不同體型與健康檢查指標相關性之研究-隱藏性肥胖者之風險指標
The relationship between body composition and indicators of physical examination: A study on the health risk indicators of concealed
中文摘要
身體質量指數(body mass index, BMI)是最常被使用作為評斷肥胖程度的指標，但 BMI 會受到性別、個人、年齡及種族的影響，無法完全表示體內脂肪堆積的情 形。臨床上常有一些年輕的受檢者，其 BMI 正常，體脂肪率過高，但因外型標 準且無重大健康問題，而忽略健康管理的重要性。將受檢者體型依體組成分為五 大類，分別為正常(Normal)、隱藏性肥胖(Concealed Obesity)、肥胖(Obesity)、BMI 偏低體脂肪未超過(Low BMI & Low Body Fat)與 BMI 過高體脂肪未超過(High BMI & Low Body Fat)。探討被歸類為隱藏性肥胖體型者，其重要的健康檢查指 標(血壓、腰臀比、空腹血糖、脂肪肝、肝功能指數、尿酸、血脂等七項指標)之 異常發生率與平均值是否高於正常體型者，是否可作為代謝性疾病的警訊，提早 給予健康對策，預防未來生活習慣病或代謝性疾病的發生。本研究是利用 2006 年度 8 萬名受檢人次之體檢資料進行分析。收集所有接受全身健康檢查者的問卷 及體檢結果資料。使用 SPSS 軟體進行資料分析，包括：百分比、平均值、標準 差、交叉分析等。以卡方檢定(Chi-square test)與一方分類變異數分析(ANOVA test) 分析各項健康指標與不同體組成之間的相關性。男性隱藏性肥胖體型，在腰臀 比、脂肪肝、肝功能檢查、尿酸與血脂肪之異常發生率明顯高於正常體型者(p <
0.001)，而在女性隱藏性肥胖、肥胖與 BMI 過高體脂率正常之體型，七項指標之 異常率皆明顯高於正常體型者(p < 0.001)。在隱藏性肥胖體型中，其尿酸、三酸 甘油酯、膽固醇與 CHOL/HDL-C 之平均值明顯高於正常體型者(p < 0.001)。若再 區分性別，男性在腰臀比、尿酸、三酸甘油酯、膽固醇、CHOL/HDL-C 之平均 值顯著地高於正常體型(p < 0.001) ， HDL-C 平均值顯著地低於正常體型(p <
0.05)；女性則在腰臀比、尿酸、三酸甘油酯、CHOL/HDL-C 之平均值顯著地高 於正常體型(p < 0.001)。對於隱藏性肥胖者，其未來發生心血管疾病、代謝症候 群、慢性病的機率可能高於正常體型者。
英文摘要
Body mass index (BMI) is the most frequently used standard for determinate obesity.
But, BMI would be affected by gender, personal, age and nationality. Also, it cannot fully indicate the distribution of body fat. Some of the younger examinees, they may disregard the importance of the health management due to their appearance look like normal and without any serious illness. However, their BMI falls in the normal range but with high percentage of body fat. Body composition of the examinees will be
divided into 5 body shapes: separately, normal, concealed obesity, obesity, Low BMI
& Low percentage of body fat, and High BMI & Low percentage of body fat. The issue is focusing to discuss the concealed obesity. It will compare the health indexes including blood pressure, hip/waist ratio, fasting blood sugar, fatty liver, liver functions, urine acid and blood lipid tests, with the healthy examinees, to study if it can be reflected the chance of having metabolic syndrome. If there are relationships between the health indexes and the chance of having metabolic syndrome, suggestions can be provided as soon as possible to prevent the life-style diseases and metabolic syndromes. This research is based on the data of the health check-up in year 2006 that it includes 80 thousands examinees with their questionnaires and check-up results.
The data is analyzed by SPSS including percentage, means, standard derivation, and alternating analysis. The research also analyzed the relation between health indexes and body shapes by Chi-square test and ANOVA test.Males with concealed obesity usually had abnormal WHR, fatty liver, abnormal liver function, elevated urine acid level, and abnormal blood lipid tests, compared with normal population (p < 0.001).
For females with concealed obesity, with obese and High BMI & Low percentage of body fat population, those 7 health indexes are usually above normal population (p <
0.001). Regarding to the concealed obesity, their triglyceride, total cholesterol and CHOL/HDL-C level are also above normal population (p < 0.001). If separated by gender, males had WHR, urine acid, triglyceride, cholesterol and CHOL/HDL-C are usually above normal population, and HDL-C is lower than normal population (p <
0.001). For females, WHR, urine acid, triglyceride, CHOL/HDL-C are usually above normal population (p < 0.001).The findings indicated that cardiovascular diseases, metabolic symptoms and chronic disease may a positively associated with concealed obesity.
