| 摘要: | 由於近二十年來全球肥胖盛行與生活型態的改變，代謝症候群成為重要問題。其高盛行率與增加趨勢，以及與多種慢性疾病的顯著相關，在公共衛生觀點更顯重要。根據過去研究，傳統心血管疾病危險因子如高血壓、膽固醇異常已有所改善，身體質量指數及肥胖等代謝相關因子卻逐年上升，顯示代謝症候群及代謝相關危險因子變化趨勢、其影響因素等問題需要探討。然而，多數研究在歐美白人種族進行，且未涵蓋腰圍、血糖、胰島素阻抗、三酸甘油酯等具有代謝症候群致病生理意義的代謝因子。代謝相關因子之表現有種族、地區差異，也受環境及生活型態因素的影響，在不同族群監測這些因子的變化有其必要性。此外，過去研究證明代謝症候群對於心血管疾病的顯著預測力，但其對於動脈硬化發展及硬化程度變化之影響還未確定。台灣金山心血管世代研究建立於1990 年，以前瞻性的研究設計調查與追蹤心血疾病罹病、死亡率趨勢及其影響因素。金山世代研究的經驗已顯示代謝症候群增加國人心血管問題危險性，本計畫擬進一步探討更深入的問題，包括國人代謝症候群、其組成因子及其他代謝相關心血管危險因子10 年來的變化趨勢，其影響因素，以及這些代謝因子對於頸動脈硬化過程(或變化)的影響。
Over the past two decades, the prevalence of obesity and the sedentary lifestyles have reached global epidemic levels, and metabolic syndrome is worldwide prevalent, and attracts an increasing attention. Previous studies have shown decreasing levels of conventional cardiovascular risk factors such as high blood pressure and total cholesterol, but revealed upward trends in the levels of body mass index and percentages of obesity. Further investigation is needed for the changes in the prevalence of metabolic syndrome and metabolic risk factors, and its predictors. However, most studies are performed in European and American whites, and lack for information on the trends of metabolic factors such as waist circumference, blood glucose, insulin resistance and triglyceride, each may play an important role in the pathophysiologic mechanism of metabolic syndrome. The presence of metabolic risk factors are different among ethnicity and areas, and relevant to environmental and lifestyle factors. Thus, it is important to monitor these metabolic factors in diverse populations. In addition, population-based studies have demonstrated that metabolic syndrome is an independent predictor of cardiovascular events, but its impact on the progress of atherosclerosis has been undetermined. The Chin-Shan Community Cardiovascular Cohort study, a community-based prospective study established in northern Taiwan since 1990, was to investigate determinants of cerebrovascular and cardiovascular events in a general population of Taiwanese adults. Metabolic syndrome has been shown a predictor of development of coronary heart disease and stroke in the study cohort. Based on the cohort, the present study seek to further investigate the trends of metabolic syndrome, its individual components and other metabolic-related risk factors, and to determine the factors associated the changes of metabolic risk factors. We also evaluate the association of metabolic risk factors and its changes with the progress of carotid atherosclerosis. |
