臺灣博碩士論文加值系統

研究背景：近年來國人在生活環境、行為與生活型態都有明顯的改變，其所衍生出來肥胖、糖尿病與心血管疾病等慢性疾病盛行率也逐漸上升。代謝症候群已被證實會增加罹患第二型糖尿病及心血管疾病的危險性，且會導致死亡率的增加。根據全國十大死因統計中可發現，苗栗縣心血管疾病、糖尿病等死亡率高於全國平均值，因此本研究欲探討苗栗社區婦女代謝症候群的危險因子。
研究目的：探討苗栗社區婦女其代謝症候群之危險因子並建立一個代謝症候群簡易的預測分數模式。
研究方法：本研究為橫斷性研究，以「98年慢性疾病之流行病學危險因子探討」計畫之資料進行分析，調查對象為參加此研究計畫之40歲以上婦女，共有235人，代謝症候群診斷標準為2007年國民健康局所發布之「成人（20歲以上）代謝症候群之判定標準」。預測模式的分數即為羅吉斯迴歸係數加總而得，且使用ROC曲線評價預測模式的預測能力。以IBM SPSS Statistics 21與R統計套裝軟體進行資料的描述性及推論性統計分析。
研究結果：苗栗社區婦女平均年齡為54.2歲，其中67人有代謝症候群。探討代謝症候群相關因素的交互作用與干擾因子後發現，身體質量指數27kg/m2以上且未停經、每天吃保健食品次數一次以下且有使用藥物習慣、有飲用含糖飲料習慣者且有心血管疾病者以及心跳一分鐘超過78次與代謝症候群風險上升有關。接著由代謝症候群之危險因子建立一預測模式，民眾加總分數並對照表格後，即可得知自己罹患代謝症候群的風險高低。
結論：身體質量指數與停經情形、吃保健食品次數與使用藥物情形、飲用含糖飲料與心血管疾病和心跳頻率會影響罹患代謝症候群之風險大小。建立一個代謝症候群之預測模式，提供民眾一個簡單、方便的評估風險方法。其結果可提供相關衛生單位參考，以便對民眾提供預防宣導及最適切之照護。

Backgroud: The health problems caused by metabolic syndrome are an important issue around all countries. Patients with metabolic syndrome are at high risk of cardiovascular diseases and diabetes.
Aim: This study aims to investigate the risk factors of metabolic syndrome in women in a Miaoli community and establish a prediction model.
Materials and Methods: This study was a cross-sectional study, and used data analysis to assess the data from the health examination of Miaoli community. Participants who were aged 40 years and more were selected in the study, finally there were 235 women were recruited for analyzed. The diagnoses for the metabolic syndrome are from the Diagnostic Criteria 2007 proclaimed by the Bureau of Health Promotion.The statistic analyses used in this study include: descriptive statistics, chi-square test, logistic regression analysis and ROC curve.
Result: The average age of women was 54.2 years old. There are 67 women in metabolic syndrome group. Using logistic regression to examine the risk factor of metabolic syndrome, the study found the factors of obesity and premenopausal, eating health food less than once a day and taking medicine, drinking sugared beverage and heart disease as well as heart rate >78 bpm were significantly related to the occurrence of metabolic syndrome. After checking the strata for the selected risk factor, individuals can acquire their total risk point. Referring to risk score by matched total risk point, individuals can recognize their risk level for the development of metabolic syndrome.
Conclusion: The results suggest that BMI and menopause situation, taking medicines and the frequency of taking health food, drinking sugared beverage and heart disease as well as heart rate are risk factors of metabolic syndrome. A prediction model for estimating risk of having metabolic syndrome was created. These findings of the study can be used to guide the prevention measures and appropriate care for health care sectors, in order to promote the health of adult population.

