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Metabolic syndrome: Prevalence in Health care and Office workers in Department of Health, Ministry of Public Health, Nonthaburi, Thailand.2009 Sunee Wongcharoen MD. Nutrition Division, Department of Health, Ministry of Public Health 100 ¡°√“§¡ - ¡’π“§¡ 2553

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°“√»÷°…“§«“¡™ÿ°¢Õß¿“«–‡¡µ“∫Õ≈‘°´‘π‚¥√¡„π°≈ÿࡇ®â“Àπâ“∑’Ë°√¡Õπ“¡—¬œ

Abstract The purpose of this study was to examine the prevalence of metabolic syndrome in healthcare and office workers in Department of health, Ministry of public health, Nonthaburi, Thailand 2009. The modified NCEP ATPIII 2005 guidelines were used to identify adults of age group more than 35 years old who met this criteria for metabolic syndrome. The sample consisted of 393 adults, 327 women and 66 men who came for annual health check-up program by health promotion hospital, Bangkok, Thailand in March, 2009. The overall prevalence of metabolic syndrome was 17.3 %, men (21.2%) and women (16.5%). The most common risk factors of metabolic syndrome in men were impaired fasting blood glucose (48.5%), hypertriglyceridemia (37.9%), high blood pressure (18.2%). Among women, elevated waist circumferences (34.3%), impaired blood glucose (27.8%) and low HDL-Cholesterol (23.9%) were the most common metabolic abnormalities noted.

Keywords: Metabolic syndrome, Prevalence, Department of health, Thailand

∫∑π” ¿“«– ‡¡µ“∫Õ≈‘°´‘π‚¥√¡ (Metabolic syndrome) ‡ªìπ°≈ÿ¡à §«“¡º‘¥ª°µ‘∑ª’Ë √–°Õ∫¥â«¿“«–Õâ«π≈ßæÿß (Central obesity) §«“¡º‘¥ ª°µ‘¢ÕßπÈ”µ“≈„π‡≈◊Õ¥(Impaired fasting blood glucose) §«“¡º‘¥ª°µ‘¢Õ߉¢¡—π„π‡≈◊Õ¥ (Elevated plasma triglyceride or low HDL-c) ·≈–§«“¡¥—π‚≈À‘µ Ÿß ¿“«–‡¡µ“∫Õ≈‘°´‘π‚¥√¡π’È ‡ªìπªí®®—¬‡ ’ˬ߄π°“√‡°‘¥‚√§‡∫“À«“π™π‘¥∑’Ë 2 ·≈–‚√§À—«„®·≈–À≈Õ¥‡≈◊Õ¥ ´÷Ë߇ªì𠓇Àµÿ°“√ ‡ ’¬™’«‘¥∑’ˇªìπÕ—π¥—∫ 3 √Õß®“°‚√§¡–‡√Áß ·≈– Õÿ∫—µ‘‡Àµÿ®“° ∂‘µ‘Õ—µ√“°“√µ“¬¢Õߪ√–™“°√‰∑„π æ.».2546-2550 √«∫√«¡‚¥¬ ”π—°π‚¬∫“·≈–¬ÿ ∑ ∏»“ µ√å ”π— ° ß“πª≈— ¥ °√–∑√«ß “∏“√≥ ÿ¢ °√–∑√«ß “∏“√≥ ÿ¢ §”𑬓¡¢Õß ¿“«–‡¡µ“∫Õ≈‘°´‘π‚¥√¡∑’Ë¡’°“√°≈à“«∂÷ß·≈–¡—° π”¡“„™â„π°“√«‘®—¬ ‰¥â·°à ‡°≥±å¢ÕßÕߧ尓√ Õπ“¡—¬‚≈°1 ªï§√‘ µå»—°√“™ 1998 (æ.».2541) ´÷Ëß®–µâÕß¡’§«“¡º‘¥ª°µ‘¢Õß√–¥—∫πÈ”µ“≈„π‡≈◊Õ¥ √«¡°—∫Õߧåª√–°Õ∫Õ’° 2 „π 4 ¢âÕµàÕ‰ªπ’È §◊Õ §«“¡ º‘¥ª°µ‘¢Õ߉¢¡—π„π‡≈◊Õ¥ ¿“«–Õâ«π(Elevated waist and hip ratio) §«“¡¥—π‚≈À‘µ Ÿß ·≈–

‚ª√µ’πÕÕ°¡“„πªí “«–(Microalbuminuria) „πªï§√‘ µå»°— √“™ 2001(æ.».2544) The National Cholesterol Education Program Adult Treatment Panel III (NCEP ATPIII)2 ‰¥â„À⧔ 𑬓¡¢Õß¿“«–‡¡µ“∫Õ≈‘°´‘π‚¥√¡ §◊Õ¡’Õß§å ª√–°Õ∫®“° 3 „π 5 ¢âÕµàÕ‰ªπ’È §◊Õ ‰¢¡—π‰µ√°√’ ‡´Õ‰√¥å„π‡≈◊Õ¥ ≥150 ¡‘≈≈‘°√—¡µàÕ‡¥´‘≈‘µ√ √–¥—∫ πÈ”µ“≈„π‡≈◊Õ¥À≈—ßÕ¥Õ“À“√ ≥ 110 ¡‘≈≈‘°√—¡µàÕ ‡¥´‘≈‘µ√ §«“¡¥—π‚≈À‘µ Ÿß ≥ 130/85 ¡‘≈≈‘‡¡µ√ ª√Õ∑ ‡ âπ√Õ∫‡Õ« „π‡æ»À≠‘ß > 88‡´πµ‘‡¡µ√ ·≈– >104 ‡´πµ‘‡¡µ√„π‡æ»™“¬ ·≈–√–¥—∫‰¢¡—π HDL-cholesterol ≤50 ·≈– ≤40 ¡‘≈≈‘°√—¡µàÕ ‡¥´‘≈‘µ√„π‡æ»À≠‘ß·≈–‡æ»™“¬µ“¡≈”¥—∫ „π ™à«ßªï§√‘ µå»—°√“™ 2005(æ.».2548) International Diabetes Federation (IDF)3 ‰¥â„À⧔ 𑬓¡¢Õß¿“«–‡¡µ“∫Õ≈‘°´‘π‚¥√¡ ‚¥¬µâÕß¡’ ¿“«–Õâ«π≈ßæÿß (Central obesity) √à«¡°—∫Õ’° 2 „π 4 Õߧåª√–°Õ∫∑’˧≈⓬°—∫„π NCEP ATPIII ¬°‡«âπ‡ª≈’ˬπ√–¥—∫πÈ”µ“≈„π‡≈◊Õ¥À≈—ßÕ¥Õ“À“√ ∑’„Ë ™â‡ªìπ‡°≥±å®“° 110 ¡‘≈≈‘°√—¡µàÕ‡¥´‘≈µ‘ √ ‡ªìπ 100 ¡‘≈≈‘°√—¡µàÕ‡¥´‘≈µ‘ √ ·≈–„πªï‡¥’¬«°—ππ’È NCEP ATPIII ‰¥â∑”°“√ª√—∫ª√ÿߧ”𑬓¡¢Õß¿“«–

