cardiovascular Nursing, 18, 161-168.
Goldstein, L. B., Adams, R., Becker, K., Furberg, C. D., Gorelick, P. B., Hademenos, G., et al. (2001). Primary prevention of ischemic stroke a statement for healthcare professionals from the stroke council of the American Heart Association. Circulation, 103, 163-182.
Gorter, P. M., Olijhoek, J. K., Van der Graaf, Y., Algra, A., Rabelink, T. J., Visseren, F. L., et al. (2004). Prevalence of the metabolic syndrome in patients with coronary heart disease, cerebrovascular disease, peripheral arterial disease or abdominal aortic aneurysm. Atherosclerosis, 173, 363-369.
Grundy, S. M., Cleeman, J. I., Daniels, S. R., Donato, K. A., Eckel, R. H., Franklin, B. A., et al. (2005). Diagnosis and management of the metabolic syndrome an American Heart Association / National Heart, Lung, and Blood Institute Scientific Statement. Circulation, 112, 1-18.
Haffner, S. M., Valdez, R. A., Hazuda, H. P., Mitchell, B. D., Morales, P. A., & Stern, M. P. (1992). Prospective analysis of the insulin-resistance syndrome (syndrome X). Diabetes, 41, 715-722.
Huang, Z. S., Chiang, T. L., & Lee, T. K. (1997). Stroke prevalence in Taiwan findings from the1994 national health interview survey. Stroke, 28, 1579-1584.
Hakim, A. A., Curb, J. D., Petrovitch, H., Rodriguez, B. L., Yano, K., Ross, G. W., et al. (1999). Effects of walking on coronary heart disease in elderly men. The Honolulu Heart Program. Circulation, 100, 9-13.
Hulthe, J., Bokemark, L., Wikstrand, J.&Fagerberg, B. (2000).The metabolic syndrome, LDL particle size, and atherosclerosis: the Atherosclerosis and InsulinResistance (AIR) study. Arterioscler Thromb Vasc Biol, 20, 2140-47.
Hu, G., Qiao, Q., Tuomilehto, J., Balkau, B., Johnsen, K. B., & Pyorala, K. (2004). Prevalence of the metabolic syndrome and its relation to all-cause and cardiovascular mortality in nondiabetic European men and women. Arch Intern Med, 164, 1066-1016.
Hunt, K. J., Resenden, R. G., Williams, K., Haffner, S. M., & Stern, M. P. (2004). National cholesterol education program versus World Health Organization metabolic syndrome in relation to all cause and cardiovascular mortality in the San Antonio Heart Study. Circulation, 110, 1251-1257.
Huang, K. C., Lee, M. S., Lee, S. D., Chang, Y. H., Lin, Y. C., Tu, S. H., et al. (2005). Obesity in the elderly and its relationship with cardiovascular risk factors in Taiwan. Obesity Research, 13, 170-178.
Isomaa, B., Almgren, P., Tuomu, T., Forsen, B., Lahti, K., Nissen, M., et al. (2001). Cardiovascular morbidity and mortality associated with the metabolic syndrome. Diabetes Care, 24,683-689.
Jia, W. P., Xiang, K. S., Chen, L., Lu, J. X., & Wu, Y. M. (2002). Epidemiological study on obesity and its comorbidities in urban Chinese older than 20 years of age in Shanghai, China. Obesity reviews, 3, 157-165.
Kaplan, N. M. (1989). The deadly quartet: upper-body obesity, glucose intolerance, hypertriglyceridemia, and hypertension. Arch Intern Med, 149, 1514-1520.
Kannel, W. B. (2002). Coronary heart disease risk factors in the elderly. Am J Geratric Cardiol, 11, 101-107.
Kip, K. E., Marroquin, O. C., Kelly, D. E., Johnson, D., Kelsey, S. F., Shaw, L. J., et al. (2004). Clinical importance of obesity versus the metabolic syndrome in cardiovascular risk in women a report from the women’s ischemia syndrome evaluation (WISE) study. Circulation, 109, 706-713.