第一章　緒論 1
第一節　研究背景 1
第二節　研究動機及重要性 3
第三節　研究目的 5
第二章　文獻探討 6
第一節　代謝症候群的定義 6
第二節　代謝症候群與疾病相關性 9
第三節 代謝症候群之危險因子 11
第四節 ROC曲線與預測分數模式之應用 17
第三章　研究材料與方法 19
第一節　研究架構與研究假設 19
第二節　研究對象與資料來源 22
第三節　研究工具 23
第四節　資料處理與分析方法 25
第五節　名詞解釋 30
第四章 研究結果 35
第一節 苗栗社區婦女基本資料之分析 35
第二節 苗栗社區婦女代謝症候群之相關因素分析 48
第三節 客家籍與非客家籍婦女罹患代謝症候群之差異與其影響因子 55
第四節 停經與未停經婦女罹患代謝症候群之差異與其調節因子 59
第五節 代謝症候群之危險因子 63
第六節 代謝症候群之預測模式 66
第五章 討論 83
第一節 代謝症候群之盛行率 83
第二節 客家籍及停經婦女之代謝症候群差異 85
第三節 代謝症候群之危險因子 88
第四節 代謝症候群之預測模式 94
第五節 研究限制 96
第六章 結論與建議 97
第一節 結論 97
第二節 建議 100
參考文獻 102

Adrian, J., Cameron, J., Onathan, E., & Shaw, P. Z. (2004). The metabolic syndrome: prevalence in worldwide populations. Endocrinol Metab Clin N Am, 33, 351-375.
Ahmed, R. L., Schmitz, K. H., Anderson, K. E., Rosamond, W. D., & Folsom, A. R. (2006). The metabolic syndrome and risk of incident colorectal cancer. Cancer, 107(1), 28-36.
Billings, S. A., Chen, S., & Korenberg, M. J. (1989). Identification of MIMO non-linear systems using a forwardregression orthogonal estimator. International Journal of Control, 49(6), 2157-2189.
Böhm, M., Swedberg, K., Komajda, M., Borer, J. S., Ford, I., Dubost-Brama, A., Lerebours, G., & Tavazzi, L. (2010). Heart rate as a risk factor in chronic heart failure (SHIFT): the association between heart rate and outcomes in a randomised placebo-controlled trial. Lancet, 376, 886-894.
Borer, J. S. (2009). Heart rate: from risk marker to risk factor in coronary artery disease. Medicographia, 31(4), 349-355.
Brilla, C. G., Pick, R., Tan, L. B., Janicki, J. S., & Weber, K. T. (1990). Remodeling of the rat right and left ventricles in experimental hypertension. Circ Res, 67, 1355-1364.
Brown, I. J., Stamler, J., Van, H. L., Robertson, C. E., Chan, Q., Dyer, A. R., Huang, C. C., Rodriguez, B. L., Zhao, L., Daviglus, M. L., Ueshima, H., & Elliott, P. (2011). Sugar-sweetened beverage, sugar intake of individuals, and their blood pressure: international study of macro/micronutrients and blood pressure. Hypertension, 57(4), 695-701.
Carr, M. C. (2003). The emergence of the metabolic syndrome with menopause. J Clin Endocrinol Metab, 88(6), 2404-2411.
Centers for Disease Control and Prevention (2009). National health htatistic reports: prevalence of metabolic syndrome among adults 20 years of age and over, by sex, age, race and ethnicity, and body mass index: united states, 2003–2006. Retrieved April 13, 2013, from the World Wide Web: http://www.cdc.gov/nchs/data/nhsr/nhsr013.pdf.
Chen, X. R., Pang, Z. C., & Li, K. J. (2009). Dietary fat, sedentary behaviors and the prevalence of the metabolic syndrome among Qingdao adults. Nutrition, Metabolism & Cardiovascular Diseases, 19, 27-34.
Chen, L., Caballero, B., Mitchell, D. C, Loria, C., Lin, P. H., Champagne, C. M., Elmer, P. J., Ard, J. D., Batch, B. C., Anderson, C. A. M., & Appe, L. J. (2010). Reducing consumption of sugar-sweetened beverages is associated with reduced blood pressure: a prospective study among U.S. adults. Circulation, 121(22), 2398-2406.
Chien, K. L., Hsu, H. C., Sung, F. C., Su, T. C., Chen, M. F., & Lee, Y. T. (2007). Metabolic syndrome as a risk factor for coronary heart disease and stroke: an 11-year prospective cohort in Taiwan community. Atherosclerosis, 194(1), 214-221.
Chuang, S. Y., Chen, C. H., & Chou, P. (2004). Prevalence of metabolic syndrome in a large health check-up population in Taiwan. J Chin Med Assoc, 67(12), 611-620.
Chuang, S.Y., Chen, C. H., Tsai, S. T., & Chou, P. (2002). Clinical identification of the Metabolic Syndrome in Kinmen, Taiwan. Acta Cardiol Sin, 18, 16-23.
Cooney, M. T., Vartiainen, E., Laakitainen, T., Juolevi, A., Dudina, A., & Graham, I. M. (2010). Elevated resting heart rate is an independent risk factor for cardiovascular disease in healthy men and women. Am Heart J, 159(4), 612-619.
