| 摘要: | 研究目的–本研究目的如下 (1)、比較不同飲食型態預測糖尿病、高血壓和代謝症候群發生的關係 (2)、探討肥胖指標變化與糖尿病發生的關係 (3)、持續追蹤建立本土的糖尿病世代 材料與方法 –以2006年起在台大雲林分院建立的糖尿病研究世代2000名個案為對象，每兩年至三年進行定期追蹤。納入本世代的條件是過去不曾被診斷出糖尿病的30歲以上的成人為對象，進行葡萄糖耐性測試診斷與各種基本和生化檢測。抽血檢查項目主要有葡萄糖耐性測試、總膽固醇、高密度膽固醇、低密度膽固醇、三酸甘油脂、胰島素、糖化血色素、發炎指標(hsCRP)、肝功能(GOT、GPT、GGT)等。另有1000份三日飲食日誌與飲食頻率問卷。 結果-不同的飲食型態與糖尿病、高血壓、代謝症候群沒有統計顯著相關。有代謝症候群的在年齡、體質比、高血壓、糖尿病、高膽固醇血症、低密度酯蛋白膽固醇皆顯著的較高。新發生糖尿病與沒發病的基本資料世代研究比較，新發生的糖尿病比沒發生的年紀較大、體質比較高、腰圍較粗、腰臀比較大、HbA1c較高、總膽固醇較高、低密度膽固醇較高、高密度膽固醇較低、三酸甘油脂較高、ΔHOMA2-β/year較高、ΔHOMA2-IR/year較高。體質比年變化量、腰圍年變化量與腰臀比年變化量與各變項的相關分析，與ΔBMI/year具有顯著相關的變項有體質比、高密度膽固醇。與ΔWC/year具有顯著相關的變項有體質比、腰圍、和空腹血糖。與ΔWHR/year具有顯著相關的變項有年齡、性別、體質比、腰圍、空腹血糖、OGTT兩小時後血糖、胰島素阻抗、總膽固醇、高密度膽固醇。從結果顯示，這三個肥胖指標似乎以腰臀比最能反映身體的許多生化指標。各肥胖指標年均變化量與糖尿病發生的危險比，校正年齡、性別、糖尿病家族史、體質比、腰圍、腰臀比、空腹血糖、OGTT 2hPG, HbA1c, HOMA2-IR, ISI0,120, HOMA2-β, 總膽固醇、三酸甘油脂、總膽固醇、低密度膽固醇與高密度膽固醇之後還有顯著的指標是ΔBMI/year與ΔWHR/year。 結論-1、飲食的型態與糖尿病、高血壓和代謝症候群的發生沒有達到統計顯著差異2、各肥胖指標與身體的生化指標相關性以腰臀比最為可以做為肥胖指標的主要參考。3、肥胖是糖尿病發生最重要的因子外，ΔBMI/year與ΔWHR/year也是重要因素。
OBJECTIVE –The purposes of this study are as followed： 1、 To compare the difference among dietary patterns for predicting the incidence of diabetes, hypertension and metabolic syndrome 2、 To explore the relationship between the changes of obesity indicators and diabetes incidence 3、 To follow-up the cohort of Taiwan Lifestyle Study continuously RESEARCH DESIGN AND METHODS –From 2006, about 2000 individuals aged≧30years, who had received health examinations at the National Taiwan University Hospital Yun-Lin branch during the previous year and had fasting plasma glucose levels <126 mg/dL, were invited to participate in the Study. And then, they had an oral glucose tolerance test (OGTT) and physical examination. We follow up the cohort every two-years. In this ongoing study, we will conduct blood examination for estimation of biochemical, metabolic and anthropometric characteristics, including weight, height, waist circumference, hip circumference, OGTT, HbA1c, triglyceride, high and low density cholesterol, blood pressure, insulin resistance, high sensitivity c-reactive protein, GPT, GPT, GGT. There were 1000 dietary data questionnaires, including food frequency questionnaire and 3-day dietary record during 2006-2009. Results—there were no significant difference for incidence of diabetes/metabolic syndrome (MS) among different dietary patterns Compared with subjects without MS, MS subjects were older, had a higher mean BMI, hypertension, total cholesterol, diabetes and high density cholesterol. Subjects with new diabetes were older and higher BMI, waist circumference, waist-to- hip ratio (WHR), HbA1c, total cholesterol, low density cholesterol, T, ΔHOMA2-β/year and ΔHOMA2-IR/year than objects without diabetes. After adjusting age, gender, family history of first degree relatives having diabetes, BMI, WC, and WHR at baseline, FPG, OGTT 2hPG, HbA1c, HOMA2-IR, ISI0,120, HOMA2-β, T-chol, TG, LDL-C, and HDL-C, there were still significantly for ΔBMI/year and ΔWHR/year , associated with incidence of type 2 diabetes. Conclusions- 1. There were no significant difference between dietary patterns and MS/DM. 2. WHR was the most significant association with biochemistry characteristics than other indices of obesity. 3. Obesity was the most important risk factor for diabetes incidence. Besides, ΔBMI/year and ΔWHR/year were important as well. |
