非酒精性脂肪肝與勞工健檢資料相關性之研究
--以桃園市為例 

陳淑楣¹　陳志明²　陳盈璋¹ 

目的：勞工因產業及工作型態改變而導致工時長、輪班、工作壓力變大等，勞工體檢中最常被關注的問題是肝功能，目前台灣勞工的非酒精性脂肪肝之盛行率和危險因子及其相關性尚未有大型研究或探討。本研究目的在於探討桃園區無酗酒習性之勞工健檢資料與非酒精性脂肪肝之相關性。

方法：回溯抽取2016年至2017年某區域醫院健檢中心的勞工健康檢查，總數量達21,386筆，排除重複個案及酗酒勞工，並選取桃園市內勞工群體，共得2,941名受試者之樣本。統計方法以描述性統計分析人口變項及勞工體檢變項之分布、卡方檢定分析人口變項及勞工體檢變項在非酒精性脂肪肝分布之差異、多變項邏輯斯分析探討影響非酒精性脂肪肝之人口變項、勞工體檢變項的因子。

結果：研究結果發現，受試者(2,941人)中非酒精性脂肪肝異常者2,168人占73.7%。單變項邏輯斯迴歸分析影響非酒精性脂肪肝之風險的勞工體檢項目，顯示BMI、腰圍、空腹血糖、總膽固醇、三酸甘油酯、高密度脂蛋白膽固醇、低密度脂蛋白膽固醇、SGPT與非酒精性脂肪肝有顯著相關。進一步以多變項邏輯斯分析，結果呈現變數皆有相關性，而其中SGPT之OR值為8.63最高，其次是腰圍為3.66，BMI為3.24及三酸甘油酯為3.04。在職業別中的電力及燃氣供應業之OR值高至3.24，但其 p 值是0.108為不顯著。

結論：勞工體檢項目與非酒精性脂肪肝有很大的相關性，為降低致病率及早警示勞工們，應鼓勵或修正條例執行勞工體檢，將腹部超音波檢查納入有肝病、BMI≥27、腰圍男性≥90公分，女性≥80公分或血液中的空腹血糖、血脂肪指數異常勞工的追蹤檢查項目，以便及早讓勞工對自己的健康有更好的認知。

（台灣家醫誌2020; 30: 1-10） DOI: 10.3966/168232812020033001001

關鍵詞：多變項邏輯斯分析、非酒精性脂肪肝、勞工健檢

¹經國管理暨管理學院健康產業管理研究所、²敏盛綜合醫院家庭醫學部
受理日期：108年9月19日　　修改日期：108年11月11日　　同意刊登：109年1月16日
通訊作者：陳盈璋　　　　　通訊地址：基隆市中山區復興路336號

On the Correlations between Nonalcoholic Fatty Liver
Disease and Workers Health Checkup: Evidence from
Taoyuan, Taiwan 

Shu-Mei Chen¹, Chih-Ming Chen² and Ying-Chang Chen¹ 

Background: In response to changes in industry structure and work style, workers in Taiwan nowadays often work longer hours, rotate through more shifts, and live under greater stress. Liver function is a focus item in workers’ health checkup; however, there has been no major research on the correlations between the risk factors and the prevalence of nonalcoholic fatty liver disease among workers in Taiwan. The purpose of this study is to explore the connections between the results of workers checkups and nonalcoholic fatty liver disease. 

Methods: A total of 21,386 physical examination records between 2016 and 2017 were obtained from a health examination center in a regional hospital in Taoyuan City. After excluding duplicate records and records of alcoholic and non-Taoyuan City workers, a total of 2,941 records were available as the selected sample of study. 

Results: The study found that 2,168 of the subjects (2,941) had nonalcoholic fatty liver abnormalities, accounting for 73.7%. Labor physical examination items, including BMI, waist, fasting blood glucose, total cholesterol, triglycerides, HDL, LDL, there was a significant correlation between non-alcoholic fatty liver. Multivariate logistic regression analysis on nonalcoholic fatty liver disease found 8.63 the highest SGPT among all groups. All the health checkup items (i.e., variables) reported an odd ratio higher than 1. 

Conclusion: Workers health checkup items show considerable correlations with non-alcoholic fatty liver disease. Workers who are fat or abdominal ultrasound examination is advised to be a routine checkup, workers are fat or having liver disease, or history of abnormal blood test results.
(Taiwan J Fam Med 2020; 30: 1-10) DOI: 10.3966/168232812020033001001 

Key words: multivariate logistic regression, nonalcoholic fatty liver, workers health checkup 

¹Health Examination center, ²Department of Family physician, Ming-Sheng General Hospital, Taoyuan; ³Ching Kuo Institute of Management and Health/ Graduate School of Health Industry Management, Keelung
Received: September 19, 2019; Revised: November 11, 2019; Accepted: January 16, 2020.