Cupp, M. J. (1999). Herbal remedies: adverse effects and drug interactions. Am Fam Physician, 59(5), 1239-1244.
DiMeglio, D. P., & Mattes, R. D. (2000). Liquid versus solid carbohydrate: effects on food intake and body weight. Int J Obes Relat Metab Disord, 24, 794–800.
Dhingra, R., Sullivan, L., Jacques, P. F., Wang, T. J., Fox, C. S., Meigs, J. B., D'Agostino, R. B., Gaziano, J. M., & Vasan, R. S. (2007). Soft drink consumption and risk of developing cardiometabolic risk factors and the metabolic syndrome in middle-aged adults in the community. Circulation, 116(5), 480-488.
Fan, A. Z., Russell, M., Dorn, J., Freudenheim, J. L., Nochajski, T., Hovey, K., & Trevisan, M. (2006). Lifetime alcohol drinking pattern is related to the prevalence of metabolic syndrome. European Journal of Epidemiology, 21, 129-138.
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(3), 356-359.
Gardiner, P., Phillips, R., & Shaughnessy, A. F. (2008). Herbal and Dietary Supplement–Drug Interactions in Patients with Chronic Illnesses. Am Fam Physician, 77(1), 73-78.
Gavrila, D., Salmeron, D., Egea-Caparros, J. M., Huerta, J. M., Perez-Martinez, A., Navarro, C., & Tormo, M. J. (2011). Prevalence of metabolic syndrome in Murcia Region, a southern European Mediterranean area with low cardiovascular risk and high obesity. BMC Public Health, 11, 562.
Gami, A. S., Witt, B. J., Howard, D. E., Erwin, P. J., Gami, L. A., & Somers, V. K. (2007). Metabolic syndrome and risk of incident cardiovascular events and death: a systematic review and meta-analysis of longitudinal studies. J Am Coll Cardiol, 49(4), 403-414.
Gupta, A., Gupta, R., Sarna, M., Rastogi, S., Gupta, V. P., & Kothari, K. (2003). Prevalence of diabetes, impaired fasting glucose and insulin resistance syndrome in an urban Indian population. Diabetes Research and Clinical Practice, 61, 69-76.
Hanatani, A., Yoshiyama, M., Kim, S., Omura, T., Toda, I., Akioka, K., Teragaki, M., Takeuchi, K., Iwao, H., & Takeda, T. (1995). Inhibition by angiotensin II type 1 receptor antagonist of cardiac phenotypic modulation after myocardial infarction. J Mol Cell Cardio, 27(9), 1905-1914.
Hjalmarson, A. (2007). Heart rate: an independent risk factor in cardiovascular disease. European Heart Journal Supplements, 9, F3–F7.
Hsu, H. F., Wang, J. Y., Chen, Y. L., Liu, C. C., Chang, Y. L., Chen, H. S., Pei, C., & Pei, D. (2011). Relationships between alanine aminotransferase levels, abnormal liver echogenicity, and metabolic syndrome. Journal of American Board of family Medicine, 24, 407-414.

Hu, G., Qiao, Q., Tuomilehto, J., Balkau, B., Borch-Johnsen, K., & Pyorala, K. (2004). Prevalence of the metabolic syndrome and its relation to all-cause and cardiovascular mortality in nondiabetic European men and women. Archives of Internal Medicine, 164(10), 1066-1076.
International Diabetes Federation (2005). The IDF consensus worldwide definition of the METABOLIC SYNDROME. Retrieved November 11, 2012, from the World Wide Web: http://www.idf.org/webdata/docs/IDF_Meta_def_final.pdf.
Isomaa, B., Almgren, P. & Tuomi, T. (2001). Cardiovascular morbidity and mortality associated with the metabolic syndrome. Diabetes Care, 24, 683-689.
Jaggers, J. R., Sui, X., Hooker, S. P., LaMonte, M. J., Matthews, C. E., & Hand, G. A. (2009). Metabolic syndrome and risk of cancer mortality in men. Eur J Cancer, 45(10), 1831-1938.
Jalal, D. I., Smits, G., Johnson, R. J., & Chonchol, M. (2010). Increased fructose associates with elevated blood pressure. J Am Soc Nephrol, 21(9), 1543-1549.