THAILAND JOURNAL OF HEALTH PROMOTION AND ENVIRONMENTAL HEALTH January - March 2010

101

∫ ∑ «‘ ∑ ¬ “ ° “ √ ‡¡µ“∫Õ≈‘ ° ´‘ π ‚¥√¡Õ’ ° §√—È ß ‚¥¬‡ª≈’Ë ¬ π√–¥— ∫ πÈ” µ“≈„π‡≈◊ Õ ¥‡ªì π ¡“°°«à “ À√◊ Õ ‡∑à “ °— ∫ 100 ¡‘≈≈‘°√—¡µàÕ‡¥´‘≈‘µ√‡∑à“°—∫‡°≥±å¢Õß IDF ·≈– ‡ª≈’ˬπ‡ âπ√Õ∫‡Õ«ª√—∫µ“¡‡™◊ÈÕ™“µ‘ „π§π‡Õ‡™’„™â‡ âπ√Õ∫‡Õ« ‡æ»À≠‘ß¡“°°«à“À√◊Õ‡∑à“°—∫ 80 ‡´πµ‘‡¡µ√ ·≈–‡æ»™“¬¡“°°«à“À√◊Õ‡∑à“°—∫ 90 ‡´πµ‘‡¡µ√ „π¥â“𧫓¡™ÿ°¢Õß¿“«–‡¡µ“∫Õ≈‘° ´‘ π ‚¥√¡ ®“°¢â Õ ¡Ÿ ≈ °“√»÷ ° …“„πª√–‡∑» À√—∞Õ‡¡√‘°“4 „πª√–™“°√Õ“¬ÿ 20 ªï¢÷Èπ‰ª „π ™à«ßªï§√‘ µå»°— √“™ 2003-2006(æ.».2546-2549) µ“¡‡°≥±å¢Õß NCEP ATPIII √“¬ß“π®“° National Health And Statistics Reports æ∫ §«“¡™ÿ°¢Õß¿“«–‡¡µ“∫Õ≈‘°´‘π‚¥√¡ ª√–¡“≥ √âÕ¬≈– 34 ‚¥¬¡’§«“¡ —¡æ—π∏å√–À«à“߇™◊ÈÕ™“µ‘ ·≈–™à«ßÕ“¬ÿ Õ“¬ÿ¡“°¢÷Èπ®–¡’§«“¡™ÿ°‡æ‘Ë¡¢÷Èπ §π ’º‘«¥”¡’§«“¡™ÿ°¡“°°«à“§πº‘«¢“« à«π°“√ »÷°…“„πª√–‡∑»∑“߇Շ™’¬ ¢âÕ¡Ÿ≈®“°°“√»÷°…“ InterAsia (Cheepudomwit, per comm.)5 ªïæ.».2546 ”√«®„πª√–™“°√∑’¡Ë Õ’ “¬ÿ¡“°°«à“ 35 ªï¢π÷È ‰ª®”π«π 5,091§π ‚¥¬„™â‡°≥±å¢Õß NCEP ATPIII æ∫Õ—µ√“§«“¡™ÿ°¢Õß ¿“«–‡¡µ“∫Õ≈‘° ´‘π‚¥√¡√âÕ¬≈– 29.3 ‚¥¬‡æ»À≠‘ß®–æ∫¡“°°«à“ ‡æ»™“¬‚¥¬‡©æ“–ºŸ â ߟ Õ“¬ÿ „πª√–‡∑»‡°“À≈’6 æ∫ Õ—µ√“§«“¡™ÿ°„π‡æ»À≠‘ß √âÕ¬≈– 12.4 ·≈–‡æ» ™“¬ √âÕ¬≈– 9.8 „πŒàÕß°ß7 ”√«®„πª√–™“°√ ‡™◊ÕÈ ™“µ‘®π’ æ∫Õ—µ√“§«“¡™ÿ°¢Õß¿“«–‡¡µ“∫Õ≈‘° ´‘π‚¥√¡ „π‡æ»À≠‘ß √âÕ¬≈– 22 ·≈–‡æ»™“√âÕ¬≈– 20 „πª√–‡∑» ‘ߧ傪√å8 æ∫§«“¡™ÿ°¢Õß ¿“«–‡¡µ“∫Õ≈‘°´‘π‚¥√¡„π‡æ»À≠‘ß√âÕ¬≈– 15 ·≈– ‡æ»™“¬√âÕ¬≈– 20.9 ·≈– ¡’°“√»÷°…“∑’Ë √«∫√«¡Õ— µ √“§«“¡™ÿ ° ¢Õß¿“«–‡¡µ“∫Õ≈‘ ° ´‘π‚¥√¡ 9 „πª√–‡∑»∑“߇Շ™’¬µ–«—πÕÕ° ·≈– µ–«—πÕÕ°‡©’¬ß„µâ „π™à«ß§√‘ µå»°— √“™ 2002-2007 (æ.».2545-2550) æ∫§«“¡™ÿ° Õ¬Ÿ√à –À«à“ß√âÕ¬≈– 102 ¡°√“§¡ - ¡’π“§¡ 2553

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§«“¡·µ°µà “ ß√–À«à “ ßÕß§å ª √–°Õ∫¢Õß¿“«– ‡¡µ“∫Õ≈‘ ° ´‘ π ‚¥√¡ µ“¡™à « ßÕ“¬ÿ ‚ ¥¬„™â ∂‘ µ‘ ANOVA ·≈–«‘‡§√“–À姫“¡·µ°µà“߇ªìπ√“¬§Ÿà ¥â«¬ ∂‘µ‘ scheffe analysis °“√«‘‡§√“–Àå¢âÕ¡Ÿ≈ ∑“ß ∂‘µ‘„™â‚ª√·°√¡ ”‡√Á®√Ÿª SPSS ß“π«‘®—¬π’È °”Àπ¥π—¬ ”§—≠∑“ß ∂‘µ‘∑’Ë√–¥—∫ 0.05

º≈°“√»÷°…“ 1. ¢âÕ¡Ÿ≈∑—Ë«‰ª °≈ÿࡪ√–™“°√∑’ËÕ“¬ÿ¡“°°«à“ 35 ªï∑’ˇ¢â“ √à«¡°“√«‘®—¬§√—Èßπ’È¡’®”π«π 393 §π ·∫à߇ªìπ ‡æ» ™“¬ 66 §π (√âÕ¬≈– 16.8) ·≈– ‡æ»À≠‘ß 327 §π (√âÕ¬≈– 83.2) ™à«ßÕ“¬ÿ∑æ’Ë ∫¡“°∑’ Ë ¥ÿ Õ¬Ÿ„à π™à«ß 45-54 ªï √âÕ¬≈– 58.4 §à“¥—™π’¡«≈°“¬¢Õß°≈ÿà¡ ª√–™“°√π’È à«π¡“°Õ¬Ÿà„π™à«ß 18.5-22.5 kg/m2 √âÕ¬≈– 41.5 ¥—ß· ¥ß¢âÕ¡Ÿ≈„πµ“√“ß∑’Ë 1

