宜蘭鄉村地區中老年人代謝性症候群與胰島素阻抗性之關係

Backgrounds: Metabolic syndrome is the clustering of multiple cardiovascular risk factors, and is also highly associated with insulin resistance. However, the diagnostic criteria of metabolic syndrome, especially central obesity demand adjustments for different ethnic populations. The aims of this study were to evaluate the relationship between insulin resistance and metabolic syndrome among the middle-aged and elderly population in I-Lan, Taiwan, and to compare the results by using waist circumferences and waist-to-hip ratio to define central obesity. Materials and Methods We conducted a community-based study for metabolic disorders among subjects aged more than 40 years old. Personal history taking, anthropometric measurements were performed by experienced research staff. Serial blood testes including serum total cholesterol, high-density lipoprotein cholesterol, triglyceride, and fasting plasma insulin levels were measured. Quantification of insulin resistance was achieved by homeostasis model assessment (HOMA), and the highest tertile of HOMA-IR was defined as insulin resistant. Results: In total, 373 subjects (male: female=159:214, mean age=61.8±11.3years) participated in this study. The prevalence of blood pressure 130/85 mmHg was 64.9%, fasting plasma glucose 110mg/dL was 24.4%, serum triglyceride levels l50mg/dL was 31.1%, low serum high density lipoprotein cholesterol (male＜40 mg/dL, female＜50 mg/dL) was 62.3%, and central obesity was 79.9% (waist circumference of ＞90 cm in males or ＞80cm in females) or 70.2% (waist-to-hip ratio＞0.9 in males or ＞0.85 in females). The prevalence of metabolic syndrome was 56.3% by using waist circumference to define central obesity, and 54.2% by using waist-to-hip ratio. The consistency of metabolic syndrome diagnosis using waist circumference or waist-to-hip ratio was 95.7%. The mean HOMA-IR was significantly elevated as each component of metabolic syndrome was added (P＜0.001). Among the subjects with insulin resistance, 75.8% were metabolic syndrome by using waist circumference, and 75% by using waist-to-hip ratio to define central obesity. Conclusions: The prevalence of metabolic syndrome among the middle-aged and elderly was about 50%, which deserved further attention in the healthcare system. The diagnostic consistency of metabolic syndrome by either waist circumference or wait- to-hip ratio was high, as well as the association of insulin resistance.(FuIl text in Chinese)