代謝症候群、憂鬱、嗜睡程度和健康關聯生活品質量表相互關聯性的探討： 中老年男女的差異

研究目的：代謝症候群病人之憂鬱、日間嗜睡及生活品質指標降低等問題，造成可觀的醫療花費及社會成本十分。而臨床實務中，這類問題重要性卻常被低估，進而造成惡性循環，更加遽醫療問題與花費，這是本研究目的。研究方法及資料：本研究利用屏東縣某區域教學醫院參與健檢的民眾。符合篩檢條件為：（一）有健保身份、（二）40-64歲且三年內未做過成人預防保健者、（三）65歲以上，99年未做過成人預防保健服務檢查者。而預防保健服務內容，包括：成人預防保健問卷以及理學、生化血液檢查。並進行(Simple Form) SF-36、Beck-II及Epworth Sleepiness Score (ESS)三種量表問卷調查。本研究共收集了378份有效樣本，年齡介於40到92歲之間，所蒐集之資料並以SPSS 18.0版與R統計軟體進行分析。研究結果：1.SF-36的八子項或兩大面向的分數差異主要來存在女性，Depression score 都是最強的影響因子；而就男性之Physical Functioning (PF)、女性與全體之PCS、女性與全體SF-36總分，Depression score 與年齡顯然是最強的兩項影響因子。2.在迴歸模型中女性組對愛普沃斯嗜睡量表分數之迴歸達統計顯著之變項均是糖尿病(DM)與憂鬱(BDI-II分數)，而男性組對愛普沃斯嗜睡量表分數之迴歸達統計顯著之變項均是BMI與年齡。3.女性族群中即使調整其餘可能相關之變數之下，代謝症候群的有無仍不會影響Beck-II的分數，男性族群亦是，調整相關之變數之下，代謝症候群的有無仍不會影響Beck-II的分數。結論與建議： SF-36的八子項或兩大面向的分數差異主要存在女性，對ESS分數之影響男女決定因子不同，代謝症候群的有無並不會影響憂鬱量表的分數

Objective： The aim of this study is to exam the associations among metabolic syndrome, depression, excessive sleepiness, and health-related quality of life (HRQoL).We hypothesized that metabolic syndrome would be associated with lower HRQoL score and higher depression and excessive sleepiness score.Methods and Materials：378 eligible mid-aged and elderly participant were recruited to our study when their adult health examination, provided by Taiwanese National Health Insurance Company, were completed. We also offer additional and free HDL measurement to meet the criteria of metabolic syndrome. The Medical Outcome Study, short form-36 (SF-36) Beck Depression Inventory 2nd edition (BDI II) and the Epworth sleepiness scale(ESS)wese used to assess HRQoL, the level of depression, and the level of sleepiness, respectively. Differences in HRQoL and in clinical and psychological characteristics were compared among participants with and without metabolic syndrome. Multiple variances regression was used to determine the predictors of HRQoL, depression, and excessive sleepiness. Results：Metabolic syndrome was associated with lower scores on the subscales of SF-36 and on the physical component summary (PCS) score only in female. Depression and age are the top two significant predictors of lower score of SF-36 by multiple variance regression analysis. For ESS score, depression and diabete mellitus (DM) history were two predictors in female, whereas BMI and age in male. After adjusting other potential confounding variances, the presence of metabolic syndrome has little effect on depression and sleepiness score . Conclusion and Suggestion： The results indicate that metabolic syndrome is associated with poor HRQoL solely in women, which might be accounted mainly for by physical instead of mental health. That gender difference on predictors of ESS score might imply heterogeneous effect on ESS score between difference gender.