臺灣女性代謝症候群與骨質密度之關聯研究

Abstract

背景：骨質疏鬆症造成骨折的風險增加與骨折後之高致死率是重要的健康議題。近期的研究發現代謝症侯群與低骨質密度的風險具有相關，但各研究的發現並不一致，也不曾有研究探討停經的狀態是否會影響兩者之間的相關。 方法：自2009到2010年間，我們以橫斷式研究，招募共1,577位年齡40至55歲之間，在台北美兆健康檢查中心參加健康檢查的台灣女性。使用雙能量放射線儀測量之腰椎骨質密度，來分析代謝症侯群與低骨質密度風險的相關。另進行分層分析，來探討代謝症侯群及個別組成因子與停經或其他干擾因子的交互作用對低骨質密度風險之影響。 結果：研究結果顯示代謝症侯群會降低女性低骨質密度的風險[adjusted OR (AOR) = 0.32, 95% confidence interval (CI) = 0.19-0.56]。腹部肥胖(AOR = 0.54, 95% CI = 0.35-0.84)、高血壓(AOR = 0.63, 95% CI = 0.43-0.94)、高空腹血糖(AOR = 0.66, 95% CI = 0.48-0.90)也會降低女性低骨質密度的風險。停經對代謝症侯群之個別因子無顯著交互作用存在(P interaction > 0.05 )。 結論：代謝症侯群、腹部肥胖、高血壓及高空腹血糖會降低女性低骨質密度的風險。停經與代謝症侯群之個別因子間無顯著交互作用。

Background Osteoporosis (OP) is a major public health issue because of it has been linked to increased fracture risk and the subsequent mortality. Metabolic syndrome (MetS) has been related to several health issues. However, the association between MetS and BMD has been inconsistent and no previous study has explored how menopausal status modified this association. Methods A total of 1,577 Taiwanese women aged 40 to 55 years old were recruited from the MJ Health Screening Center between 2009 and 2010. Bone mineral density (BMD, g/cm2) was measured at the lumbar spine by using dual-energy X-ray absorptiometry (DXA) and were tertiled (T1, T2, and T3). MetS is based on the definition from ATP III report with modification for the Asian criteria for waist circumference and fasting glucose. High BMD was defined as T2 plus T3, low BMD was defined as T1. This study was aimed to explore the association between MetS or individual component of MetS and BMD in Taiwanese women. We also explored how menopausal status or other potential confounders modified this association. Results Women with MetS had a decreased risk of low BMD [adjusted OR (AOR) = 0.32, 95% confidence interval (CI) = 0.19-0.56]. Women with abdominal obesity (AOR = 0.54, 95% CI = 0.35-0.84), high blood pressure (BP, AOR = 0.63, 95% CI = 0.43-0.94), or high fasting glucose (AOR = 0.66, 95% CI = 0.48-0.90) had a decreased risk of low BMD. Menopausal status did not significantly modify the association of each individual components of MetS (P interaction >0.05), or MetS itself, with BMD. Conclusions Women with MetS, abdominal obesity, high BP, or fasting glucose were significantly associated with a decreased risk of low BMD. Menopausal status did not significantly modify the associations between MetS or individual components of MetS and the risk of low BMD.