Jensen, M. T., Suadicani, P., Hein, H. O., & Gyntelberg, F. (2013). Elevated resting heart rate, physical fitness and all-cause mortality: a 16-year follow-up in the Copenhagen Male Study. Heart, 00, 1-6.
Jesmin, S., Islam, A. S., Akter, S., Islam, M. M., Sultana, S. N., Yamaguchi, N., Okazaki, O., Moroi, M., Hiroe, M., Kimura, S., Watanabe, T., Saturo, K., & Mizutani, T. (2013). Metabolic syndrome among pre- and post-menopausal rural women in Bangladesh: result from a population-based study. BMC Research Notes, 6(1), 157.
Jordan, H. T., Tabaei, B. P., Nash, D., Angell, S. Y., Chamany, S., & Kerker, B. (2012). Metabolic syndrome among adults in New York City, 2004 New York City Health and Nutrition Examination Survey. CDC-Prevening Chronic Disease, 9.
Juurlink, D. N., Mamdani, M., Kopp, A., Laupacis, A., & Redelmeier, D. A. (2003). Drug-drug interactions among elderly patients hospitalized for drug toxicity. JAMA, 289(13), 1652-1658.
Kanaya, A. M., Fyr, C. L. W., Rekeneire, N. D., Shorr, R. I., Schwartz, A. V., Goodpaster, B. H., Newman, B. H., Harris, T., & Barrett-Connor, E. (2005). Predicting the development of diabetes in older adults. Diabetes Care, 28(2), 404-408.
Kassi, E., Pervanidou, P., Kaltsas, G., & Chrousos, G. (2011). Metabolic syndrome: Definitions and controversies. BMC Medicine, 9, 1-13.
Kesaniemi, Y. A., Lilja, M., Kervinen, K., & Rantala, A. (1992). Multiple metabolic syndrome: Aspects of genetic epidemiology and molecular genetics. Annals of Medicine, 24, 461-464.
Kylin, E. (1923). Studien über das. Hypertonie-Hyperglykemie syndrom. Zentralblatt für. Innere Medizin, 44, 105-127.
Kwasniewska, M., Kaleta, D., Dziankowska-Zaborszczyk, E., & Drygas, W. (2009). Healthy beharvious, Lifestyle patterns and sociodemographic determinants of the metabolic syndrome. Central European Journal of public Health, 17, 14-19.
Lalonde, M. (1974). A new perspective on the health of Canadians- a working document. Ottawa: Government of Canada.

Lakka, H. M., Laaksonen, D. E., Lakka, T. A., Niskanen, L. K., Kumpusalo, E., & Tuomilehto, J. (2002). The metabolic syndrome and total and cardiovascular disease mortality in middle-aged men. JAMA, 288(21), 2709-2716.
Lidfeldt, J., Nyberg, P., Nerbrand, C., Samsioe, G., Schersten, B., & Agardh, D. (2003). Socio-demographic and psychosocial factors are associated with features of the metabolic syndrome.The Women´s Health in the Lund Area(WHILA)study. Diabetes Obes Metab, 5(2), 106-112.
Li, G., de, C. M., Jiao, S., & Wang, Y. (2010). Prevalence and characteristics of the metabolic syndrome among adults in Beijing, China. Asia Pac J Clin Nutr, 19(1), 98-102.
Li, Y., Yatsuya, H., Iso, H., Tamakoshi, K., & Toyoshima, H. (2010). Incidence of metabolic syndrome according to combinations of lifestyle factors among middle-aged Japanese male workers. Preventive Medicine, 51, 118-122.
Lovejoy, J. C. (2003). The menopause and obesity. Prim Care, 30(2), 317-325.
Lovejoy, J. C., Champagne, C. M., de Jonge, L., Xie, H., & Smith, S. R. (2008). Increased visceral fat and decreased energy expenditure during the menopausal transition. Int J Obes (Lond), 32(6), 949-958.
Matthews, K. A., Meilahn, E., Kuller, L. H., Kelsey, S. F., Caggiula, A. W., & Wing, R. R. (1989). Menopause and risk factors for coronary heart disease. New Engl J Med, 321, 641-646.
McRae, S. (1996). Elevated serum digoxin levels in a patient taking digoxin and Siberian ginseng. CMAJ, 155(3), 293-295.

Netjasov, A. S., Vujović, S., Ivović, M., Tancić-Gajić, M., Marina, L., & Barać, M. (2013). Relationships between obesity, lipids and fasting glucose in the menopause. Srp Arh Celok Lek, 141(1-2), 41-47.
