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完整後設資料紀錄
DC 欄位 | 值 | 語言 |
---|---|---|
dc.contributor.advisor | 蕭寧馨(NING-SING SHAW) | |
dc.contributor.author | Jui-Line Wang | en |
dc.contributor.author | 王瑞蓮 | zh_TW |
dc.date.accessioned | 2021-06-13T06:54:56Z | - |
dc.date.available | 2005-07-30 | |
dc.date.copyright | 2005-07-30 | |
dc.date.issued | 2005 | |
dc.date.submitted | 2005-07-27 | |
dc.identifier.citation | 中國營養學會(2000)中國居民善食營養素參考攝取量。中國輕工業出版社。北京。
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dc.identifier.uri | http://tdr.lib.ntu.edu.tw/jspui/handle/123456789/35485 | - |
dc.description.abstract | 本研究之主要目的是評估台灣地區男女兩性成人與老人之鐵營養與貧血狀況,並篩選其重要影響因子。樣本取自兩個調查資料:(1)「82年-85年國民營養健康狀況變遷調查」﹙NAHSIT 1993-1996﹚之19-64歲成人,計有男性886人及女性1017人,共計1903人。(2)「台灣地區老人國民營養健康狀況調查」(NAHSIT 1999-2000)之65歲以上居家老人,完成問卷資料與鐵營養指標分析者,計有男性724人及女性703人,共計1427人。缺鐵評估採用多指標模式,以血紅素、運鐵蛋白飽和度及鐵蛋白濃度三項。預測模式與影響因子之篩選採用多元逐步迴歸分析及邏輯式迴歸分析。
結果可見,缺鐵率方面:男性輕度缺鐵率為0.1 %、19-50歲女性8.6 %、51-64歲女性6.2 %,男性老人2.3 %、女性老人1.4 %。男性缺鐵貧血率為0.1 %、19-50歲女性6.8 %、51-64歲女性1.3 %,男性老人2.5 %、女性老人2.0 %。男性總缺鐵率為0.2 %、19-50歲女性15.4 %、51-64歲女性7.5 %,男性老人4.8 %、女性老人3.4 %。貧血率方面:男性為6.6 %、19-50歲女性25.2 %、51-64歲女性16.0 %,男性老人19.5 %、女性老人18.8 %。女性是缺鐵、也是貧血的主要危險群,尤其是停經前女性。 鐵營養方面,多元逐步迴歸分析結果,血清鐵蛋白濃度的迴歸公式分別為: 19-50歲女性:血清鐵蛋白濃度對數值=3.62-0.83×(是否有月經)-0.11×(月經天數)+0.52×(是否規律使用補充劑)-0.001×(飲食維生素C量)+0.02×(年齡)+26.97×(飲食鐵密度)+0.06×(血液維生素狀況)-0.16×(生產次數)+0.03×(BMI; Body Mass Index);51-64歲女性:血清鐵蛋白濃度對數值=2.69+0.03×(年齡)-1.21×(是否有月經)+0.001×(飲食維生素C量)+0.09×(血液維生素狀況)+0.06×(BMI);男性:血清鐵蛋白濃度對數值=4.55+0.07×(血液維生素狀況)+0.001×(酒精攝取量)+0.01×(海鮮與肉類攝取頻率);女性老人:血清鐵蛋白濃度對數值=1.59+0.01×(年齡)-0.01×(血液葉酸濃度)+0.10×(營養資訊)+0.41×(血液肌酸酐濃度)+0.34×(白蛋白濃度)+0.01×(肌酸酐排除速率);男性老人:血清鐵蛋白濃度對數值=4.15-0.01×(年齡)+2.33×(腰臀比)+0.91×(ETKAC; Erythrocyte transketolase activity coefficient)-1.44×(EGRAC; Erythrocyte glutathione reductase activity coefficient)-0.02×(血液葉酸值)-0.04×(飲食血基質鐵量)-0.03×(飲食粗纖維量)+0.001×(飲食維生素C量)。升高缺鐵風險的因素分別是:19-50歲女性有月經者、教育程度高、年齡大;51-64歲女性為BMI<18.5;男性老人為飲食鐵密度高。降低缺鐵風險的因素分別是:19-50歲女性為BMI大、水果攝取頻率高、酒精攝取≧3 g;51-64歲女性為月經週期天數長;男性老人為BMI大。 貧血方面,多元逐步迴歸分析結果,血紅素濃度的迴歸公式分別為:19-50歲女性:血紅素濃度=10.83+0.43×(鐵蛋白濃度)+0.03×(水果攝取頻率);51-64歲女性:血紅素濃度=11.92+0.46×(鐵蛋白濃度)-0.29×(血液維生素狀況);女性老人:血紅素濃度=10.61-0.04×(年齡)+0.10×(BMI)+0.96×(白蛋白濃度)-0.80×(血液肌酸酐濃度)+0.23×(血清鐵蛋白濃度)-0.04×(飲食血基質鐵);男性老人:血紅素濃度=9.26-1.26×(血液肌酸酐濃度)+0.88×(白蛋白濃度)+0.06×(BMI)+0.03×(飲食肉類攝取)-0.01×(生肉/煙燻肉/茶/咖啡攝取頻率)-0.01×(飲食指南分數)+0.77×(ETKAC)-0.01×(年齡)。