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研究生:許啓松
研究生(外文):Chi-Sung Hsu
論文名稱:某區域醫院年輕女性員工骨質健康狀況及相關因素之探討
論文名稱(外文):A study on bone health status and related factors in young female employees of a regional hospital
指導教授:林以勤林以勤引用關係
指導教授(外文):Yi-Chin Lin
學位類別:碩士
校院名稱:中山醫學大學
系所名稱:營養學研究所
學門:醫藥衛生學門
學類:營養學類
論文種類:學術論文
論文出版年:2013
畢業學年度:101
語文別:中文
論文頁數:62
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研究目的:隨著人口年齡的老化,骨質疏鬆症盛行率逐年攀升,預防疾病的產生將是目前最重要的策略。本研究為一橫斷性觀察研究,以中部某區域醫院30-40歲女性員工為對象進行資料收集,期望了解年輕女性醫護人員之骨質密度及其與預防骨質疏鬆相關行為、飲食攝取狀況、血液維生素D和副甲狀腺素濃度的關聯性。
研究方法及資料:本研究收案期間自2011年5月至11月;實際參與本研究人數共計94人。個案之骨質密度、體脂率及體組成以雙能X光吸收儀(DXA)檢測,並收集血液檢體以分析其副甲狀腺素和維生素D之濃度;另以問卷收集個案基本資料、骨質疏鬆症相關預防行為、鈣質攝取相關知識與預防骨質疏鬆症認知及態度,並請個案提供三天飲食記錄以評估其飲食營養素攝取狀況。
研究結果:分析結果顯示,個案平均年齡為35.2±3.2歲,每日平均鈣質攝取量為371.7±167.2毫克。所有個案在腰椎及股骨頸皆無骨質疏鬆問題。相關分析顯示體重(r=0.375, p<0.001)、BMI(r=0.372, p<0.001)、瘦體組織量(r=0.325, p=0.002)和碳水化合物佔總熱量百分比(r=0.209, p=0.043)皆與脊椎骨骨密度呈現顯著相關;每天接受戶外日光曝曬時間大於20分鐘(p=0.002)、接受戶外日光照射部位愈多(β=2.890, p=0.040)之個案有顯著較高之股骨頸骨密度,而體重(r=0.388, p<0.001)、BMI(r=0.423, p<0.001)、瘦體組織量(r=0.313, p=0.004)、腰部脂肪(r=0.288, p=0.008)、臀部脂肪(r=0.233, p=0.032)及全身脂肪(r=0.360, p=0.001)與股骨頸骨密度呈現顯著相關。經過逐步迴歸分析進行變項之共線性診斷,顯示體重與脊椎骨骨密度有顯著性相關;而BMI、接受戶外日光曝曬時間及年齡與股骨頸骨密度有顯著性關聯。
結論與建議:建議年輕女性應避免體重過輕,適度接受戶外陽光照射,並且避免可能加速骨質流失的行為,以保護骨骼健康並可能降低日後發生骨質疏鬆症的風險。

With the aging of the population, the prevalence of osteoporosis has increased steadily, and the prevention is the most important strategy to manage this disease. The current cross-sectional observational study is conducted to examine the association among behaviors related to osteoporosis prevention, dietary intake, blood levels of parathyroid hormone and vitamin D and bone density in relatively young adult females. The subjects were female hospital staff at a regional hospital in central Taiwan aged 30-40 years old. DXA was used to assess the subjects’ bone density and body composition, and blood samples were collected for analyzing their levels of parathyroid hormone and vitamin D status. Subjects’ demographic information, behaviors related to osteoporosis prevention, knowledge of calcium intake, and the awareness and attitude towards prevention of osteoporosis were collected by questionnaire. All subjects were required to provide three-day diet records for the evaluation of their dietary intake.
There were 94 subjects recruited to participate in this study. The mean age was 35.2±3.2years, and the mean daily dietary calcium intake is 371.7 ± 167.2 mg. All subjects didn’t have problems of osteoporosis at lumbar spine and femoral neck. The results of correlation analyses showed that body weight(r=0.375, p<0.001), BMI(r=0.372, p<0.001), the amount of lean body mass(r=0.325, p=0.002) and the carbohydrates intake percentage of total calories(r=0.209, p=0.043) were significantly correlated with lumbar spine bone mineral density. The subjects who exposed to outdoor sunlight longer than 20 minutes daily(p=0.002) and had more body parts exposed to outdoor sunlight had significant higher femoral neck bone mineral density. Body weight(r=0.388, p<0.001), BMI(r=0.423, p<0.001), the total amount of lean body mass(r=0.313, p=0.004), and fat mass at waist(r=0.288, p=0.008) and hip(r=0.233, p=0.032) and total body (r=0.360, p=0.001) were significantly related to femoral neck bone mineral density. Stepwise regression analyses have been performed for collinearity among variables significantly correlated to bone mineral density. The results of the multiple regression analyses showed that weight was significantly correlated with lumbar spine bone mineral density; whereas BMI, time for outdoor sun exposure and age were significantly associated with femoral neck bone mineral density.
In conclusion, it appears that young women should avoid underweight, try to have appropriate outdoor sun exposure and avoid the behaviors which may accelerate bone mass loss for better bone health and possibly for lowering the future risk of osteoporosis.

誌謝 I
中文摘要 II
Abstract III
目錄 V
表目錄 VII
圖目錄 VII
第一章 前言 1
第二章 文獻探討 2
第一節 骨骼再塑作用(bone remodeling) 2
第二節 骨質疏鬆症之定義與診斷原則 3
第三節 骨質疏鬆症盛行率 5
第四節 影響骨質健康的相關因素 7
第三章 研究目的 15
第四章 研究對象與方法 16
第一節 研究設計及研究對象 16
第二節 研究方法 16
第三節 統計分析 18
第五章 結果 20
第六章 討論 24
第七章 結論 34
參考文獻 44
附錄1 行政院衛生署豐原醫院臨床試驗審查證明書 51
附錄2 研究計劃流程 52
附錄3 受試者同意書 53
附錄4 骨密檢測調查表及飲食記錄 55

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