臺灣博碩士論文加值系統

近年來，越來越多研究顯示，睡眠對於腦血管疾病、血壓、血脂和血糖皆有負面之影響，這些症狀皆是代謝症候群的警訊。因此，本研究目的主要探討睡眠品質與代謝症候群之間相關性及此相關性在性別上之差異。本研究為橫斷性研究，採用國民健康署「2007年台灣地區高血壓、高血糖、高血脂之追蹤調查研究」，具有台灣族群代表性的研究對象，共計4,325名。其中無代謝症候群者3,508人（81.1%），有代謝症候群者817人（18.9%）。研究工具採用面訪問卷、測量紀錄及檢體採集資料進行分析。在面訪問卷中，睡眠品質測量變項，係參考匹茲堡睡眠品質量表及國內外文獻擬定之五個變項，來評估過去一個月睡眠品質量性及質性。代謝症候群定義依據2007年國民健康署判定標準。統計方法為多元羅吉斯迴歸，估計勝算比與95%信賴區間。結果顯示，在睡眠品質「量性」變項中，將半年內平均睡眠時間分為三分類，以睡眠時間正常（7小時（含）~不到9小時）為參考組，睡眠時間過短者（不到7小時），其得到代謝症候群危險性有顯著上升之情形（勝算比=1.24，95%信賴區間=1.05-1.48）。將性別分層後，男性族群睡眠時間過短（不到7小時），與代謝症侯群危險性有顯著相關（勝算比=1.47，95%信賴區間=1.15-1.87），而女性睡眠時間過短（不到7小時）與代謝症候群無統計上顯著相關（勝算比=1.03，95%信賴區間=0.80-1.32）。在睡眠品質「質性」變項中，整體睡眠品質異常與代謝症候群沒有統計上顯著相關（勝算比=1.13，95%信賴區間=0.89-1.43）。性別分層後，在男性族群，睡眠品質異常與代謝症候群沒有統計上顯著相關（勝算比=1.10，95%信賴區間=0.82-1.49）。而在女性族群中，將沒有睡眠品質異常項目當參考組，有一種睡眠品質異常（在夜間會醒來3次以上）者，與代謝症候群危險性有顯著相關（勝算比=1.47，95%信賴區間=1.15-1.87）。
根據本研究結果可以得知，半年內平均睡眠時間過短（不到7小時）與代謝症候群盛行率有顯著相關，而睡眠品質雖然與代謝症候群無顯著相關，但在性別分層後，女性在夜間會醒來3次以上者，則可能提高代謝症候群盛行率，因此，睡眠品質與代謝症候群之相關性因性別不同而有所差異。

The past studies show that sleep disorders were associated with the risks of hypertension, diabetes, dyslipidemia, and cardiovascular disease. Therefore, the aim of this study was to examine the relationships of sleep quality and sleep duration with metabolic syndrome (MetS).
Study participants for this cross-sectional study were identified from the 2007 Taiwan Survey of Hypertension, Hyperglycemia, and Hyperlipidemia (2007TwSHHH). A total of 4,325 adults were recruited, including 3,508(81.1%) participants without MetS and 817 subjects (18.9%) with MetS. Data collected included questionnaire, anthropometric, and blood pressure measurements, and blood biochemistries.
Assessment of sleep status was based on 5 questions derived from the Pittsburgh Sleep Quality Index (PSQI). The MetS was defined according to 2007 version of the Health Promotion Administration, Ministry of Health and Welfare in Taiwan.The multivariable logistic regression models were used to estimate the odds ratios (ORs) and 95% confidence intervals(95%CI）.
The results of this study showed that short sleep duration (<7 hours per night) was a significant correlate of MetS (OR=1.24, 95% CI=1.05-1.48). As compared with normal sleep duration (7-9 hours per night).As stratified by gender, short sleep duration was associated with a significantly higher prevalence of MetS in men (OR=1.14, 95%CI=1.03-1.56), but not in women (OR=1.03, 95% CI=0.80-1.32). With respect to sleep quality, there were no significant associations between specific components of sleep quality and MetS in men.However, women who wake up three times a night had a significantly higher prevalence of MetS than those without such sleep complaint (OR=1.47, 95% CI=1.15-1.87).
In conclusion, short sleep duration was a significant correlate of MetS. In addition, there was a gender-dependent effect of poor sleep quality on the prevalence of MetS.

正文目錄..........................................................................I
圖表目錄..........................................................................Ⅲ
中文摘要 ........................................................................ V
Abstract. ..................................................................... VII
第一章 前言 ........................................................................ 1
第一節 研究背景及重要性............................................................... 1
第二節 研究目的...................................................................... 2
第二章文獻探討 ...................................................................... 3
第一節代謝症候群定義及比較 ............................................................ 3
第二節代謝症候群現況 ................................................................. 6
第三節 睡眠品質探討................................................................... 9
第四節 睡眠品質與代謝症候群相關性...................................................... 14
第三章材料與方法 .......................... ......................................... 23
第一節研究設計 ...................................................................... 23
第二節研究對象 ...................................................................... 24
第三節研究工具 ...................................................................... 25
第四節研究變項操作型定義 ............................................................. 28
第五節統計方法 ...................................................................... 30
第四章研究結果 ...................................................................... 31
第一節代謝症候群基本人口學、生活習慣、體位與生化測量及睡眠狀態分佈情形.......................31
第二節性別分層代謝症候群基本人口學、生活習慣、體位與生化測量及睡眠狀態分佈情形 .............. 33
第三節睡眠品質與代謝症候群之相關分析 ................................................... 38
第四節睡眠品質與代謝症候群五個異常項目多變量分析 ........................................ 41
第五章討論 .......................................................................... 56
第一節影響代謝症候群之危險因素 ........................................................ 56
第二節各種睡眠狀態與代謝症候群之關聯性 .................................................. 60
第三節睡眠品質與代謝症候群五個異常項目之關聯性 ........................................... 66
第四節研究限制 ....................................................................... 70
第六章結論 ........................................................................... 71
參考文獻 ............................................................................. 72

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