µ“√“ß∑’Ë 1 ¢âÕ¡Ÿ≈∑—Ë«‰ª¢Õ߇®â“Àπâ“∑’Ë°√¡Õπ“¡—¬ ∑’Ë∑”ß“π„π à«π°≈“ß °√–∑√«ß “∏“√≥ ÿ¢ µ—«·ª√ ‡æ» Õ“¬ÿ(ªï) 35-44 45-54 55-60 πÈ”Àπ—° (°‘‚≈°√—¡) < 40 40-49 50-59 60-69 70-79 80-89 > 90 §«“¡ Ÿß (‡´πµ‘‡¡µ√) 140-149

™“¬(®”π«π)

√âÕ¬≈–

À≠‘ß(®”π«π)

√âÕ¬≈–

66

16.8

327

83.2

12 37 17

3.1 9.4 4.3

78 192 56

19.9 49 14.3

0 1 9 15 19 3 2

0 0.3 2.7 4.5 5.7 0.9 0.6

1 51 132 68 27 4 3

0.3 15.2 39.4 20.3 8.1 1.2 0.9

0

0

26

7.2

THAILAND JOURNAL OF HEALTH PROMOTION AND ENVIRONMENTAL HEALTH January - March 2010

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∫ ∑ «‘ ∑ ¬ “ ° “ √ µ“√“ß∑’Ë 1 ¢âÕ¡Ÿ≈∑—«Ë ‰ª¢Õ߇®â“Àπâ“∑’°Ë √¡Õπ“¡—¬ ∑’∑Ë ”ß“π„π à«π°≈“ß °√–∑√«ß “∏“√≥ ÿ¢(µàÕ) µ—«·ª√ 150-159 160-169 170-179

™“¬(®”π«π)

√âÕ¬≈–

À≠‘ß(®”π«π)

√âÕ¬≈–

5 29 20

1.4 8 5.5

207 68 6

57.3 18.8 1.7

1 17 15 18 3

0.3 4.8 4.2 5 0.8

12 131 64 75 21

3.4 36.7 17.9 21 5.9

32 22

9 6.2

91 210

25.6 59.2

25 29

7 8.1

55 248

15.4 69.5

12 29

4.3 10.5

51 184

18.5 66.7

12 43

21.8 78.2 112 192

36.8 63.2

78 225

25.7 74.3

BMI <18.5 18.5-22.9 23-24.9 25-29.9 >30 FBS (mg/dl) ≥ 100 < 100 Triglyceride (mg/dl) ≥ 150 < 150 §«“¡¥—π‚≈À‘µ (mmHg) ≥ 130/85 < 130/85 ‡ âπ√Õ∫‡Õ« (‡´πµ‘‡¡µ√) ™“¬ ≥90 <90 À≠‘ß ≤80 <80 HDL-cholesterol (mg/dl) ™“¬ ≤40 >40 À≠‘ß ≤50 >50

9 45

2. §«“¡™ÿ°¢Õß¿“«–‡¡µ“∫Õ≈‘°´‘π‚¥√¡ ®“°§”𑬓¡¢Õß¿“«–‡¡µ“∫Õ≈‘°´‘π‚¥√¡¢Õß Modified NCEP ATPIII „π°“√«‘®—¬§√—Èßπ’Èæ∫ 104 ¡°√“§¡ - ¡’π“§¡ 2553

°√¡Õπ“¡—¬ à߇ √‘¡„Àâ§π‰∑¬ ÿ¢¿“楒

16.7 83.3

§«“¡™ÿ°‚¥¬√«¡ ª√–¡“≥√âÕ¬≈– 17.3 ‡¡◊ËÕ·∫àß µ“¡‡æ»æ∫§«“¡™ÿ°¢Õß¿“«–‡¡µ“∫Õ≈‘°´‘π‚¥√¡ ¥—ßµ“√“ß∑’Ë 2

°“√»÷°…“§«“¡™ÿ°¢Õß¿“«–‡¡µ“∫Õ≈‘°´‘π‚¥√¡„π°≈ÿࡇ®â“Àπâ“∑’Ë°√¡Õπ“¡—¬œ

µ“√“ß∑’Ë 2 ‡ª√’¬∫‡∑’¬∫¿“«–‡¡µ“∫Õ≈‘°´‘π‚¥√¡ µ“¡≈—°…≥–∑“ß‡æ» ‡æ»

®”π«π 14 54

™“À≠‘ß p=0.000

®–‡ÀÁπ‰¥â«“à ¿“«–‡¡µ“∫Õ≈‘°´‘π‚¥√¡ ‡æ» ™“¬¡’Õ—µ√“°“√ªÉ«¬¡“°°«à“‡æ»À≠‘ß Õ¬à“ß¡’𗔧—≠∑“ß ∂‘µ‘ (p<0.05)

√âÕ¬≈– 21.2 16.5

·≈–‡ª√’¬∫‡∑’¬∫¿“«–‡¡µ“∫Õ≈‘°´‘π‚¥√¡ ·∫àßµ“¡‡æ» ·≈–™à«ßÕ“¬ÿ ¥—ßµ“√“ß∑’Ë 3

µ“√“ß∑’Ë 3 ‡ª√’¬∫‡∑’¬∫¿“«–‡¡µ“∫Õ≈‘°´‘π‚¥√¡·∫àßµ“¡‡æ» ·≈–™à«ßÕ“¬ÿ ‡æ» ™“¬

Õ“¬ÿ(ªï) 35-44 45-54 55-60 35-44 45-54 55-60

˭ԧ

®“°µ“√“ß∑’Ë 3 ‡ª√’ ¬ ∫‡∑’ ¬ ∫¿“«– ‡¡µ“∫Õ≈‘°´‘π‚¥√¡‡ª√’¬∫‡∑’¬∫µ“¡™à«ßÕ“¬ÿ·≈– ‡æ» „π‡æ»™“¬ æ∫¿“«–‡¡µ“∫Õ≈‘°´‘π‚¥√¡ ¡“° ∑’Ë ÿ¥„π™à«ßÕ“¬ÿ 45-54 ªï ª√–¡“≥ √âÕ¬≈– 57.1 „π‡æ»À≠‘ß æ∫¿“«–‡¡µ“∫Õ≈‘°´‘π‚¥√¡ ¡“°

®”π«π

√âÕ¬≈–

2 8 4 5 39 10

14.3 57.1 28.6 9.3 72.2 18.5

∑’Ë ÿ¥™à«ßÕ“¬ÿ 45-54 ªï ª√–¡“≥ √âÕ¬≈– 72.2 3. ‡ª√’¬∫‡∑’¬∫Õߧåª√–°Õ∫µà“ßÊ ¢Õß ¿“«–‡¡µ“∫Õ≈‘°´‘π‚¥√¡µ“¡ ‡æ» ·≈–™à«ßÕ“¬ÿ ¥—ßµ“√“ß∑’Ë 4