升高貧血風險的因素分別有:19-50歲女性為缺鐵;51-64歲女性為缺鐵與血液維生素狀況佳;女性老人為缺鐵與血液肌酸酐濃度高;男性老人為缺鐵。降低貧血風險的因素分別有:19-50歲女性為水果攝取頻率高;51-64歲女性為抽煙者;女性老人為BMI高與血液白蛋白濃度高;男性老人為BMI高與肌酸酐排除數率高。 本研究結果顯示,男女兩性成人與老人的鐵營養狀況都會受飲食因素的影響;此外,停經前女性還受個人生理特性的影響。老人則受個人生理特性與慢性疾病的影響。男女兩性成人與老人貧血的主要影響因素是缺鐵以及飲食與營養因素,老人的貧血還受個人生理特性與慢性疾病的影響。因此,改善個人微量營養素之充足程度有助於降低國人的缺鐵與貧血問題,此外若能針對性別與年齡特質提供進一步的保健防治措施,例如停經前婦女的個人生理問題的調理,老人慢性疾病的良好控制等,成效將可更為顯著。 | zh_TW |
dc.description.abstract | The thesis was aimed to assess the iron status and anemia of both female and male adults and elderly and their associated factors in Taiwan, using data collected in the Nutrition and Health Survey in Taiwan (NAHSIT) 1993-1996 and the Elderly NAHSIT 1999-2000. The sample analyzed included 703 women and 724 men aged between 19 and 64 years and 1202 elderly men and 1152 elderly women aged 65 years and older. Iron status was assessed using a multiple factor model including serum ferritin, transferrin saturation and hemoglobin. Factors and models associated with iron deficiency and anemia were analyzed with multiple logistic regression and stepwise regression.
The prevalence of iron deficient erythropoiesis was 0.1 % in adult men, 8.6 % in women aged 19-50 years, 6.2 % in women aged 51-64 years, 2.3 % in elderly men and 1.4 % in elderly women. The prevalence of iron deficiency anemia was 0.1 % in adult men, 6.8 % in women aged 19-50 years, 1.3 % in women aged 51-64 years, 2.5 % in elderly men and 2.0 % in elderly women. The prevalence of anemia was 6.6 % in adult men, 25.2 % in women aged 19-50 years, 16.0 % in women aged 51-64 years, 19.5 % in elderly men and 18.8 % in elderly women. The regression formula for serum ferritin concentration were: for women aged 19-50 years: log (ferritin)=3.62- 0.83×(menstruating or not)- 0.11×(days of menstruation period)+ 0.52×(regular supplement user or not)- 0.001×(Vitamin C intake)+ 0.02×(age)+ 26.97×( dietary iron density)+ 0.06×(blood vitamin status)- 0.16×(parity)+ 0.03×(BMI; Body Mass Index);for women aged 51-64 years: log (ferritin)=2.69+ 0.03×(age)- 1.21× (menstruating