| 摘要: | 目的：本研究旨為探討與慢性腎臟病有關的因素，尤其是健康生活型態(health lifestyles)與飲食行為，並比較慢性腎臟病有無在社會人口學特徵、過去疾病史及生活型態和飲食等變項之分佈，並檢驗與慢性腎臟病有關之危險因素。
方法：本研究為橫斷式研究(cross-sectional study)，研究對象為嘉義縣六個鄉鎮市區參加成人健檢之民眾，以結構式的自製問卷及血液、尿液樣本蒐集相關資料，剔除資料不完整的樣本，共獲得有效樣本4499人。
結果：有慢性腎臟病者比率為19.65%，一至五期分別為0.4%、2.5%、15.9%、0.7%、0.2%。經複邏輯斯迴歸分析後，結果發現顯著影響慢性腎臟病的因素有族群、工作狀態、年齡、高血壓、高血糖、心臟病和水果攝取行為等七個因素。其中，原住民罹患慢性腎臟病的風險是閩南人的1.51倍(OR=1.51, p=0.004)，無工作者罹患慢性腎臟病的風險是有工作者的1.28倍(OR=1.28, p=0.017)，年齡每增加一歲其罹患慢性腎臟病的風險亦會增加至1.08倍(OR=1.08, p<0.001 )，有高血壓、高血糖、心臟病者罹患慢性腎臟病風險較無該疾病者高，且分別是1.87倍、1.73倍與1.42倍(OR=1.87, p<0.001; OR=1.73, p<0.001; OR=1.42, p=0.015)，每天攝取兩份(含)以上水果者比起每天攝取少於兩份水果者於罹患慢性腎臟病的風險上較低，且為後者的0.74倍(OR=0.74, p=0.024)。
結論：本研究結果顯示農業型縣市區民眾的慢性腎臟病比率偏高，在控制其他因素對慢性腎臟病的影響後，影響慢性腎臟病的因素除了族群與年齡外，還包括過去的三高及心臟病史，而攝食水果的行為具保護降低罹患慢性腎臟病的效果。綜合上述，防治慢性腎臟病可藉由防治其他慢性疾病和改變飲食行為，尤其是攝取水果的行為來著手。
Objectives: The aims of this study were to understand the rate of chronic kidney disease in adults, and to examine the risk factor associated with the occurrence of chronic kidney disease.
Methods: This study used a cross-sectional study design. The study subjects were recruited from participants in the health examination services provided by Chiayi County Health Bureau. With obtaining subjects’ informed consents, information on sociodemographics, medical history of chronic diseases, health lifestyles and eating behaviors was collected by administering a face-to-face interview survey with a structured-questionnaire instrument. In addition, data on creatinine and urine protein were collected from blood and urine specimens. After the exclusion of incomplete data, the analytical sample size in this study is 4499.
Results: The rate of CKD was 19.65%, and the rate for CKD one to five stage were 0.4%, 2.5%, 15.9%, 0.7%, and 0.2%, respectively.The result of multiple logstic regression analyses revealed that the significant risk factors were ethnicity, work status, age, hypertension, hyperglycemia, heart disease, and fruit intake per day. The odds of having CKD in indigenous people were 1.51 times higher than those in Taiwanese people (OR=1.51, p=0.004). The likelihood of having CKD in people without work had 1.28 times higher than that in people without to have CKD than people with work (OR=1.28, p=0.017). One year increase in age would increase 1.08 times likelihood to have CKD(OR=1.08, p<0.001 ). The odds of having CKD in people with medicial history of hypertension, hyperglycemia, and heart disease were 1.87, 1.73, and 1.42 times higher than those for pepple without the diseases histories (OR=1.87, p<0.001;OR=1.73, p<0.001;OR=1.42, p=0.015). Consuming equals to or more than two servings of fruit one day would lower the likelihood of having CKD to 0.74 times, comparing to consuming less than two servings of fruit one day (OR=0.74, p=0.024).
Conclusion: In this study, we found the rate of CKD in the population of the agricultural county was higher than that in the general Taiwan population. The significantly associated risk factors were ethnicity, age, hypertension, hyperglycemia, heart disease, and fruit intake per day. Therefore, this study suggested that for health governments to implement a assuccessful prevention programs, CKD educating and promoting behavioral change programs, fruit intake in particles, and making more efforts on chronic diseases' prevention programs would be right directions to go further. |