Onat, A., Ceyhan, K., Basar, O., Erer, B., Toprak, S., & Sansoy, V. (2002). Metabolic syndrome: Major impact on coronary risk in a population with low cholesterol levels-a prospective and cross-sectional evaluation. Atherosclerosis, 165, 285-292.
Panagiotakos, D. B., Pitsavos, C., Chrysohoou, C., Skoumas, J., Tousoulis, D., & Toutouza, M. (2004). Impact of lifestyle habits on the prevalence of the metabolic syndrome among Greek adults from the ATTICA study. Am Heart J, 147(1), 106-112.
Pandey, S., Srinivas, M., Agashe, S., Joshi, J., Galvankar, P., Prakasam, C. P., & Vaidya, R. (2010). Menopause and metabolic syndrome: A study of 498 urban women from western India. J Midlife Health, 1(2), 63-69.
Park, B. J., Park, J. O., Kang, H. T., & Lee, Y. J. (2013). Elevated intraocular pressure is associated with metabolic syndrome in postmenopausal women: the Korean National Health and Nutrition Examination Survey. Menopause, 20 (7), 00-00.
Park, E. J., & Hellerstein, M. K. (2000). Carbohydrate-induced hypertriacylglycerolemia: historical perspective and review of biological mechanisms. Am J Clin Nutr, 71, 412 -433.
Park, H. S., Oh, S. W., Cho, S. I., Choi, W. H., & Kim, Y. S. (2004). The metabolic syndrome and associated lifestyle factors among South Korean adults. Int J Epidemiol, 33(2), 328-336.

Park, M. J., Yun, K. E., Lee, G. E., Cho, H. J., & Park, H. S. (2007). A Cross-Sectional Study of Socioeconomic Status and the Metabolic Syndrome in Korean Adults. Ann Epidemiol, 17, 320-326.
Park, Y. W., Zhu, S., Palaniappan, L., Heshka, S., Carnethon, M. R., & Heymsfield, S. B. (2003). The metabolic syndrome: prevalence and associated risk factor findings in the US population from the Third National Health and Nutrition Examination Survey, 1988-1994. Arch Intern Med, 163, 427-436.
Ploner, M., Dunkler, D., Southworth, H., & Heinze, G. (2010). logistf: Firth's bias reduced logistic regression. R package version 1.10. Retrieved November 11, 2012, from the World Wide Web: http://CRAN.R-project.org/package=logistf.
Rampal, S., Mahadeva, S., Guallar, E., Bulgiba, A., Mohamed, R., Rahmat, R., Arif, M. T., & Rampal, L. (2012). Ethnic differences in the prevalence of metabolic syndrome: results from a multi-ethnic population-based survey in malaysia. PLoS One, 7(9), e46365.
Reaven, G. M. (1988). Role of insulin resistance in human disease. Diabetes, 37, 1595-1607.
Rojas, R., Aguilar-Salinas, C. A., Jimenez-Corona, A., Shamah-Levy, T., Rauda, J., Ávila-Burgos, L., Villalpando, S., & Ponce, E. L. (2010). Metabolic syndrome in Mexican adults. Results from the National Health and Nutrition Survey 2006. Salud Publica Mex, 52, 11-18.
Ruiz, J., Blanché, H., Cohen, N., Velho, G., Cambien, F., Cohen, D., Passa, P., & Froguel, P. (1994). Insertion/deletion polymorphism of the angiotensin-converting enzyme gene is strongly associated with coronary artery disease in non-insulin-dependent diabetes mellitus. Proc Natl Acad Sci USA, 91, 3662-3665.
Santos, A. C., Ebrahim, S. & Barros, H. (2007). Alcohol intake, smoking, sleeping hours, physical activity and the metabolic syndrome. Preventive Medicine, 44, 328-334.
Sarkar, S., Das, M., Mukhopadhyay, B., Sekhar Chakraborty, C., & Majumder, P. P. (2005). Prevalence of metabolic syndrome in two tribal populations of the sub-Himalayan region of India: ethnic and rural-urban differences. Am J Hum Biol, 17(6), 814-817.
Sattar, N., Gaw, A., Scherbakova, O., Ford, I., O'Reilly, D. S., & Haffner, S. M. (2003). Metabolic syndrome with and without C-reactive protein as a predictor of coronary heart disease and diabetes in the West of Scotland Coronary Prevention Study. Circulation, 108(4), 414-419.