µ“√“ß∑’Ë 4 ‡ª√’¬∫‡∑’¬∫¿“«–‡¡µ“∫Õ≈‘°´‘π‚¥√¡µ“¡Õߧåª√–°Õ∫„π°≈ÿࡇ®â“Àπâ“∑’Ë°√¡Õπ“¡—®”·π°µ“¡‡æ» ‡æ»

FBS(mg/dl)

™“¬ 32(48.5%) À≠‘ß 91(27.8%) √«¡ 123 P value 0.017*

TG(mg/dl)

BP(mmHg) √Õ∫‡Õ«(‡´πµ‘‡¡µ√) HDL-c(mg/dl)

25(37.9%) 55(16.8%) 80 0.00*

12(18.2%) 51(15.6%) 63 0.056

12(18.2%) 112(34.3%) 124 ™“¬ 0.00* À≠‘ß 0.056

9(13.6%) 78(23.9%) 87 À≠‘ß 0.00* ™“¬ 0.00*

*p<0.05 THAILAND JOURNAL OF HEALTH PROMOTION AND ENVIRONMENTAL HEALTH January - March 2010

105

∫ ∑ «‘ ∑ ¬ “ ° “ √ FBS≥100mg/dl,TG≥150mg/dl,BP≥ 130/85mmHg,HDLc ‡æ»À≠‘ßπâÕ¬°«à“50mg/ dl ‡æ»™“¬πâÕ¬°«à“ 40mg/dl,√Õ∫‡Õ«¡“°°«à“ 80‡´πµ‘‡¡µ√„π‡æ»À≠‘ß ¡“°°«à“ 90 ‡´πµ‘‡¡µ√ „π‡æ»™“Õߧåª√–°Õ∫µà“ßÊ ¢Õß¿“«–‡¡µ“∫Õ≈‘° ´‘π‚¥√¡ ∑’Ëæ∫¡“°∑’Ë ÿ¥ 3 Õ—π¥—∫·√°„π‡æ»™“‰¥â·°à √–¥—∫πÈ”µ“≈„π‡≈◊Õ¥ Ÿß √âÕ¬≈– 48.5 √–¥—∫ ‰¢¡—π‰µ√°≈’‡´Õ‰√¥å„π‡≈◊Õ¥ Ÿß √âÕ¬≈– 37.9 ·≈– Õ—π¥—∫∑’Ë 3 ·≈– 4 ‡∑à“°—π§◊Õ§«“¡¥—π‚≈À‘µ Ÿß·≈– ‡ âπ√Õ∫‡Õ«‡°‘π‡°≥±å √âÕ¬≈– 18.2

Õߧåª√–°Õ∫µà“ßÊ ¢Õß¿“«–‡¡µ“∫Õ≈‘° ´‘π‚¥√¡ ∑’Ëæ∫¡“°∑’Ë ÿ¥ 3 Õ—π¥—∫·√°„π‡æ»À≠‘ß ‰¥â·°à ‡ âπ√Õ∫‡Õ«‡°‘π‡°≥±å √âÕ¬≈– 34.3 √–¥—∫ πÈ”µ“≈„π‡≈◊Õ¥ Ÿß √âÕ¬≈– 27.8 √–¥—∫‰¢¡—π™π‘¥¥’ „π‡≈◊Õ¥µË”(HDL-Cholesterol) √âÕ¬≈– 23.9 ·≈–¡’ § «“¡·µ°µà “ ßÕ¬à “ ß¡’ π— ¬ ”§— ≠ (p<0.05) √–À«à “ ß‡æ» ‚¥¬‡æ»™“¬¡’ √ –¥— ∫ πÈ”µ“≈„π‡≈◊Õ¥ Ÿß ·≈–√–¥—∫‰¢¡—π‰µ√°≈’‡´Õ‰√¥å „π‡≈◊Õ¥ Ÿß¡“°°«à“‡æ»À≠‘ß 4. ‡ª√’ ¬ ∫‡∑’ ¬ ∫Õß§å ª √–°Õ∫¿“«– ‡¡µ“∫Õ≈‘°´‘π‚¥√¡ µ“¡‡æ» ·≈–™à«ßÕ“¬ÿ µ“¡ µ“√“ß∑’Ë 5 ·≈– 6

µ“√“ß∑’Ë 5 ‡ª√’¬∫‡∑’¬∫Õߧåª√–°Õ∫¢Õß¿“«–‡¡µ“∫Õ≈‘°´‘π‚¥√¡„π‡æ»™“¬µ“¡™à«ßÕ“¬ÿ (‡æ» ™“¬) Õ“¬ÿ(ªï)

FBS(mg/dl)

TG(mg/dl)

BP(mmHg)

35-44 45-54 55-60 √«¡ P value

2(6.3%) 19(59.4%) 11(34.4%) 32 0.077

3(12%) 13(52%) 9(36%) 25 0.460

2(16.7%) 7(58.3%) 3(25%) 12 0.828

√Õ∫‡Õ«(´¡.) HDL-c(mg/dl) 2(16.7%) 7(58.3%) 3(25%) 12 0.985

1(11.1%) 5(55.6%) 3(33.3%) 9 0.898

µ“√“ß∑’Ë 6 ‡ª√’¬∫‡∑’¬∫Õߧåª√–°Õ∫¢Õß¿“«–‡¡µ“∫Õ≈‘°´‘π‚¥√¡„π‡æ»À≠‘ßµ“¡™à«ßÕ“¬ÿ (‡æ» À≠‘ß) Õ“¬ÿ(ªï)

35-44 45-54 55-60 √«¡ P value *p<0.05

FBS(mg/dl)

TG(mg/dl)

BP(mmHg)

14(15.6%) 58(64.4%) 18(20%) 90 0.035

2(12%)* 40(72.7%)* 13(23.6%)* 55 0.00*

10(20%) 28(56%) 12(24%) 50 0.051

106 ¡°√“§¡ - ¡’π“§¡ 2553

°√¡Õπ“¡—¬ à߇ √‘¡„Àâ§π‰∑¬ ÿ¢¿“楒

√Õ∫‡Õ«(´¡.) HDL-c(mg/dl)

