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Obesity and hypertension are now considerd as serious health problem, and cause the
huge medical expenditure even more. We aimed to evaluate the status of obesity in Collegy
students population and describe the relationships between obesity and hypertension. A
total of 7875 of the National Chin-Yi University of Technology freshmen were selected as
subjects from 2005 to 2008. Blood pressure, height, and weight were obtained by doctor
and nurse using standard protocols and processure. Obesity was defined according to
Taiwan definition and hypertension was defined according to JNC-7. The method of PCIs
were used to set up obesity indices to evaluate the prevalence of obesity. Logistic
regression analysis was used to find out the associations between obesity and hypertension.
The obesity prevalence of the National Chin-Yi University of Technology was 12.92% in
boy students and 4.01% in girl students. The prevalence of obesity was lower than the
national population based on Nutrition and Health Survey in Taiwan in 2005~2006 (12.1%
vs. 17%). BMI increased by 1 unit (kg/m2) had 16.7% (95% CI:15.0%~18.4%) fold risk to
get hypertension. Obesity indices were simple and convenient tool of assessing the
prevalence of obesity. Logistic regression analysis revealed that obesity was risk factor for
hypertension. Our study quantifies the associations of obesity and hypertension in college
students population.
Key words: obesity, obseity indices, body mass index, logstic regression, hypertension,
process capability index
147
JNC-7
12.92%
4.01% 17%BMI 1
16.7%(95% CI:15.0%~18.4%)
BMI
(WHO)
(Snijder et al., 2003; Chien, Liou, & Chen, 2004; Hotu, Carter,
Watson, Cutfield, & Cundy, 2004)
5.5-7.0% 2.0-3.5%(Thompson & Wolf, 2001)
2002 2.9%2008
(Ogden, Flegal, Carroll, & Johnson, 2002)
? BMI
(Mei et al., 2002 Lobstein & Frelut, 2003
2008)WHO (2008)
BMI
148
BMI
BMI
BMI
BMI BMI
BMI
()
() 94 - 97
()
1/5
1.2.3.
4.5.
12-20%
20-30%
(Himes & Dietz, 1994)
()
WHO WHO (2004)
BMI 30 kg/m2 BMI 30-34.9
kg/m2 BMI 35-39.9 kg/m2 BMI 40 kg/m2
2002
BMI=24 BMI 27
BMI 18.5 BMI 18.5-242002
()
149
(1)
2003
()
1997 WHO
:
1.
(Hall, 1997)
2.
(Wicklgren, 1998)
3.
Blocket, 1982)
4.
(Rathmann, Funkhouser, & Dyer., 1998)
()
(Brownell, 1998)
1.
1994 10%
40% 80%Chen (1997)
5
150
2.
Binkley, Eales, and
Jekanowski(2000)
(Volger, Sorensen,
(Hunter, KeKes-Szabo,
Snyder, 1997)
()
19801987 1990 3
39% 43% 26% 29% 8%
16%6% 13% (Colhoun & Prescott, 1996; Knight, 1994)
NHANES(National Health and Nutrition Examination Survey)
1976 1980 8%1988 1994 15%
2003 2004 31.1% 2005 2006 33.3% (Ogden et al., 2006Ogden et al.,
2007)
1980 1996 3 BMI
BMI 25kg/m2 Lin et al. (2003) 1993-1996
BMI 27
2004
()
(systolic blood pressure, SBP) (diastolic blood pressure,
DBP)JNC-7(2003)
140 mmHg 90 mmHg 18
120 mmHg 80 mmHg
151
()
1.
35%
(JNC-, 1997)
2.
(TG)
(TC)
(HDL-C) (Kastarinen et al.,
1997)Eisenmann, Welk, Ihmels, and Dollman(2007) Eisenmann, Welk, Wickel, and Blair (2007)
BMI BMI
3.
50 50
(Whelton, 1994)
4.