or not)+ 0.001×(Vit.C intake)+ 0.09×(blood vitamin status)+ 0.06×(BMI); for adult men: log (ferritin)=4.55+ 0.07×(blood vitamin status)+ 0.001×(alcohol consumption)+ 0.01×(frequency of seafood and meat consumption);for elderly women: log (ferritin)=1.59+ 0.01×(age)- 0.01×(serum folate) +0.10×(nutrition information) +0.41×(serum creatinine)+ 0.34×(serum albumin)+ 0.01×(CrCl; Creatinine clearance); for elderly men: log (ferritin)=4.15- 0.01×(age)+ 2.33×(waist-hip-ratio)+ 0.91×(ETKAC; Erythrocyte transketolase activity coefficient)- 1.44×(EGRAC; Erythrocyte glutathione reductase activity coefficient)- 0.02×(serum folate)- 0.04×(heme iron intake)- 0.03×(dietary fiber)+ 0.001×(Vit.C intake). Factors associated with increased iron deficiency risk were: menstruating, education years>12 and increased age for 19-50-year women; BMI<18.5 for 51-64-year women; increased dietary iron density for elderly men. Factors related to decreased iron deficiency risk were: increased BMI, high frequency of fruit consumption and alcohol intake≧3 g for 19-50-year women; days of menstruation cycle for 51-64-year women; increased BMI for elderly men. The regression formula for serum ferritin concentration were: for 19-50-years women: hemoglobin=10.83+ 0.43×(serum ferritin)+ 0.03×(frequency of seafood and meat consumption); for 51-64-year women: hemoglobin=11.92+ 0.46×(serum ferritin)- 0.29×(blood vitamin status); for elderly women: hemoglobin=10.61- 0.04×(age)+ 0.10×(BMI)+ 0.96×(serum albumin)- 0.80×(serum creatinine)+ 0.23×(serum ferritin)- 0.04×(heme iron intake); for elderly men: hemoglomin=9.26- 1.26×(serum creatinine)+ 0.88×(serum albumin)+ 0.06×(BMI)+ 0.03×(meat intake)-0.01×(frequency of raw meat/smoked meat/tea/coffee consumption)- 0.01×(dietary guideline score)+ 0.77×(ETKAC)- 0.01×(age). Factors related to increased anemia risk were: iron deficiency for 19-50-year women; iron deficiency and better blood vitamin status for 51-64-year women; iron deficiency and increased serum creatinine for elderly women; iron deficiency for elderly men. Factors related decreased risk were: increased frequency of fruit consumption for 19-50-year women; smoking for 51-64-year women; BMI and increased CrCl for elderly men. | en |