Katzmarzyk, P. T., Church, T. S., Janssen, I., Ross, R., & Blair, S. N. (2005). Metabolic syndrome, obesity, and mortality. Diabetes Care, 28, 391-397.
LaCrox, A. Z., Lang, J., Scherr, P., Wallace, R. B., Comoni-Huntley, J., Benkman, L., et al. (1991). Smoking and mortality among older men and women in three communities. The New England Journal of Medicine, 324, 1619-1625.
Lindenstrom, E., Boysen, G., & Nyboe, J. (1994). Influence of total cholesterol, high-density lipoprotein cholesterol, and triglycerides on risk of cerebrovascular disease: the Copenhagen city heart city. BMJ, 309, 11-15.
Lee, T. K., Huang, Z. S., Ng, S. K., Chan, K. W., Wang, Y. S., Liu, H. W., et al. (1995). Impact of alcohol consumption and cigarette smoking on stroke among the elderly in Taiwan. Stroke, 26, 790-794.
Labarthe, D. R. (1998) Epidemiology and prevention of cardiovascular disease: a global challege. Gaithersburg, Maryland, Aspen.
Lakka, H. M., Laaksonen, D. E., Lakka, T. A., Niskanen, L. K., Kumpusalo, E., Tuomlehto, J., et al. (2002).The metabolic syndrome and total and cardiovascular disease mortality in middle-aged men. JAMA, 288, 2709-2716.
Laaksonen, D. E., Lakka, H. M., Niskanen, L. K., Kaplan, G. A., Salonen, J. T., & Lakka, T. A. (2002). Metabolic syndrome and development of diabetes mellitus: Application and validation of recently suggested definitions of the metabolic syndrome in a prospective cohort study. Am J Epidemiol, 156, 1070-1077.
Lee, Y. T., Lin, R. S., Sung, F.C., Yang, C.Y., Chien, K.L., Chen, W.J., et al. (2000). Chin-Shan community cardiovascular cohort in Taiwan baseline data and five year follow up morbidity and mortality. Journal of clinical epidemiology, 53, 838-846.
Manson, J. E., Willet, W. C., Stampfer, M. J., Colditz, G. A., Hunter, D. J., Hankinson, S. E., et al. (1995). Body weight and mortality among women. New England Journal of Medicine, 333, 677-685.
Milionis, H., Winder, A. F., & Mikhailidis, D. P. (2000). Lipoprotein (a) and stroke. J Clin Pathol, 53, 487-496.
Marroquin O. C., Kip, K. E., Kelly, D. E., Johnson, B. D., Shaw, L. J., Merz, N. B., et al. (2004). Metabolic syndrome modifies the cardiovascular risk associated with angiographic coronary artery disease in women A report from the women’s ischemia syndrome evaluation. Circulation, 109, 714-721.
NCEP ATP III. (2001). Executive Summary of the Third Report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III)
Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults. JAMA. 285:2486-2497.
National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adults Treatment Panel Ⅲ). Third Report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel Ⅲ) final report. Circulation, 106, 3143-3421.
Paffenbarger, R. S., Hyde, R. T., Wing, A. L., Lee, I. M., Jung, D. L., & Kampert, J. B. (1993). The association of change in physical-activity level and other lifestyle characteristics with mortality among men. New England Journal of Medicine, 328, 538-545.
Pan, W. H., Li, L. A., & Tsai, M. J. (1995). Temperature extremes and mortality from coronary heart disease and cerebral infarction in elderly Chinese. Lancet, 345, 353-355.
Papadakis, J. A., Mikhailidis, D. P., & Winder, A. F. (1998). Lipids and stroke: neglect of a useful preventive measure? Cardiovascular Research, 40, 265-271.
