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題名 | 醫院從業人員尿酸及其健康風險評估--以北部某醫院為例=Uric Acid and Health Risk Assessment of Hospital Workers in a Northern Taiwan Hospital |
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作者姓名(中文) | 鄭又華; 莊海華; 盧美君; 葉維中; 陳運弘; 林溥; 陳昭源; 鄭又華; | 書刊名 | 中華職業醫學雜誌 |
卷期 | 24:4 2017.10[民106.10] |
頁次 | 頁317-324 |
分類號 | 415.593 |
關鍵詞 | 尿酸; 心血管疾病; 佛萊明罕風險; 醫院從業人員; Uric acid; Cardiovascular disease; Framingham risk score; Hospital worker; |
語文 | 中文(Chinese) |
中文摘要 | 目的:尿酸為許多慢性疾病的危險因子,但並未列於常規勞工健檢項目,以致容易忽略其重要性。有關尿酸是否為心血管疾病之獨立危險因子在不同研究結論分歧。本研究旨在探討北台灣某醫院員工尿酸與健康風險及心血管疾病風險的關係。方法:本研究為橫斷性研究,收錄北部某醫院員工年度健檢報告,依抽血尿酸數值分成四組Q1~Q4,利用獨立樣本t檢定、卡方檢定來分析四組間差異。皮爾森相關係數分析尿酸與佛萊明罕風險指數的關係,並以多變項邏輯斯迴歸建立尿酸對心血管疾病風險影響的模型。結果:856位醫療從業人員中,平均年齡43.3歲,男性占40.2%。體組成分析及生化指標中,身體質量指數、空腹血糖、三酸甘油酯、總膽固醇、高密度膽固醇、血清轉胺酶、肌酸酐及腎絲球過濾率在四組間具顯著差異(p<0.05)。佛萊明罕風險與尿酸數值呈正相關性。佛萊明罕低與中高風險族群比率在四組間呈顯著差異,隨尿酸升高,中高風險比率呈現上升趨勢。在校正性別、年齡、抽菸史、收縮壓、空腹血糖後,尿酸其勝算比(odds ratio)為1.57,95% CI=1.10-2.23,p=0.012。結論:本研究顯示尿酸與健康風險指標及心血管疾病相關。目前尿酸未明列於勞工體檢項目,故除了痛風病史族群外,也應提醒高風險勞工注重尿酸控制,以降低罹患心血管等慢性疾病風險。 |
英文摘要 | Background and Purpose: Mounting evidence had revealed uric acid is the risk factor of several chronic diseases. However, uric acid is not listed as labor health checkup item, and workers often ignore its importance. Furthermore, studies about whether uric acid is the independent risk factor of cardiovascular disease are inconclusive. Therefore, the purpose of this study is to explore the relationship between uric acid and health risks, including cardiovascular disease, among northern Taiwan hospital workers. Methods: This is a cross-sectional study of northern Taiwan hospital workers. We collected annual health checkup data, and divided workers into four groups Q1~Q4, according to uric acid level. T-test and chi square analysis were used to compare health risk difference among four groups. Pearson's correlation was performed to analyze the relationship between uric acid and Framingham risk score. Finally, we conducted the multivariable logistic regression analysis to establish relationship between uric acid and Framingham risk score. Results: Of 856 hospital workers, there was 40.2% male, and average age was 43.3 years old. Body composition and biochemical lab data revealed that body mass index (BMI), fasting blood sugar, triglyceride (TG), total cholesterol, high-density lipoprotein(HDL), alanine aminotransferase (ALT), creatinine and estimated glomerular filtration rate(eGFR) were significantly different among four groups(p<0.05). Analysis of correlation between uric acid and Framingham risk score showed positive correlation. The composition of Framingham risk group was significantly different among four groups; the higher the uric acid level, the higher the proportion of middle and high risk Framingham risk group. Further adjusted confounding factors, odds ratio of uric acid was 1.57, 95% CI= 1.10-2.23, p=0.012. Conclusion: In this study, the results showed that uric acid is associated with health condition and cardiovascular disease. However, currently uric acid is not listed as labor health checkup item. Therefore, we suggest that besides workers with gouty arthritis, other high risk workers should be aware of uric acid level control to avoid chronic disease such as cardiovascular disease. |
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