dc.description.provenance | Made available in DSpace on 2021-06-13T06:54:56Z (GMT). No. of bitstreams: 1 ntu-94-D87623702-1.pdf: 1189366 bytes, checksum: eb90b6e438592cf4535463a9eb91029c (MD5) Previous issue date: 2005 | en |
dc.description.tableofcontents | 目 錄 頁 數
中文摘要 I 英文摘要 III 第一章 緒論 1 第一節 研究背景 1 1.1.1.鐵的生化與生理功能 1 1.1.2.鐵之需要量 1 1.1.3.鐵營養狀況變化與缺鐵評估 2 1.1.4鐵之可利用率、建議量與攝取量 3 1.1.5缺鐵對健康之影響 4 1.1.6貧血之標準與影響 5 1.1.7國人缺鐵與貧血狀況 7 1.1.8鐵過量之疑慮 7 第二節 研究目的 9 第三節 研究資料來源 10 第二章 台灣地區成人鐵營養與貧血狀況和影響因素 11 第一節 文獻回顧 11 2.1.1 成人缺鐵狀況與影響因素 11 2.1.1.1 各國成人缺鐵標準與缺乏盛行率 11 2.1.1.2 鐵營養與個人生理與疾病因素 12 2.1.1.3 鐵營養與生活環境因素 13 2.1.1.4 影響鐵營養狀況之飲食食物組成份因素 14 (1)鐵攝取量 (2)不同食物來源的鐵有不同的可利用率 (3)食物其他成分之影響 2.1.2 成人貧血狀況與影響因素 15 2.1.2.1 各國成人貧血標準與盛行率 15 2.1.2.2 貧血與個人生理與疾病因素 16 2.1.2.3 貧血與生活環境因素 16 2.1.2.4 貧血之飲食營養因素 16 第二節 研究目的與研究架構 18 2.2.1 研究目的 18 2.2.2 研究架構 19 目 錄 頁 數 第三節 料料與方法 20 2.3.1 資料來源 20 2.3.2 資料內容 20 2.3.2.1 問卷調查資料 20 2.3.2.2 臨床血液生化檢查資料 21 2.3.2.3 飲食健康指數分析 23 2.3.2.4 飲食型態分析 24 2.3.3 統計分析 25 第四節 結果 27 2.4.1 缺鐵狀況與影響因素 27 2.4.1.1 鐵營養指標分析 27 2.4.1.2 鐵營養指標間之相關性 27 2.4.1.3 缺鐵盛行率與鐵營養指標表現 28 2.3.1.4 缺鐵者與正常者之影響因素比較 29 2.4.1.5 血清鐵蛋白濃度影響因素之多元迴歸分析 29 2.4.1.6 女性成人缺鐵影響因素之邏輯式迴歸分析 30 2.4.2 貧血狀況與影響因素 31 2.4.2.1 貧血盛行率 31 2.4.2.2 貧血者與正常者之影響因素比較 31 2.4.2.3 血紅素濃度影響因素之多元迴歸分析 32 2.4.2.4 女性貧血影響因素之邏輯式迴歸分析 32 2.4.2.5 男性貧血影響因素之邏輯式迴歸分析 33 第五節 討論 34 2.5.1 兩性之鐵營養狀況 34 2.5.2 影響成人鐵營養狀況之重要因素 34 2.5.2.1 缺鐵與個人生理與疾病因素 35 2.5.2.2 缺鐵與生活環境因素 36 2.5.2.3 缺鐵與飲食營養因素 37 2.5.3 兩性之貧血狀況 37 2.5.4影響成人貧血狀況之重要因素 37 2.5.4.1 貧血與生理、疾病與生活環境因素 38 2.5.4.2 貧血與飲食營養因素 38 目 錄 頁 數 第六節 結論 39 第三章 台灣地區老人鐵營養與貧血狀況和影響因素評估 41 第一節 文獻回顧 41 3.1.1老人缺鐵狀況與影響因素 41 3.1.1.1老化之影響 41 3.1.1.2 各國老人缺鐵盛行率 42 3.1.1.3 感染與發炎現象對老人鐵營養指標之影響 42 3.1.2老人貧血與影響因素 43 3.1.2.1 老人貧血盛行率 43 3.1.2.2 老人貧血影響因素 43 第二節 研究目的與架構 45 3.2.1 研究目的 45 3.2.2 研究架構 46 第三節 材料與方法 47 3.3.1. 資料來源 47 3.3.2 資料內容 47 3.3.2.1 問卷調查資料 47 3.3.2.2 臨床血液生化檢查資料 48 3.3.2.3 飲食健康指數 51 3.3.2.4飲食型態 51 3.3.3 統計分析 51 第四節 結果 53 3.4.1缺鐵狀況與影響因素 53 3.4.1.1 性別年齡分層之鐵營養指標 53 3.4.1.2 鐵營養指標間之相關性 53 3.4.1.3 缺鐵率與缺鐵者之鐵營養指標 54 3.4.1.4 缺鐵與非缺鐵者之影響因素比較 55 3.4.1.5 血清鐵蛋白濃度影響因素多元迴歸分析 55 3.4.1.6 缺鐵影響因素之邏輯式迴歸分析 56 3.4.2 貧血狀況與影響因素 57 3.4.2.1 貧血盛行率 57 3.4.2.2 貧血之影響因素 57 3.4.2.3 血紅素濃度影響因素之多元迴歸分析 58 3.4.2.4 貧血影響因素之邏輯式迴歸分析 58 目 錄 頁 數 第五節 討論 60 3.5.1 