咖啡飲用與運動行為對代謝症候群風險的交互作用及其性別差異 ：橫斷研究

研究目的：本研究希望透過橫斷式研究，探討咖啡飲用及運動行為對於代謝症候群的影響，並且探討咖啡飲用及運動行為對於代謝症候群的影響是否有性別差異。研究方法： 本研究採用橫斷式研究，納入2005至2022年間參與彰化縣整合性篩檢之40歲以上民眾，共計128,169人。資料來源為彰化縣萬人篩檢資料庫（包括身體量測及問卷調查），並透過卡方檢定與多變項羅吉斯回歸分析咖啡飲用次數頻率與運動行為對代謝症候群之關聯，控制性別、年齡、生活習慣等因子，並進行性別與年齡分層分析。代謝症候群為依變項，定義為以下五項危險因子符合三項(含)即被判定為代謝症候群，(1)腹部肥胖:男性的腰圍≧90cm(35吋)、女性腰圍≧80cm(31吋)，(2)血壓偏高:收縮壓≧130mmHg或舒張壓≧85mmHg，(3)空腹血糖偏高：空腹血糖值≧100mg/dL，(4)空腹三酸甘油酯偏高：≧150mg/dL，(5)高密度脂蛋白膽固醇偏低：男性<40mg/dL、女性<50mg/dL；運動行為分為三類，分別為從不運動、不規律運動(每周運動時間<150分鐘)、規律運動(每周運動時間≧150分鐘)；咖啡飲用行為分為五類，分別為很少/不喝咖啡、每周飲用一至二次、每周飲用三至四次、每周飲用五至六次、每周飲用七次以上。研究結果：(1). 咖啡飲用頻率為每週五至六次者，其代謝症候群風險顯著較低（OR:0.840; 95% CI:0.761-0.927; p=0.0006）。(2). 運動行為方面，與從不運動相比不規律運動（OR:0.924; 95% CI:0.882-0.968; p=0.0009）及規律運動（OR:0.905; 95% CI:0.963-0.949; p<0.0001）皆與較低的代謝症候群風險相關。(3). 性別分層分析中，男性在每週飲用三次以上咖啡並進行規律運動者代謝症候群風險明顯下降低(每周飲用三、四次且規律運動：OR: 0.674; 95% CI: 0.511-0.891; p=0.0055、每周飲用五、六次且規律運動：OR: 0.632; 95% CI: 0.430-0.927; p=0.0190、每周飲用七次以上且規律運動：OR: 0.793; 95% CI: 0.641-0.980; p=0.0318)；而女性則需同時具備高頻率咖啡飲用及規律運動，才顯現顯著的保護效果(每周飲用七次以上且規律運動：OR: 0.800; 95% CI: 0.645-0.991; p=0.0410)。咖啡飲用行為負向影響代謝症候群風險，其中每週飲用五、六次咖啡者風險最低。(4). 咖啡飲用與運動行為的交互作用顯示兩者可能具有加乘效果，適量咖啡結合運動可進一步降低代謝異常風險每週三次咖啡以上且規律運動者之代謝症候群風險顯著較低(每周飲用三、四次且規律運動：OR: 0.753, 95% CI: 0.619-0.916, p=0.0046；每周飲用五、六次且規律運動：OR: 0.724, 95% CI: 0.550-0.952, p=0.0209；每周飲用七次以上且規律運動：OR: 0.804, 95% CI: 0.691-0.936, p=0.0049)。結論：本研究發現，規律運動與適度咖啡攝取皆有助於降低代謝症候群風險，且兩者合併可產生加乘效果，不同性別與年齡層間亦呈現影響差異。建議未來健康促進措施應考量行為組合與族群特性，以提升介入效益。研究發現咖啡飲用頻率與運動行為皆顯著影響代謝症候群的發生風險。

Objectives:This study aimed to explore the association between coffee consumption and physical activity with the risk of metabolic syndrome (MetS) using a cross-sectional design. Additionally, it examined whether these associations differ by sex.Methods:A cross-sectional analysis was conducted using data from 128,169 individuals aged 40 years and above who participated in the Changhua County Community-based Integrated Screening between 2005 and 2022. Data were obtained from the Changhua County large-scale screening database, which included anthropometric measurements and questionnaire responses. Chi-square tests and multivariable logistic regression analyses were employed to investigate the associations of coffee consumption frequency and physical activity behavior with MetS, adjusting for sex, age, and lifestyle factors. Stratified analyses by sex and age were also performed.MetS was the dependent variable and was defined as having at least three of the following five criteria: (1) Abdominal obesity (waist circumference ≥90 cm for men, ≥80 cm for women); (2) Elevated blood pressure (systolic ≥130 mmHg or diastolic ≥85 mmHg); (3) Elevated fasting glucose (≥100 mg/dL); (4) Elevated triglycerides (≥150 mg/dL); and (5) Low HDL cholesterol (<40 mg/dL in men, <50 mg/dL in women).Physical activity was categorized into three levels: never exercise, irregular exercise (less than 150 minutes/week), and regular exercise (≥150 minutes/week). Coffee consumption was categorized into five levels: rarely/never, 1–2 times/week, 3–4 times/week, 5–6 times/week, and ≥7 times/week.Results:(1) Individuals who consumed coffee 5–6 times per week had a significantly lower risk of MetS (OR: 0.840; 95% CI: 0.761–0.927; p = 0.0006).(2) Regarding exercise behavior, compared with those who never exercised, both irregular exercise (OR: 0.924; 95% CI: 0.882–0.968; p = 0.0009) and regular exercise (OR: 0.905; 95% CI: 0.863–0.949; p < 0.0001) were associated with a lower risk of metabolic syndrome.(3) In sex-stratified analyses, men who drank coffee ≥3 times per week and exercised regularly had a significantly lower risk of MetS (3–4 times/week: OR: 0.674; 95% CI: 0.511–0.891; p = 0.0055; 5–6 times/week: OR: 0.632; 95% CI: 0.430–0.927; p = 0.0190; ≥7 times/week: OR: 0.793; 95% CI: 0.641–0.980; p = 0.0318). Among women, only those with both high-frequency coffee intake and regular exercise showed significant protection (≥7 times/week and regular exercise: OR: 0.800; 95% CI: 0.645–0.991; p = 0.0410).(4) Interaction analysis suggested a synergistic effect between coffee and exercise: individuals who exercised regularly and consumed coffee ≥3 times/week had the lowest risk of MetS (3–4 times/week: OR: 0.753; 95% CI: 0.619–0.916; p = 0.0046; 5–6 times/week: OR: 0.724; 95% CI: 0.550–0.952; p = 0.0209; ≥7 times/week: OR: 0.804; 95% CI: 0.691–0.936; p = 0.0049).Conclusion:Regular exercise and moderate coffee consumption were both associated with reduced risk of metabolic syndrome. When combined, these behaviors produced a synergistic effect. The magnitude of associations varied across sex and age groups. Future health promotion strategies should consider behavioral combinations and population characteristics to enhance intervention effectiveness. This study highlights the significant impact of coffee consumption frequency and physical activity on MetS risk.