Faber 1924
McCarthy et al. (2008)
23-30% (JNC-, 1997)Juhaeri et al. (2002)
1kg 1.36
1.35 1.12 1.43 Gentile et al. (2007)
5 (12 vs. 72 mmHg)
(-14 vs. 51 mmHg)McCarthy et al. (2008)
BMI
152
()
JNC-7 (2003) 10 5000
1 1993-1996
26% 19% 2003
()
Juran (1974)
( , ) Kane (1986)
Juran (1974) Cp
(tolerances) Cp
Cp =
USL LSL
6
(2)
specification limit) d
( , ) 6 3
%Yield = (3 C p )
(3)
(x )
2
1 2x
( x ) =
e dx, x = 3C p
2
x
(4)
Cp 1 1
Cp
Cp
0 Cp
Cp Kane (1986)
Cpk
C C pl d m
C pk = pu
,
=
3
3
3
USL
C pu =
3
153
(5)
(6)
C pl =
LSL
3
(7)
1 1 USL 1 LSL
S pk = -1
+
3 2
2
(8)
1 1
%Yield = 2(3S pk ) - 1
(9)
()
2002
Hung (2005)
Hung (2006) Hung and Su (2007)(BMI)
2002
S I
Perf = S I L
Hung (2005)
F j , j = u ,l , n
Fu =
(10)
Fl =
(11)
U
L
Fn = 1 1 / 2
+ 1 / 2
154
(12)
18
B T = 1 W j (B j )
j =2
(13)
1 1 Y
I BMI = 1
2 Y
1 + Y
+
(14)
BMI BMI
BMI Hung
BMI BMI I BMI
BMI B j
BT
(PCI)
94 ~ 97 7,923
()
(underweight)(normal range)(overweight)(obesity)
BMI BMI
U L BMI U=27 L=24
X BMI BMI X
BMI BMI
(12)
Bow
24
27
Bow = 1 1/2
+ 1/2
(15)
27
24
pow % = P
Z
= 2 (Bow ) 1
(16)
155
Bow
pow % Bow
pow %
LBMI 27
(11) Bob
Bob =
27
(17)
pob %
pob % Bob
27
pob % = P Z
= (Bob ) 1
(18)
Z Bob
pob %
()
JNC-7 (systolic
H sys =
140
(19)
psys % H sys
p sys % = (H sys )
(20)
H dia
H dia =
90
(21)
pdia % H dia
pdia % = (H dia )
(22)
() BMI
(logistic regression) BMI
140 mmHg 90 mmHg (high blood
156
BMI
kg/m2
2. 94-97 12.1% 12.92 % 4.01
157
1. 94-97 BMI
(cm)
(N)
94 (2208)
(1638)
( 570)
BMI(kg/m2)
(kg)
168.36
171.63
158.94
7.91
5.74
5.33
63.28
66.82
53.10
13.56
13.00
9.33
22.24
22.68
21.01
4.10
4.21
3.48
95 (1993)
(1455)
( 538)
168.45
171.84
159.3
8.30
6.36
5.58
63.38
67.39
52.53
14.29
13.47
10.23
22.23
22.81
20.66
4.31
4.37
3.69
96 (1783)
(1237)
( 546)
168.10
171.78
159.75
8.56
6.95
5.43
63.02
67.49
52.91
14.18
13.72
9.12
22.17
22.82
20.71
4.11
4.29
3.25
97 (1891)
(1256)
( 635)
167.91
171.84
160.14
7.98
5.92
5.45
62.16
66.56
53.45
13.94
13.42
10.43
21.94
22.51
20.80
4.11
4.19
3.77
(7875)
(5586)
(2289)
168.22
171.77
159.55
8.18
6.23
5.46
62.30
67.06
53.01
13.98
13.38
9.81
22.15
22.71
20.80
4.16
4.27
3.54
(N)
Bow
p ow %
Bob
p ob %
94 (2208)
(1638)
( 570)
0.28
0.31
0.19
22.06
24.34
15.06
-1.12
-1.03
-1.71
12.30
15.15
4.36
95 (1993)
(1455)
( 538)
0.29
0.29
0.18
22.82
22.82
14.28
-1.11
-0.96
-1.72
13.35
16.11
4.27
96 (1783)
(1237)
(546)
0.26
0.28
0.13
20.52
22.06
10.34
-1.18
-0.97
-1.94
11.90
16.60
2.62
97 (1891)
(1256)
( 635)
0.25
0.33
0.20
19.74
25.86
15.86
-1.23
-1.07
-1.68
10.93
14.23
4.65
(7875)
(5586)
(2289)
0.27
0.28
0.18
21.28
22.06
14.28
-1.17
-1.13
-1.75
12.10
12.92
4.01
158
3. 94-97
(mmHg)
(mmHg)
(N)
94 (2208)
(1638)
( 570)
121.16
124.20
112.42
12.55
11.37
11.67
75.2
76.56
71.29
9.62
9.31
9.42
95 (1993)
(1455)
( 538)
122.21
125.28