18(16.1%)* 72(64.3%)* 22(19.6%) 112 0.023*

15(19.2%) 49(62.8%) 14(17.9%) 78 0.403

°“√»÷°…“§«“¡™ÿ°¢Õß¿“«–‡¡µ“∫Õ≈‘°´‘π‚¥√¡„π°≈ÿࡇ®â“Àπâ“∑’Ë°√¡Õπ“¡—¬œ

FBS≥100mg/dl,TG≥150mg/dl,BP≥ 130/85mmHg,HDLc ‡æ»À≠‘ßπâÕ¬°«à“À√◊Õ ‡∑à“°—∫50mg/dl ‡æ»™“¬πâÕ¬°«à“À√◊Õ‡∑à“°—∫ 40mg/dl,√Õ∫ ‡Õ«¡“°°«à“ 80 ‡´πµ‘‡¡µ√„π‡æ»À≠‘ß ¡“°°«à“ 90 ‡´πµ‘‡¡µ√„π‡æ»™“„π‡æ»™“¬ ‡¡◊ËÕ‡ª√’¬∫‡∑’¬∫µ“¡™à«ßÕ“¬ÿ æ∫„π°≈ÿà¡Õ“¬ÿ 45-54 ªï ¡’Õߧåª√–°Õ∫¢Õß ¿“«–‡¡µ“∫Õ≈‘°´‘π‚¥√¡ ‰¥â·°à √–¥—∫πÈ”µ“≈„π ‡≈◊Õ¥ Ÿß √–¥—∫‰¢¡—π‰µ√°≈’‡´Õ‰√¥å„π‡≈◊Õ¥ Ÿß §«“¡ ¥—π‚≈À‘µ Ÿß ‡ âπ√Õ∫‡Õ«‡°‘π‡°≥±å ·≈–‰¢¡—π ™π‘¥¥’(HDL-cholesterol)„π‡≈◊Õ¥µË” ¡“°∑’Ë ÿ¥ „π‡æ»À≠‘ß ¡’√–¥—∫‰¢¡—π‰µ√°≈’‡´Õ‰√¥å „π‡≈◊Õ¥ Ÿß „π°≈ÿ¡à Õ“¬ÿ 45-54 ªï ·≈–°≈ÿ¡à Õ“¬ÿ 5560 ªï æ∫¡“°°«à“°≈ÿà¡Õ“¬ÿ 35-44 ªï Õ¬à“ß¡’𗔧—≠∑“ß ∂‘µ‘ (p<0.05) ·≈–¡’‡ âπ√Õ∫‡Õ«‡°‘π ‡°≥±å „π°≈ÿ¡à Õ“¬ÿ 45-54 ªï ¡“°°«à“°≈ÿ¡à Õ“¬ÿ 3544 ªï Õ¬à“ß¡’π—¬ ”§—≠∑“ß ∂‘µ‘ (p<0.05)

«‘®“√≥å Õ—µ√“§«“¡™ÿ°¢Õß¿“«–‡¡µ“∫Õ≈‘°´‘π‚¥√¡ „π°≈ÿ¡à ‡®â“Àπâ“∑’°Ë √¡Õπ“¡—¬ ∑’∑Ë ”ß“π„π à«π°≈“ß ®—ßÀ«—¥ππ∑∫ÿ√’ °√–∑√«ß “∏“√≥ ÿ¢ ∑’ÕË “¬ÿ¡“°°«à“ 35 ªï „πªï æ.». 2552 „π°“√»÷°…“π’È ‰¥â§à“§«“¡ ™ÿ°‡∑à“°—∫√âÕ¬≈– 17.3 ‚¥¬‡ªìπ‡æ»™“¬¡“°°«à“ ‡æ»À≠‘ß (√âÕ¬≈– 21.2 ·≈–√âÕ¬≈– 16.5 µ“¡ ≈”¥—∫) Õߧåª√–°Õ∫¢Õß¿“«–‡¡µ“∫Õ≈‘°´‘π‚¥√¡ ∑’Ëæ∫¡“°∑’Ë ÿ¥ 3 Õ—π¥—∫·√° „π‡æ»™“¬§◊Õ √–¥—∫ πÈ”µ“≈„π‡≈◊Õ¥ Ÿß √âÕ¬≈– 48.5 √–¥—∫‰¢¡—π‰µ√° ≈’‡´Õ‰√¥å„π‡≈◊Õ¥ Ÿß √âÕ¬≈– 37.9 ·≈–§«“¡¥—π ‚≈À‘µ Ÿß√âÕ¬≈– 18.2 „π‡æ»À≠‘ß “¡Õ—π¥—∫·√° ∑’Ëæ∫∫àÕ¬‰¥â·°à √Õ∫‡Õ«¡“°°«à“ 80 ‡´πµ‘‡¡µ√ √âÕ¬≈– 34.3 √–¥—∫πÈ”µ“≈„π‡≈◊Õ¥ Ÿß √âÕ¬≈– 27.8 ·≈–‰¢¡—π™π‘¥¥’ (HDL-Cholesterol)„π‡≈◊Õ¥µË”

√âÕ¬≈– 23.9 ‚¥¬‡æ»™“¬¡’√–¥—∫πÈ”µ“≈„π‡≈◊Õ¥ Ÿß ·≈–√–¥—∫‰¢¡—π‰µ√°≈’‡´Õ‰√¥å„π‡≈◊Õ¥ Ÿß ¡“° °«à“‡æ»À≠‘ßÕ¬à“ß¡’π—¬ ”§—≠∑“ß ∂‘µ‘(p<0.05) ®“°°“√«‘®—¬π’ȇ¡◊ËÕ‡ª√’¬∫‡∑’¬∫°—∫°“√«‘®—¬‡√◊ËÕß ¿“«–‡¡µ“∫Õ≈‘°´‘π‚¥√¡„πª√–‡∑»‰∑¬„π™à«ßªï æ.».2544-2550 ∑’˺à“π¡“°àÕπÀπâ“π’È ‡™àπ°“√ «‘®—¬„πªï æ.».254410 ‚¥¬«‘±Ÿ√¬å ‚≈à ÿπ∑√ ·≈– §≥–‡ªìπ°“√»÷°…“√–¬– —Èπ·∫∫ cross sectional study ∑”°“√»÷°…“„π°≈ÿà¡π—°«‘™“™’æ·≈–æπ—° ß“π„π°√ÿ߇∑æ¡À“π§√ ®”π«π 1,339 §π (™“535 §π·≈–À≠‘ ß 804 §π)∑’Ë ¡“∑”°“√µ√«® ÿ¢¿“æª√–®”ªï∑‚’Ë √ß欓∫“≈®ÿÓ≈ß°√≥å √–À«à“ß ‡¥◊Õπ ‘ßÀ“§¡ ∂÷ß ∏—𫓧¡ æ.».2544 𑬓¡ ¢Õß¿“«–‡¡µ“∫Õ≈‘ ° ´‘ π ‚¥√¡‰¥â „ ™â ‡ °≥±å ¥—¥·ª≈ߢÕß NCEP ATPIII ‡ª√’¬∫‡∑’¬∫§«“¡ ·µ°µà“ߢÕß°“√°√–®“¬µ—«·ª√µà“ßÊ „π°≈ÿà¡∑’Ë¡’ ·≈–‰¡à¡’Õ“°“√‡¡µ“∫Õ≈‘°‚¥¬„™â°“√∑¥ Õ∫‰§ · §«√å º≈°“√»÷°…“ æ∫Õ—µ√“§«“¡™ÿ°‡∑à“°—∫ √â Õ ¬≈– 15.2 ‡æ»™“¬æ∫¡“°°«à “ ‡æ»À≠‘ ß ª√–¡“≥ 3 ‡∑à“(√âÕ¬≈– 25.8 ‡∑’¬∫°—∫ √âÕ¬≈– 8.2) ™“¬·≈–À≠‘ß∑’¡Ë °’ ≈ÿ¡à Õ“°“√‡¡µ“∫Õ≈‘° ¡’Õ“¬ÿ¡“° (p<0.05) ·≈–¡’°“√»÷°…“πâÕ¬°«à“(p<0.05)°≈ÿ¡à ∑’ˉ¡à¡’Õ“°“√‡¡µ“∫Õ≈‘° Õߧåª√–°Õ∫¢Õß¿“«– ‡¡µ“∫Õ≈‘°´‘π‚¥√¡∑’Ëæ∫¡“°∑’Ë ÿ¥ “¡Õ—π¥—∫·√° „π‡æ»™“¬ §◊Õ §«“¡¥—π‚≈À‘µ Ÿß √âÕ¬≈– 45 ¥—™π’ ¡«≈°“¬¡“°°«à“À√◊Õ‡∑à“°—∫ 25 kg/m2√âÕ¬≈– 40.7 ·≈–√–¥—∫‰µ√°≈’‡´Õ‰√¥å„π‡≈◊Õ¥ Ÿß √âÕ¬≈– 38.7 „π ‡æ»À≠‘ß “¡Õ—π¥—∫·√°∑’Ëæ∫∫àÕ¬ ‰¥â·°à §«“¡ ¥—π‚≈À‘µ Ÿß√âÕ¬≈– 22.8 ¥—™π’¡«≈°“¬¡“°°«à“ À√◊Õ‡∑à“°—∫ 25 kg/m2 √âÕ¬≈– 20.9 ·≈– ‰¢¡—π §Õ‡≈ ‡µÕ√Õ≈™π‘¥¥’µË” √âÕ¬≈– 18.4 µ“¡≈”¥—∫ „πªï æ.».2546-254711 ∑’Ë®—ßÀ«—¥¢Õπ·°àπ ¡’°“√ »÷°…“§«“¡™ÿ°¢Õß¿“«–Õâ«π≈ßæÿß(Metabolic syndrome)·≈–§«“¡ — ¡ æ— π ∏å °— ∫ πÈ” Àπ— ° „π