Smith, J. B., Niven, B. E., & Mann, J. I. (1996). The effect of reduced extrinsic sucrose intake on plasma triglyceride levels. Eur J Clin Nutr, 50, 498-504.
Stanhope, K. L., Griffen, S. C., Bair, B. R., Swarbrick, M. M., Keim, N. L., & Havel, P. J. (2008a). Twenty-four-hour endocrine and metabolic profiles following consumption of high-fructose corn syrup-, sucrose-, fructose-, and glucose-sweetened beverages with meals. Am J Clin Nutr, 87, 1194-1203.
Stanhope, K. L., & Havel, P. J. (2008b). Endocrine and metabolic effects of consuming beverages sweetened with fructose, glucose, sucrose, or high-fructose corn syrup. Am J Clin Nutr, 88, 1733S-1737S.

Takeuchi, T., Nakao, M., Nomura, K., & Yano, E. (2009). Association of metabolic syndrome with smoking and alcohol intake in Japanese men. Nicotine Tobacco Research, 11, 1093-1098.
Taki, K., Nishio, K., & Niwa, T. (2008). Metabolic syndrome defined by new criteria in Japanese is associated with increased liver enzymes and c-reactive protein. Nagoya journal of Medical Science, 70, 1-9.
Teff, K. L., Grudziak, J., Townsend, R. R., Dunn, T. N., Grant, R. W., Adams, S. H., Keim, N. L., Cummings, B. P., Stanhope, K. L., & Havel, P. J. (2009). Endocrine and metabolic effects of consuming fructose- and glucose-sweetened beverages with meals in obese men and women: influence of insulin resistance on plasma triglyceride responses. J Clin Endocrinol Metab, 94, 1562-1569.
Thakkinstian, A., Ingsathit1, A., Chaiprasert, A., Rattanasiri1, S., Sangthawan, P., Gojaseni, P., Kiattisunthorn, K., Ongaiyooth L., & Thirakhupt, P. (2011). A simplified clinical prediction score of chronic kidney disease: A cross-sectional-survey study. BMC Nephrology, 12(45), 1-8.
The Third Report of the National Cholesterol Education Program Expert Panel (NCEP) on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (2001). Executive Summary. Retrieved November 11, 2012, from the World Wide Web: http://www.nhlbi.nih.gov/guidelines/cholesterol/atp3xsum.pdf.
Tiret, L., Kee, F., Poirier, O., Nicaud, V., Lecerf, L., Evans, A., Cambou, J. P., Arveiler, D., Luc, G., Amouyel, P., & Cambien, F. (1993). Deletion polymorphism in angiotensin- converting enzyme gene associated with parental history of myocardial infarction. Lancet, 341, 991-992.
Torng, P. L., Su, T. C., Sung, F. C., Chien, K. L., Huang, S. C., Chow, S. N., & Lee, Y. T. (2002). Effects of menopause on intraindividual changes in serum lipids, blood pressure, and body weight-the Chin-Shan Community Cardiovascular Cohort study. Atherosclerosis, 161(2), 409-415.
Weber, T. K., Brilla, C. G., & Janicki, J. S. (1993). Myocardial fibrosis: functional significance and regulatory factors. Cardiovasc Res, 27, 341-348.
World Health Organization (1999). Definition, diagnosis and classification of diabetes mellitus and its complications- Part 1: Diagnosis and classification of diabetes mellitus. Geneva (Switzerland): Department of Non-communicable Disease Surveillance.
Yuanying, L., Hiroshi Y., Hiroyasu, I., Koji, T., & Hideaki, T. (2010). Incidence of metabolic syndrome according to combinations of lifestyle factors among middle-aged Japanese male workers. Preventive Medicine, 51, 118-122.
Zhang, W., McWilliams, D. F., Ingham, S. L., Doherty, S. A., Muthuri, S., Muir, K. R., & Doherty, M. (2011). Nottingham knee osteoarthritis risk prediction models. Ann Rheum Dis, 70, 1599-1604.
Zijlstra, F., Hoorntje, J. C. A., & Boer, M. J. D. (1997). Spontaneous Hyphema Associated with Ingestion of Ginkgo biloba Extract. N Engl J Med, 336, 1101-1109.
