背景：由于在台湾对代谢综合征的种族差异及其危险因素的研究仍然很少，本研究的目的是：（1）检测代谢综合征发病率的差异，居住在同一地区且年龄和性别分布相似的两个种族（土族和非土族汉族）之间的肥胖和健康行为；（2）研究种族本身是否在代谢综合征的发生中起着重要作用，同时考虑其他风险因素，包括社会人口统计学特征，考虑肥胖和健康行为。
方法：这是一项横断面研究，使用了在台湾西南部嘉义县进行的一项社区调查的数据。采用年龄和性别的频率匹配策略，比例为1（Tsou）与3（Han），从调查参与者中选择两个种族（667Tsou和2001Han）之间的可比样本。此外，排除在调查日之前诊断为心脏代谢疾病的参与者,以避免混淆发生代谢综合征(MS)的任何相关危险因素.剩下1482年的最终分析样本。使用的信息包括社会人口统计学特征，病史,健康行为,和甘油三酯的浓度，胆固醇,和葡萄糖。
结果：土生土长的Tsou患代谢综合征的比率明显较高，肥胖和不健康行为比他们的汉族同行(MS：54.0%vs.29.1%,肥胖：54.0%vs.23.2%,饮酒：17.5％vs.13.6%,油炸食品的摄入量较高：6.4%vs.4.4%），尽管他们的年龄和性别分布相似。随后发展为MS的重要危险因素包括土著Tsou（调整后的POR=2.62，P<0.001），年长的,单身,和肥胖。对健康行为和肥胖问题导致MS发展的危险因素的分层分析也表明，成为土著Tsou的风险增加。
结论：代谢综合征的患病率存在种族差异，肥胖，和健康行为。种族本身在发展MS方面确实发挥了重要作用；特别是土著祖人的风险增加，提示可能的生物学原因植根于它们的起源，需要进一步探索。此外,不健康行为可能通过对肥胖的影响对MS的发展产生间接影响.
BACKGROUND: As studies on ethnic disparities in metabolic syndrome and its risk factors in Taiwan are still rare, the aims of this
study were: (1) to detect the differences in the rates of metabolic syndrome, obesity and health behaviors between two ethnic groups (indigenous Tsou and nonindigenous Han) living in the same area and with similar age and sex distributions; (2) to examine whether ethnicity per se plays a significant role in the occurrence of metabolic syndrome, while taking other risk factors including sociodemographic characteristics, obesity and health behaviors into consideration.
METHODS: This is a cross-sectional
study using data from a community survey conducted in Chiayi County in southwestern Taiwan. A frequency matching strategy by age and sex with a ratio of 1 (Tsou) to 3 (Han) was applied to select a comparable sample between both ethnic groups (667 Tsou and 2001 Han) from among the survey participants. Furthermore, participants with cardiometabolic diseases diagnosed before the surveyed day were excluded to avoid confounding any associated risk factors for developing metabolic syndrome (MS). A final analytic sample of 1482 remained. The used information included sociodemographic characteristics, medical histories, health behaviors, and the concentrations of triglycerides, cholesterol, and glucose.
RESULTS: Indigenous Tsou had significantly higher rates of metabolic syndromes, obesity and unhealthy behaviors than their Han counterparts (MS: 54.0% vs. 29.1%, obesity: 54.0% vs. 23.2%, drinking alcohol: 17.5% vs. 13.6%, and higher intake of fried food: 6.4% vs. 4.4%), even though they were similar in age and sex distributions. The significant risk factors for subsequently developing MS included being indigenous Tsou (adjusted POR = 2.62, P < 0.001), older, single, and obese. Stratified analyses on the risk factors for developing MS by health behaviors and by obese problems also indicated increased risks of being indigenous Tsou.
CONCLUSIONS: There existed ethnic differences in the rates of metabolic syndrome, obesity, and health behaviors. Ethnicity per se did play a significant role in developing MS; in particular indigenous Tsou people had increased risks, suggesting possible biological reasons rooted in their origins that need further exploration. In addition, unhealthy behaviors may potentially have an indirect effect on developing MS via their effect on obesity.
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