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∫ ∑ «‘ ∑ ¬ “ ° “ √ ª√–‡∑»‰∑¬ ‚¥¬ ©—µ√‡≈‘» æ߅剙¬°ÿ≈·≈–§≥– ∑”°“√»÷°…“„πºŸâ∑’Ë¡“√—∫∫√‘°“√µ√«® ÿ¢¿“æ∑’Ë‚√ß æ¬“∫“≈»√’π§√‘π∑√å ®—ßÀ«—¥¢Õπ·°àπ„π™à«ßªï æ.».

2546-2547 ‚¥¬„™â§à“¥—™π’¡«≈°“¬¡“°°«à“À√◊Õ ‡∑à“°—∫ 27 kg/m2„π‡æ»™“¬ ·≈–¡“°°«à“À√◊Õ ‡∑à“°—∫ 25 kg/m2„π‡æ»À≠‘ß ·∑π§à“‡ âπ√Õ∫ ‡Õ«´÷Ë ß „πª√–‡∑»‰∑¬§à “ ¥— ß °≈à “ «‡∑’ ¬ ∫‡∑à “ °— ∫ ª√‘¡“≥‰¢¡—π„π√à“ß°“¬√âÕ¬≈– 25 „π‡æ»™“¬ ·≈– √âÕ¬≈– 35 „π‡æ»À≠‘ß µ“¡≈”¥—∫ ·≈–º≈°“√»÷°…“ æ∫§«“¡™ÿ°¢Õß¿“«–Õâ«π≈ßæÿ߇∑à“°—∫√âÕ¬≈– 15 ´÷Ë߉¡à¡’§«“¡·µ°µà“ß√–À«à“ß ‡æ»™“¬ (√âÕ¬≈– 15.3) ·≈–‡æ»À≠‘ß (√âÕ¬≈– 14.6) §à“§«“¡™ÿ° π’‡È æ‘¡Ë µ“¡Õ“¬ÿ∑¡’Ë “°¢÷πÈ ∑—ßÈ „π‡æ»™“¬·≈–‡æ»À≠‘ß ‡¡◊ËÕµ—¥§à“¥—™π’¡«≈°“¬ÕÕ°®“°‡°≥±å°“√«‘π‘®©—§«“¡™ÿ°√«¡‚¥¬„™â‡°≥±å¡“°°«à“ 3 ¢âÕ∑’ˇÀ≈◊Õ ®–æ∫§«“¡™ÿ°‡∑à“°—∫√âÕ¬≈– 7.8 Õ¬à“߉√°Áµ“¡ §«“¡™ÿ°¢Õß¿“«–Õâ«π≈ßæÿß∑’˵—¥‡°≥±å¥—™π’¡«≈ °“¬ÕÕ° ¬—ß —¡æ—π∏å°—∫§à“¥—™π’¡«≈°“¬∑’ˇæ‘Ë¡¢÷Èπ ‚¥¬§à“¥—™π’¡«≈°“¬∑’ËπâÕ¬°«à“ 25 kg/m2 æ∫ §«“¡™ÿ°√âÕ¬≈– 4.6 „π‡æ»™“¬ ·≈– √âÕ¬≈– 5 „π ‡æ»À≠‘ß ‡∑’¬∫°—∫√âÕ¬≈–13 „π‡æ»™“¬·≈– √âÕ≈– 16 „π‡æ»À≠‘ß ‡¡◊ËÕ¥—™π’¡«≈°“¬¡“°°«à“ 25 kg/m2 ‚¥¬ √ÿªæ∫¿“«–π’„È πª√–™“°√‰∑¬ √âÕ¬≈– 15 ´÷Ë ß æ∫∫à Õ ¬‡™à 𠇥’ ¬ «°— ∫ ™“µ‘ µ –«— π µ°·≈– §«“¡Õâ«π‡ªìπ à«πª√–°Õ∫¢Õß¿“«–‰¢¡—π∑’ËÀπâ“ ∑âÕ߇°‘π„πª√–™“°√‰∑¬ µàÕ¡“ªï æ.».2549-2550 ∑’Ë®—ßÀ«—¥ÀπÕߧ“¬ ¡’°“√»÷°…“Õ—µ√“§«“¡™ÿ° ¢Õß¿“«–‡¡µ“∫Õ≈‘°´‘π‚¥√¡„πª√–™“°√∑’Ë¡“ µ√«® ÿ ¢ ¿“æ„πÕ”‡¿Õ»√’ ‡ ™’ ¬ ß„À¡à ®— ß À«— ¥ ÀπÕߧ“¬ ‚¥¬·À≈¡∑Õß ·°â«µ√–°Ÿ≈æß»å 𑬓¡ ¢Õß¿“«–‡¡µ“∫Õ≈‘ ° ´‘ π ‚¥√¡‚¥¬‡°≥±å ¢ Õß NCEP ATPIII ‡ªìπ°“√»÷°…“‡™‘ßæ√√≥“·∫∫ ¬âÕπÀ≈—ß ∑”°“√»÷°…“„π™à«ß‡¥◊Õπµÿ≈“§¡ ∂÷ß ‡¥◊Õπ°—𬓬π æ.». 2549 ª√–™“°√∑’Ë√à«¡„π°“√ 108 ¡°√“§¡ - ¡’π“§¡ 2553

