Purpose: Diabetes mellitus (DM) significantly impacts public health by increasing mortality and reducing quality of life. Early diagnosis is crucial yet challenging due to the asymptomatic nature of early-stage DM. Obesity, a modifiable risk factor, is strongly linked to the prevalence of DM. This study aims to identify which obesity indices most accurately predict DM among middle-aged and elderly adults to enhance early screening and intervention strategies.
Methods: This community-based cross-sectional study included 396 middle-aged and elderly adults from northern Taiwan, assessed from January to October 2014. We evaluated three obesity indices—Body Mass Index (BMI), body fat percentage (BF%), and waist circumference (WC)—and their correlation with DM using multiple logistic regression models adjusting for various demographic and clinical variables.
Results: Our study included 396 community-dwelling middle-aged and elderly adults with a mean age of 64.44±8.46. There are 79 (19.9%) participants with DM. DM people had a higher BMI (p=0.03) and higher BF% (p=0.35) but without statistical significance and higher WC (p=0.001). Multiple logistic regression adjusted for age and other factors related to DM risk showed that WC still had a significantly increased risk for DM (OR 1.06, 95% CI 1.02-1.10, p=0.0038) in women.
Conclusion: Obesity indices were associated with DM. WC is the most effective obesity index for predicting DM among middle-aged and elderly adults, suggesting that it should be included in routine health assessments to better identify high-risk individuals.
(Taiwan J Fam Med 2025; 35: 45-58) DOI: 10.53106/168232812025033501005

Key words: anthropometry, body mass index, diabetes mellitus, obesity, waist circumference

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¹Department of Family Medicine, Chang-Gung Memorial Hospital, Chiayi Branch, Chiayi, Taiwan
²Department of Family Medicine, Chang-Gung Memorial Hospital, Linkou Branch, Taoyuan, Taiwan
³College of Medicine, Chang-Gung University, Taoyuan, Taiwan
⁴Department of Health Management and General Practice, Xiamen Chang-Gung Hospital, Xiamen, China
Received: May 31, 2024; Revised: July 1, 2024; Accepted: July 26, 2024.
^*Corresponding author: Jau-Yuan Chen, M.D., Department of Family Medicine, Chang-Gung Memorial Hospital, Linkou
Branch, Taoyuan, Taiwan. E-mail: welins@cgmh.org.tw
 

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中老年族群肥胖指標與糖尿病的相關性研究： 一個社區橫斷性研究
 
陳文學¹ 陳朝棟¹ 蘇弘濟² 陳昭源^2,3,4*
 

目的：糖尿病會造成死亡率上升以及降低生活品質，是個全球性的健康議題。但糖尿病在早期階段通常無症狀，也因此及早篩檢出糖尿病就顯得非常重要。肥胖是糖尿病的獨立風險因子且和糖尿病的盛行率相關，且肥胖指標在篩檢糖尿病上扮演特殊的角色。本實驗的目的在於探討何種肥胖指標和中老年族群的糖尿病最有相關性。
方法：本研究為橫斷性研究，分析台灣北部某社區2014年1月至10月，共396位中老年人之健康檢查資料，我們使用多元邏輯斯迴歸分析並校正其他變數後，評估三種肥胖指標、身體質量指數(BMI)、體脂率、和腰圍與糖尿病的相關性。
結果：396位受檢者的平均年齡為64.44±8.46歲，其中有19.9%罹患糖尿病。有糖尿病者有較高的BMI (p=0.03)、較大的腰圍(p=0.001），但體脂率(p=0.35)無統計學上的差異。使用多元邏輯斯迴歸分析，在校正年齡及其他糖尿病相關變數後，發現女性族群中腰圍仍然和罹患糖尿病的風險有顯著相關性(OR 1.06, 95% CI 1.02-1.10, p=0.0038)。
結論：肥胖指標和糖尿病存在相關性，在中老年族群中，腰圍是肥胖指標中最能夠預測糖尿病的一項指標。在例行健康檢查中應包含腰圍以及早辨識出糖尿病高風險族群。
(台灣家醫誌2025; 35: 45-58) DOI: 10.53106/168232812025033501005
 
關鍵詞：糖尿病、腰圍、身體質量指數、肥胖、人體測量學
 

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¹嘉義長庚紀念醫院家庭醫學科
²林口長庚紀念醫院家庭醫學部
³長庚大學醫學系
⁴廈門長庚醫院體檢科及全科醫學
受理日期：113年5月31日 修改日期：113年7月1日 同意刊登：113年7月26日
^*通訊作者