113.92
13.84
13.16
12.13
74.51
75.24
72.54
9.48
9.45
9.30
96 (1783)
(1237)
( 546)
122.83
127.64
111.93
16.48
15.36
13.46
74.26
74.85
72.93
11.00
11.63
9.28
97 (1891)
(1256)
( 635)
118.36
124.41
106.39
17.15
15.61
13.37
71.71
72.65
69.99
11.06
11.70
9.42
(7875)
(5586)
(2289)
121.13
125.27
110.98
15.08
13.85
13.03
73.99
74.96
71.61
10.35
10.55
9.42
159
(N)
H sys
p sys %
H dia
pdia %
94 (2208)
(1638)
( 570)
-1.50
-1.41
-2.37
10.20
7.93
0.89
-1.54
-1.44
-1.99
6.18
7.49
2.33
95 (1993)
(1455)
( 538)
-1.29
-1.12
-2.15
9.85
13.14
1.58
-1.63
-1.56
-1.88
5.16
5.94
3.01
96 (1783)
(1237)
( 546)
-1.04
-0.81
-2.08
14.92
20.90
1.83
-1.43
-1.30
-1.84
7.64
9.68
3.29
97 (1891)
(1256)
( 635)
-1.26
-1.00
-2.51
10.38
15.83
0.60
-1.65
-1.48
-2.12
4.95
6.94
1.70
(7875)
(5586)
(2289)
-1.26
-1.06
-2.23
10.38
14.46
1.29
-1.69
-1.43
-1.95
4.55
7.64
2.56
BMI
BMI 140 mmg 90
5.
0
6660
1
61
1067
87
99.1
7.5
85.73
6. 94-97 14.7%
18.5% 5.2% 70.9% 29.1 %
Pearson 2 = 228.54p=.000.05 0.75p=.000.05
160
6.
%
%
2169
32.3%
94.8%
4552
7.7%
81.5%
6721
100.0%
85.3%
%
%
120
10.4%
5.2%
1034
89.6%
18.5%
1154
100.0%
14.7%
%
%
2289
29.1%
100.0%
5586
70.9%
100.0%
7875
100.0%
100.0%
p
ln
= 0.693 Sex + 0.051 Weight 5.738 = f ( x )
1 p
(23)
e f (x )
e 0.693Sex + 0.051Weight 5.738
p=
=
1 + e f ( x ) 1 + e 0.693Sex + 0.051Weight 5.738
(24)
7.
S.E.
OR
Wald
N=7875
OR 95%CI
.693
.107
42.3
.000
2.000***
1.623
2.464
.051
.002
454.3
.000
1.052***
1.048
1.057
-5.738
.169
1146.1
.000
.003
**
p < .01
***
p < .001
161
8. BMI
p
ln
= 1.155 Sex + 0.154 BMI 7.176 = f ( x )
1 p
(25)
BMI
p=
e f (x)
e1.155Sex + 0.154BMI 7.176
=
1 + e f ( x ) 1 + e1.155Sex + 0.154BMI 7.176
(26)
8. OR 3.174(95% CI:2.596~3.882)
3.174 (26) OR
BMI 1 (kg/m2) e (0.154BMI ) = 1.167 BMI
OR 1.167 = (e BMI 1) 100% =16.7% BMI 1 (kg/m2)
16.7% BMI
8. BMI
S.E.
OR
Wald
N=7875
OR 95%CI
1.155
.103
126.5
.000
3.174***
2.596
3.882
BMI
.154
.007
443.1
.000
1.167***
1.150
1.184
-7.176
.238
911.1
.000
.002
**
p < .01
***
p < .001
162
2005 9
2006 6 17% 30%
20%2008
94-96
23.5%37.9%38.38%Lu et al. (2007)
9.28%2007 2002-2005
BMI
2007 28.7% 4.8%
BMI
BMI OR
McCarthy et al.(2008)
OR 1.052 (95% CI:1.048~1.057)
(kg) 5.2% BMI
163
BMI Engstrom,
BMI BMI
164
2004
2009 1 5
http://www.acsm.org/AM/Template.cfm?Section=Search&Template=/CM/ContentDisplay.cfm
&ContentID=3580
(20084 9 ) 17% 216 2008
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20022008 10 14
http://food.doh.gov.tw/Health_5.asp?idCategory=47
2003
2008 12 4
http://www.bhp.doh.gov.tw/BHPnet/Portal/StatisticsShow.aspx?No=200712250001
(2003)
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199419(3)319-334
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(2007)
29(5)484-486
2008
2008-
2002
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