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¢âÕ‡ πÕ·π– 1. §«√¡’ ° “√ à ß ‡ √‘ ¡ °“√„Àâ § «“¡√Ÿâ ‡ √◊Ë Õ ß ¿“«–‡¡µ“∫Õ≈‘°´‘π‚¥√¡ „π¥â“𧫓¡ ”§—≠¢Õß °“√‡ªì𠓇Àµÿ¢Õß‚√§‡∫“À«“π™π‘¥∑’Ë 2 ‚√§ À—«„®·≈–À≈Õ¥‡≈◊Õ¥ ªí®®—¬‡ ’¬Ë ß∑—ßÈ 5 ¢âÕ ‡™àπ √–¥—∫ πÈ”µ“≈„π‡≈◊Õ¥ Ÿß √–¥—∫‰¢¡—π‰µ√°≈’‡´Õ‰√¥å„π ‡≈◊Õ¥ Ÿß §«“¡¥—π‚≈À‘µ Ÿß ‡ âπ√Õ∫‡Õ«‡°‘π‡°≥±å ¡“µ√∞“π ·≈– ‰¢¡—π™π‘¥¥’„π‡≈◊Õ¥µË” √«¡∑—ßÈ °“√ √—°…“·≈–°“√ªÑÕß°—π°“√‡°‘¥¿“«–‡À≈à“π’È „π ª√–™“°√°≈ÿࡇ®â“Àπâ“∑’Ë°√¡Õπ“¡—¬ ∑’Ë∑”ß“π„π à«π°≈“ß ππ∑∫ÿ√’ °√–∑√«ß “∏“√≥ ÿ¢π’È ‡æ◊ËÕ ‡ªìπª√–‚¬™πå„π°“√¥Ÿ·≈√—°…“ ÿ¢¿“æ¢Õßµπ‡Õß 2. ¡’°“√®—¥°“√°—∫ªí≠À“ªí®®—¬‡ ’ˬߢÕß ¿“«–‡¡µ“∫Õ≈‘°´‘π‚¥√¡„πª√–™“°√°≈ÿà¡π’È ´÷Ëß „π‡æ»™“¬·≈–‡æ»À≠‘ß ¡’ªí®®—¬‡ ’ˬ߄π 3 Õ—π¥—∫ ·√°∑’Ë¡“°∑’Ë ÿ¥∑’˵à“ß°—π ‰¥â·°à - „π‡æ»™“¬ æ∫ √–¥—∫πÈ”µ“≈„π‡≈◊Õ¥ Ÿß √–¥—∫‰¢¡—π‰µ√°≈’‡´Õ‰√¥å„π‡≈◊Õ¥ Ÿß ·≈– §«“¡ ¥— π ‚≈À‘ µ Ÿ ß ¡“°∑’Ë ÿ ¥ ¥— ß π—È π °“√≈¥¿“«– ‡¡µ“∫Õ≈‘°´‘π‚¥√¡„πª√–™“°√°≈ÿà¡π’È ®÷ߧ«√ ‡πâπ‰ª∑’Ë 2.1ªí ≠ À“‡√◊Ë Õ ß√–¥— ∫ πÈ” µ“≈„π‡≈◊ Õ ¥ Ÿ ß (impaired fasting blood glucose) ‚¥¬°“√ à߇ √‘¡°“√„À⧫“¡√Ÿâ¥â“π‚¿™π“°“√ √—∫ª√–∑“π Õ“À“√∑’Ë¡’§“√å‚∫‰Œ‡¥√µ≈¥≈ß ·≈–‡πâπÕ“À“√ à«π∑’‡Ë ªìπ∏—≠æ◊™ ‡™àπ ¢â“«°≈âÕ߉¡à¢¥— ¢“« ¢â“«‚Õäµ ¢â“«‚æ¥ ‡¡≈Á¥æ◊™æ«°‚Œ≈«’µ à«πÕ“À“√æ«° ‰¢¡—π ‡πâπ°“√√—∫ª√–∑“π°≈ÿࡉ¢¡—π‰¡àÕ‘Ë¡µ—« ‡™‘߇¥’ˬ« (monounsaturated fat) ‡™àπ πÈ”¡—π

¡–°Õ° ∂—«Ë ™π‘¥µà“ßÊ ‡æ‘¡Ë Õ“À“√æ«°‰ø‡∫Õ√å ‡™àπ º—° º≈‰¡â Õ¬à“ßπâÕ¬ 30 °√—¡µàÕ«—π ≈¥πÈ”Àπ—° ·≈– ¡’°“√ÕÕ°°”≈—ß°“¬Õ¬à“ßπâÕ¬ 30 π“∑’µÕà «—π Õ¬à“ß πâÕ¬ 3-4 «—πµàÕ —ª¥“Àå 2.2ªí≠À“‡√◊ËÕß√–¥—∫‰¢¡—π‰µ√°≈’‡´Õ‰√¥å „π‡≈◊Õ¥ Ÿß ¡’«‘∏’°“√ªØ‘∫—µ‘µ—«‡À¡◊Õπ°—∫·π«∑“ß °“√≈¥√–¥—∫πÈ”µ“≈„π‡≈◊Õ¥ Ÿß ·≈–§”·π–π”∑’Ë ‡æ‘Ë¡‡µ‘¡§◊Õ §«√≈¥°“√¥◊Ë¡‡À≈â“ ‰¡à‡°‘π 2 ·°â«µàÕ «—π„πºŸ™â “¬ ·≈–‰¡à‡°‘π 1 ·°â«µàÕ«—π„πºŸÀâ ≠‘ß ·≈– ‡æ‘¡Ë °“√√—∫ª√–∑“πÕ“À“√∑’¡Ë °’ ≈ÿ¡à ‰¢¡—π‚Õ‡¡°â“ 3 ‡™àπ Õ“À“√ª√–‡¿∑ª≈“Õ¬à“ßπâÕ¬Õ“∑‘µ¬å≈– 1 §√—ßÈ 2.3ªí ≠ À“§«“¡¥— π ‚≈À‘ µ Ÿ ß ¡’ «‘ ∏’ ° “√ ªØ‘∫—µ‘µ—«‡À¡◊Õπ°—∫·π«∑“ß°“√≈¥√–¥—∫πÈ”µ“≈ ·≈–√–¥—∫‰¢¡—π‰µ√°≈’‡´Õ‰√¥å„π‡≈◊Õ¥ Ÿß ·≈–§” ·π–π”∑’ˇæ‘Ë¡‡µ‘¡ §◊Õ§«√≈¥Õ“À“√∑’Ë¡’‰¢¡—πÕ‘Ë¡ µ— « Ÿ ß °≈ÿà ¡ ‡π◊È Õ — µ «å ∑’Ë ¡’ ’ · ¥ß ‡π¬ π¡°Á § «√ ‡ª≈’ˬπ‡ªìπÕ“À“√ª√–‡¿∑π¡ low fat ‡·≈– §«√ ‡πâπ°“√≈¥°“√√—∫ª√–∑“πÕ“À“√∑’Ë¡’‡°≈◊Õ≈¥≈ß (‰¡à‡°‘π 6 °√—¡µàÕ«—π¢Õߪ√‘¡“≥‡°≈◊Õ À√◊Õ ‚´‡¥’¬¡‰¡à‡°‘π 2.4 °√—¡µàÕ«—π‚¥¬¥Ÿ‰¥â®“°©≈“° Õ“À“√∑’˵‘¥¡“°—∫∫√√®ÿ¿—≥±å) - „π‡æ»À≠‘ß æ∫ ‡ âπ√Õ∫‡Õ«‡°‘π‡°≥±å √–¥—∫πÈ”µ“≈„π‡≈◊Õ¥ Ÿß √–¥—∫‰¢¡—π™π‘¥¥’(HDLCholesterol) „π‡≈◊ Õ ¥µË” ¡“°∑’Ë ÿ ¥ ¥— ß π—È π °“√≈¥¿“«–‡¡µ“∫Õ≈‘°´‘π‚¥√¡„πª√–™“°√°≈ÿ¡à π’È ®÷ߧ«√‡πâπ‰ª∑’Ë 2.4ªí≠À“‡ âπ√Õ∫‡Õ«‡°‘π‡°≥±å §«√‡πâ𠉪∑’Ë °“√‡æ‘Ë¡ physical activity °“√≈¥πÈ”Àπ—° ‚¥¬°“√§«∫§ÿ¡Õ“À“√ ·≈–°“√ÕÕ°°”≈—ß°“Õ¬à“ßπâÕ¬ 30 π“∑’µàÕ«—π Õ¬à“ßπâÕ¬ 3-4 «—πµàÕ —ª¥“Àå 2.5ªí≠À“√–¥—∫πÈ”µ“≈„π‡≈◊Õ¥ Ÿß ¡’«‘∏’ ªØ‘∫—µ‘‡™àπ‡¥’¬«°—∫¢âÕ 2.1 2.6ªí≠À“√–¥—∫‰¢¡—π™π‘¥¥’ (HDL- Cho-