行政院客家委員會（2011）。99 年至100 年全國客家人口基礎資料調查研究。取自2013年5月2日：https://www.google.com.tw/url?sa=t&rct=j&q=&esrc=s&source=web&cd=2&ved=0CDYQFjAB&url=http%3A%2F%2Fwww.hakka.gov.tw%2Fdl.asp%3FfileName%3D1521131271.pdf&ei=CUyBUfDkL4HUkwW0wID4BQ&usg=AFQjCNHn3cEiKtDODaX0WcLYvnPbtTOVVg&sig2=14uekHrBa-Ezg_q3D2yIZA。
行政院衛生署（2012a）。民國100年主要死因分析。取自2012年10月11日：http://www.doh.gov.tw/CHT2006/DM/DM2_2.aspx?now_fod_list_no=12336&class_no=440&level_no=4。
行政院衛生署（2012b）。民國100年縣市別主要死因_新制行政區。取自2012年11月10日：http://www.doh.gov.tw/CHT2006/DM/DM2_2.aspx?now_fod_list_no=12333&class_no=440&level_no=3。
行政院衛生署國家衛生研究院（2010）。台灣營養健康狀況變遷調查- 2005-2008 國人代謝症候群（Metabolic Syndrome）之狀況。取自2012年11月10日：http://nahsit.nhri.org.tw/node/21。
行政院衛生署國民健康局（2007）。2007年台灣地區高血壓、高血糖、高血脂之追蹤調查研究。取自2012年10月8日：http://www.bhp.doh.gov.tw/BHPnet/Portal/Them_Show.aspx?Subject=200712250023&Class=2&No=200712250123。

吳香錡、李世強、趙泰宏、吳文智、葉慶輝、葉淑娟（2009）。台灣南部健檢成人代謝症候群之盛行率與危險因子探討。中華職業醫學雜誌，16（2），127-139。
李諭昇、紀櫻珍、張偉斌、吳振龍（2010）。臺灣地區職業與代謝症候群之相關研究。北市醫學雜誌，7（3），243-254。
何咏梅（2005）。華法林臨床應用研究概況。China Pharmacist, 8(2), 160-162.
林銘慧（2010）。台灣地區40 歲以上女性代謝症候群之探討。亞洲大學健康產業管理學系碩士論文，台中市。
林文元（2002）。利用指標個案病例對照研究來探討代謝症候群的家族群集現象。台灣大學預防醫學研究所碩士論文，台北市。
林文元、劉秋松、林正介、陳慶餘、李龍騰、黃國晉（2006）。停經婦女代謝症候群之研究。台灣老年醫學雜誌，1（1），26-33。
林珠如（2012）。以規律運動方案改善社區中年女性代謝症候群危險因子之成效。志為護理-慈濟護理雜誌，11（4），84-94。
林嘉玲（2010）。中部某區域教學醫院員工發生代謝症候群與生活型態和飲食的關係。中山醫學大學營養系碩士論文，台中市。
客家委員會（2005）。客家飲食文化 --- 潘江東。取自2013年5月2日：http://www.hakka.gov.tw/content.asp?CuItem=7163&mp=1699。

姚建安、李龍騰、陳慶餘、黃國晉（2006）。健檢老年人代謝症候群之相關研究。台灣老年醫學雜誌，1（1），18-26。
國民健康局（2007）。成人（20歲以上）代謝症候群之判定標準（2007 台灣）。取自2012年9月17日：http://www.bhp.doh.gov.tw/BHPnet/Portal/Them.aspx?No=200712250023。
國民健康局（2007）。2007年台灣地區高血壓、高血糖、高血脂之追蹤調查研究。台北市：孫建安。
國民健康局（2012a）。代謝症候群。取自2012年9月26日：http://www.bhp.doh.gov.tw/BHPnet/Portal/Them_Show.aspx?Subject=200712250023&Class=2&No=200712250123。
國民健康局（2012b）。Metabolic Syndrome in Taiwan。取自2012年10月9日：http://www.google.com.tw/url?sa=t&rct=j&q=&esrc=s&source=web&cd=3&ved=0CDMQFjAC&url=http%3A%2F%2Fwww.dryahoo.org.tw%2F1%2Fphbb3%2Fmetabolic%2520syndrome%2520in%2520taiwan-0950329revised.ppt&ei=21tzUPrtL8jNmgWbi4CIBw&usg=AFQjCNFBj0DnNswptM6FSdQMsXPMZAUrPg。