Park, Y. W., Zhu, S., Palaniappan, L., Heshka, S., Carnethon, M. R., & Heymsfield, S. B. (2003). The metabolic syndrome: Prevalence and association risk factor findings in the US population from the third national health and nutrition examination survey, 1988-1994. Arch Intern Med, 163, 427-436.
Prabhakaran, D., & Anand, S. S. (2004). The metabolic syndrome: an emerging risk state for cardiovascular disease. Vascular Medicine, 9, 55-68.
Pan, W. H., Hung, Y. T., Shaw, N. S., Lin, W., Lee, S. D., Lin, M. C., et al. (2005). Elderly nutrition and health survey in Taiwan (1999-2000): research design, methodology and content. Asia Pac J Clin Nutr, 14, 203-210.
Reaven, G. M. (1988). Banting lecture1988: Role of insulin resistance in human disease. Diabetes, 37, 1595-1607.
Rimm, E. B., Giovannucci, E. L., Willett, W. C., Colditz, G. A., Ascherio, A., Rosner, B., et al. (1991). Prospective study of alcohol consumption and risk of coronary disease in men. Lancet, 338, 464-468.
Rapaport, E. (2000). Cardiovascular disease in the Octogenarian: a major challenge for the new millennium. Am J Geriatric Cardiol, 9, 43-48.
Shinozaki, K., Suzuki, M., Ikebuchi, M., Hara, Y. & Harano, Y. (1996). Demonstration of insulin resistance in coronary artery disease documented with angiography. Diabetes Care, 19, 1-7.
Smith, S. C., Jackson, R., Pearson, T. A., Fuster, V., Yusuf, S., Faergeman, O. et al. (2004). Principles of national and regional guidelines on cardiovascular disease prevention a scientific statement from the world heart and stroke fortum. Circulation, 109, 3112-3121.
Scuteri, A., Najjar, S. S., Morrell, C. H. & Lakatta, E. G. (2005). The metabolic syndrome in older individuals: Prevalance and prediction of cardiovascular events. Diabetes Care, 28, 882-887.
Trevisan, M., Liu, J., Bahsas, F. B. & Menotti, A. (1998). Syndrome X and mortality: a population-based study. Am J Epidemiol, 148, 958-966.
Tolonen, H., Mahonen, M., Asplund, K., Rastenyte, D., Kuulasmaa, K., Vanuzzo, D. et al. (2002). Do trends in population levels of blood pressure and other cardiovascular risk factors explain trends in stroke event rates? Comparisons of 15 populations in 9 countries within the WHO MONICA stroke project. Stroke, 33, 2367-2375.
WHO MONICA Project Principal Investigators. (1988). The World Health Organization MONICA Project (monitoring trends and determinants in cardiovascular disease): a major international collaboration. Journal Clinical Epidemiology, 41, 105-114.
WHO(1989). Stroke-1989 recommendations on stroke prevention, diagnosis, and therapy: Report of the WHO task force on stroke and other cerebrovascular disorders. Stroke, 20,1407-1431.
Wolf, P. A., Clagett, G. P., Easton, J. D., Goldstein, L. B., Gorelick, P. B., Hayes, M. K., et al. (1999). Preventing ischemic stroke in patients with prior stroke and transient ischemic attack: a statement for healthcare professionals from the stroke council of the American Heart Association. Stroke, 30, 1991-1994.
World Health Organization. (2003年4月16日). GBD 2002: Deaths by age, sex, and cause for the year 2002. http://www3.who.int/whosis/menu.cfm?path=evidence,burden,burden_estimates,burden_estimates_2002N,burden_estimates_2002N_2002,burden_estimates_2002N_2002_Region&language=english
World Health Organization. (2007年7月26日). Health situation analysis and trends summary.
http://www.paho.org/English/DD/AIS/cp_188.htm
Zhu, S. K., St-Onge, M. P., Heshka, S. & Heymsfield, S. B. (2004). Lifestyle behavior associated with lower risk having the metabolic syndrome. Metabolism, 53, 1503-1511
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