臺灣博碩士論文加值系統

在流行病學研究中發現，嚼檳榔與肥胖、高血糖及第2型糖尿病發生相關；根據前人研究嚼食檳榔與肥胖之相關性，在老鼠研究中發現，嚼食檳榔與肥胖及高血糖有相關性。本研究主要目的是探討肥胖之危險因子，並進一步分析嚼食檳榔、抽菸及喝酒對肥胖之交互作用。本研究中從94-96年於雲林縣古坑鄉及台西鄉舉辦之整合性社區健康篩檢之民眾中，篩選出40歲以上之男性且身體測量、血液/生化檢查及問卷完整者，共419人。將研究對象分為非肥胖組(18.5≦BMI＜24，277人)及肥胖組(BMI≧27，142人)。結果顯示肥胖組之平均年齡、身高小於非肥胖組外，其餘腰圍、臀圍、收縮壓及舒張壓、骨質密度則大於非肥胖組，且皆有顯著差異(P＜0.05)。
肥胖者有嚼食檳榔的習慣或曾嚼食檳榔的情形較非肥胖者顯著；現在嚼食檳榔者（相較於無嚼食或曾經嚼食檳榔者）常伴隨著吸菸（72.2%）、飲酒（31.9%）之習慣；且有肥胖（BMI≧27）、較少運動、職業活動量較重等情形（皆有顯著差異）；另外飲食方面，現在嚼檳榔者每天吃早餐的習慣比例較高，這可能與執業活動量程度較重有關。
在控制年齡、總膽固醇、三酸甘油酯、葡萄糖、運動、職業、抽菸、飲酒、嚼食檳榔及飲食變因後，發現嚼食檳榔的時間(年)、量(顆)及強
度(時間×量)皆與肥胖有緊密正相關性。嚼檳榔且吸菸者，較嚼檳榔但無吸菸者較容易有肥胖之情形。嚼檳榔且飲酒者，也較嚼檳榔但無飲酒者較容易有肥胖之情形發生。但嚼食檳榔者之吸菸行為對肥胖並無顯著加乘作用，而飲酒行為則有加強嚼食檳榔者肥胖的可能性。

Betel nut chewing has been shown to be associated with obesity and hyperglycemia in animal models and in epidemiological studies. The main goal of the present study was to determine the association between betel nut chewing and obesity, and to explore the interaction between betel nut chewing, and smoking or drinking habit. Subjects were recruited in the health survey in Yunlin county during 2005-2007. Inclusion criteria was men over 40 years old who completed the survey. The criteria for obesity was BMI≧27.
Results indicated that betel nut chewer had higher occurrence of obesity than the non-chewers. Betel nut chewer had higher incidence of smoking (72%) and drinking (31.9%), lack of exercise, heavy labor and eating breakfast.
As age, total cholesterol, triglyceride, glucose, exercise, occupation, smoking, drinking, betel nut chewing and diet was adjusted, the duration, quantity and extent (time × quantity of betal nut) of betel nut chewing was closed association with obesity, respectively. Betel nut chewer with smoking or drinking habit was easier to be obese, respectively, than chewers without smoking, or drinking habit. Drinking and betal nut chewing exerted synergistic effect on obesity.

中文摘要 ………………………………………………………………I
英文摘要………………………………………………………………III
目錄……………………………………………………………………IV
表目錄…………………………………………………………………VI
圖目錄 ………………………………………………………………VIII
附錄目錄………………………………………………………………IX
第一章、 前言…………………………………………………………1
第二章、 文獻回顧……………………………………………………3
第一節、 檳榔的成分………………………………………………3
第二節、 嚼檳榔盛行率……………………………………………4
第三節、 肥胖的定義………………………………………………8
第四節、 肥胖盛行率………………………………………………10
第五節、 肥胖與代謝症候群………………………………………10
第六節、 嚼食檳榔與肥胖…………………………………………11
第三章、 材料與方法 ……………………………………………14
第一節、 研究對象…………………………………………………14
第二節、 研究設計…………………………………………………14
第三節、 體位及血壓測量…………………………………………15
第四節、 血液收集及生化檢驗……………………………………17
第五節、 問卷內容及調查方法……………………………………17
第六節、 統計分析…………………………………………………20
第四章、 結果………………………………………………………20
第一節、 基本資料…………………………………………………20
一、體位測量及血壓 ……………………………………20
二、血液生化………………………………………………22
第二節、生活型態 ………………………………………………24
第三節、飲食型態 …………………………………………………27
第四節、肥胖相關因子之分析 ……………………………………32
一、嚼檳榔及其它因子與肥胖之相關性………………………35
二、嚼檳榔、吸菸及飲酒對肥胖之交互作用…………………35
1.吸菸者中嚼檳榔與肥胖之影響……………………………37
2.非吸菸者中嚼檳榔與肥胖之影響…………………………39
3.飲酒者中嚼檳榔與肥胖之影響……………………………41
4.非飲酒者中嚼檳榔與肥胖之影響…………………………41
5.嚼檳榔（與血脂、吸菸、飲酒）對肥胖之交互作用……43
第五章、 討論 ………………………………………………………46
第六章、 結論 ………………………………………………………49
第七章、 參考文獻 …………………………………………………50

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