國民健康局（2013）。老媽的更年期。取自2013年4月26日：http://www.bhp.doh.gov.tw/BHPNet/Web/HealthTopic/TopicArticle.aspx?id=200712250108&parentid=200712250020。
張明毅、林鉅勝、唐憶淨（2009）。某榮民安養機構老年男性代謝症候群之盛行率及其與死亡率的關係。台灣老年醫學暨老年學雜誌，4（2），130-142。
張新儀、謝耀德、潘文涵、鄭喬薇（2010）。甜飲料攝取的代謝症候群風險：NAHSIT 2005-2008。取自2012年11月11日：http://consumer.fda.gov.tw/Files/doc/10.%E7%94%9C%E9%A3%B2%E6%96%99%E6%94%9D%E5%8F%96%E7%9A%84%E4%BB%A3%E8%AC%9D%E7%97%87%E5%80%99%E7%BE%A4%E9%A2%A8%E9%9A%AA%20NAHSIT2005-2008.pdf。
張立群（2012）。代謝症候群對大腸腫瘤盛行率與大腸直腸癌篩檢的影響。臺灣大學臨床醫學研究所學位論文，台北市。
張珮嘉（2005）。台中市四十歲以上民眾代謝症候群盛行率及相關危險因子之探討。中國醫藥大學醫務管理學研究所碩士論文，台中市。
張榮哲、黃麗卿、詹欣隆（2005）。某醫學中心體重過重員工罹患代謝症候群之危險因子研究。家醫研究，3，149-161。
梁妍慧（2011）。代謝症候群、心血管疾病與就業。淡江大學產業經濟學系碩士班碩士論文，新北市。
許世正（1997）。談婦女停經症候群及其保健。高醫醫刊，16，12。
陳建仁、游山林、白其卉、蘇大成、曾慶孝、簡國龍、黃麗卿（2002）。台灣地區高血壓、高血糖、高血脂之盛行率調查期末報告。行政院衛生署國民健康局，台北市。
葉志嶸、張新儀、潘文涵（2010）。台灣近十二年來之肥胖與代謝症候群之變遷趨勢由NAHSIT1993-1996到2005-2008。取自2012年11月11日：http://consumer.fda.gov.tw/Files/doc/9.%E5%8F%B0%E7%81%A3%E8%BF%91%E5%8D%81%E4%BA%8C%E5%B9%B4%E4%BE%86%E4%B9%8B%E8%82%A5%E8%83%96%E8%88%87%E4%BB%A3%E8%AC%9D%E7%97%87%E5%80%99%E7%BE%A4%E4%B9%8B%E8%AE%8A%E9%81%B7%E8%B6%A8%E5%8B%A2%20%E7%94%B1NAHSIT1993-1996%E5%88%B02005-2008.pdf。
彭仁奎、黃國晉、陳慶餘（2006）。肥胖與代謝症候群。基層醫學，21（12），367-371。
馮世祥、羅慶徽、陳宏一、徐尚為、朱基銘、林金定（2007）。某醫學中心員工代謝症候群盛行率與影響因子初探。中華職業醫學雜誌，14（3），141-147。
黃惠屏、許秀月、鍾蝶起、孫建安、朱基銘、楊燦（2008）。不同族群間代謝症候群相關指標之探討－以屏東地區整合性篩檢民眾為例。臺灣公共衛生雜誌，27（3），250-258。
黃麗卿（2006）。台灣地區代謝症候群的盛行率及發生率與代謝症候群的進展：男女性別之差異。台灣大學公共衛生學院預防醫學研究所博士論文，台北市。
劉易承、宋鴻樟、謝玲玲、唐瑞平、葉志清（2008）。大腸直腸癌之風險預測模式與風險指標。台灣衛誌，27（1），1-12。
劉亮吟（2008）。中部科學園區某薄膜液晶顯示器公司員工新陳代謝症候群之盛行率及相關危險因子探討。中國醫藥大學醫務管理學研究所碩士論文，台中市。
劉秋松、黃亦潔、廖珮彤、林正介、李采娟、葉志清（2012）。代謝症候群危險因子探討。長庚科技學刊，16，1-14。
蔡崇煌、黃素雲、林高德（2005）。代謝症候群與其相關因子之研究—健檢資料分析。台灣家醫誌，16（2），112-122。
謝怡君（2009）。睡眠時數與代謝症候群相關性研究。臺灣大學職業醫學與工業衛生研究所學位論文，台北市。
羅元鴻（2008）。新陳代謝症候群及其延伸疾病與運動介入之相關探討。長榮運動休閒學刊，2，58-67。
龔如媛（2008）。高屏地區中老年人代謝症候群影響因子調查與生活品質相關性探討。美和技術學院健康照護研究所碩士論文，屏東縣。