兩性之鐵營養狀況 60 3.5.2 影響老人鐵營養狀況之重要因素 61 3.5.2.1 缺鐵與個人生理、疾病因素 62 3.5.2.2 缺鐵與生活環境因素 62 3.5.2.3 缺鐵與飲食營養因素 62 3.5.3 兩性之貧血狀況 63 3.5.4 影響老人貧血狀況之重要因素 63 3.5.4.1 老人貧血與生理疾病因素 64 3.5.4.2 老人貧血與飲食營養因素 64 第六節 結論 66 第四章 綜合討論與結論 67 4.1 國人缺鐵與貧血盛行率 67 4.2 國人缺鐵與貧血之影響因素 67 4.3 結論 67 4.4 建議 68 4.5 未來研究 68 參考文獻 69 表格 80 表格目錄 頁數 表2-1 兩性各年齡層鐵營養指標之平均值及鐵蛋白濃度中位數 80 表2-2 兩性成人鐵營養指標之相關性 81 表2-3 兩性成人各年齡層之缺鐵率 82 表2-4 兩性成人不同缺鐵狀況之鐵營養指標值 83 表2-5 不同年齡層女性缺鐵者與正常者在各變項之差異性比較 84 表2-6 成人影響血清鐵蛋白濃度之多元逐步迴歸分析 86 表2-7 19-50歲女性缺鐵危險因子之多變量邏輯式迴歸分析 87 表2-8 51-64歲女性缺鐵危險因子之多變量邏輯式迴歸分析 88 表2-9 兩性成人各年齡層之貧血盛行率 89 表2-10 不同年齡層成人貧血者與非貧血者在各變項之差異性比較 90 表2-11 兩性成人影響血紅素濃度之多元逐步迴歸分析 92 表2-12 19-50歲女性貧血危險因子之多變量邏輯式迴歸分析 93 表2-13 51-64歲女性貧血危險因子之多變量邏輯式迴歸分析 94 表2-14 19-64歲男性貧血危險因子之多變量邏輯式迴歸分析 95 表2-15 不同國家兩性成人之缺鐵盛行率 96 表2-16 不同國家之兩性成人之貧血盛行率 97 表3-1 兩性成人完成問卷調查及鐵營養狀況分析者之人數表 98 表3-2 兩性老人各年齡層鐵營養指標之平均值及鐵蛋白濃度中位數 99 表3-3 兩性老人鐵營養指標之相關性 100 表3-4 老人不同鐵蛋白濃度之運鐵容量與運鐵蛋白飽和度變化 101 表3-5 兩性老人各年齡層之不同程度缺鐵盛行率 102 表3-6 兩性老人不同程度缺鐵之各項鐵營養指標表現 103 表3-7 兩性老人缺鐵者與正常者在各變項之差異性比較 104 表3-8 影響兩性老人血清鐵蛋白濃度之多元逐步迴歸分析 106 表3-9 男性老人缺鐵危險因子之多變量邏輯式迴歸分析 109 表3-10 女性老人缺鐵危險因子之多變量邏輯式迴歸分析 107 表3-11 兩性老人不同年齡層之血紅素濃度與貧血盛行率 108 表3-12 兩性老人貧血者與正常者在各變項之差異性比較 110 表3-13 兩性老人影響血紅素之多元逐步迴歸分析 112 表3-14 男性老人貧血危險因子之多變量邏輯式迴歸分析 113 表3-15 女性老人貧血危險因子之多變量邏輯式迴歸分析 114 表3-16 不同國家之兩性老人之血清鐵蛋白濃度 115 表3-17 不同國家之兩性老人人之缺鐵盛行率 116 表3-18 不同國家之兩性老人之血紅素濃度 117 表3-19 不同國家之兩性老人人之貧血盛行率 118 表4-1 影響成人與老人缺鐵與貧血狀況之危險因素 119 | |
dc.language.iso | zh-TW | |
dc.title | 台灣地區成人與老人鐵營養與貧血狀況及其影響因子之研究 | zh_TW |
dc.title | Status of Iron Nutrition and Anemia and Their Associated Factors in Taiwanese Adults and Elderly | en |
dc.type | Thesis | |
dc.date.schoolyear | 93-2 | |
dc.description.degree | 博士 | |
dc.contributor.oralexamcommittee | 黃伯超,高美丁,曾浩洋,潘文涵,駱菲莉,劉燦榮 | |
dc.subject.keyword | 國民營養健康狀況變遷調查,台灣地區老人國民營養健康狀況調查,輕度缺鐵,缺鐵性貧血, | zh_TW |
dc.subject.keyword | Nutrition and Health Survey in Taiwan (NAHSIT) 1993-1996,Elderly NAHSIT 1999-2000,iron deficient erythropoiesis,iron deficiency anemia, | en |
dc.relation.page | 119 | |
dc.rights.note | 有償授權 | |
dc.date.accepted | 2005-07-28 | |
dc.contributor.author-college | 生命科學院 | zh_TW |
dc.contributor.author-dept | 微生物與生化學研究所 | zh_TW |
顯示於系所單位: | 微生物學科所 |
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