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∫ ∑ «‘ ∑ ¬ “ ° “ √ lesterol) „π‡≈◊Õ¥µË” ¡’«∏‘ °’ “√ªØ‘∫µ— µ‘ «— §◊Õ°“√‡æ‘¡Ë physical activity °“√≈¥πÈ” Àπ— ° ‚¥¬°“√ §«∫§ÿ¡Õ“À“√ ·≈–°“√ÕÕ°°”≈—ß°“¬Õ¬à“ßπâÕ¬ 30 π“∑’µàÕ«—π Õ¬à“ßπâÕ¬ 3-4 «—πµàÕ —ª¥“Àå ·≈–∑’Ë ‡æ‘Ë¡‡µ‘¡§◊Õ ‡æ‘Ë¡°“√√—∫ª√–∑“πÕ“À“√°≈ÿࡉ¢¡—π ‰¡àÕ‘Ë¡µ—«‡™‘߇¥’ˬ« (monounsaturated fat) ‡™àπ ‡π◊ÈÕª≈“ ∂—Ë«™π‘¥µà“ßÊ πÈ”¡—π¡–°Õ° ·≈–°“√ À¬ÿ¥ Ÿ∫∫ÿÀ√’Ë 3. °“√ à߇ √‘¡°‘®°√√¡§π‰∑¬‰√âæßÿ Õ¬à“ß ®√‘ß®—ß ·≈–¡’°“√ª√–™“ —¡æ—π∏å„π«ß°«â“ß „Àâ°—∫ ∫ÿ § ≈“°√Àπà « ¬ß“πµà “ ßÊ ∑’Ë Õ ¬Ÿà „ π°√–∑√«ß “∏“√≥ ÿ¢ „π à«π°≈“ß ®—ßÀ«—¥ππ∑∫ÿ√’ ‚¥¬‡√‘Ë¡ ®“°‡®â“Àπâ“∑’Ë°√¡Õπ“¡—¬‡ªìπµâπ·∫∫‡æ◊ËÕ∑”„Àâ¡’ ÿ¢¿“æ∑’Ë·¢Áß·√ß ·≈– “¡“√∂≈¥Õ—µ√“°“√ªÉ«¢Õ߇®â“Àπâ“∑’Ë∑’ˇ°‘¥®“°‚√§‡∫“À«“𠧫“¡¥—π ‚≈À‘µ Ÿß ·≈–‚√§À≈Õ¥‡≈◊Õ¥À—«„®‰¥â 4. à ß ‡ √‘ ¡ „Àâ À πà « ¬ß“π∑’Ë ¡’ ¢â Õ ¡Ÿ ≈ ·≈– §«“¡√Ÿâ „π¥â“πµà“ßÊ ‡™àπ „π¥â“π‚¿™π“°“√ ·≈– ¥â“π°“√ à߇ √‘¡°“√ÕÕ°°”≈—ß°“¬ „π°√–∑√«ß

“∏“√≥ ÿ¢ ¡“„À⧫“¡√Ÿâ ·≈–«‘∏’°“√ªØ‘∫—µ‘µπ ‡æ◊ËÕ∑’Ë®–≈¥¿“«–‡¡µ“∫Õ≈‘°´‘π‚¥√¡ ·≈–¡’ à«π √à « ¡„π°“√«“ß·π«∑“ß°“√ªØ‘ ∫— µ‘ µ— « ‡æ◊Ë Õ ∑’Ë ® – ∑”„À⇰‘¥°“√æ—≤𓂧√ß°“√≈¥¿“«–‡¡µ“∫Õ≈‘° ´‘π‚¥√¡ À√◊Õ §π‰∑¬‰√âæÿ߉¥â¡’ª√– ‘∑∏‘¿“æ¡“° ¢÷πÈ 5. ¡’ ° “ √ µ—È ß ‡ ªÑ “ À ¡ “ ¬ ° “ √ ≈ ¥ ¿ “ « – ‡¡µ“∫Õ≈‘ ° ´‘ π ‚¥√¡ „π·µà ≈ –ªï ‡™à π ≈¥„Àâ ‰ ¥â √âÕ¬≈– 1 µàÕªï ·≈–„π 10 ªï “¡“√∂≈¥‰¥â√âÕ¬≈– 10 ‡ªìπµâπ 6. ¡’ ° “√°√–®“¬§«“¡√Ÿâ ¥â “ π°“√ à ß ‡ √‘ ¡ ÿ ¢ ¿“æ ·≈–°“√ªÑ Õ ß°— π °“√‡°‘ ¥ ¿“«– ‡¡µ“∫Õ≈‘°´‘π‚¥√¡„Àâ°—∫ª√–™“°√‰∑¬ „π«ß °«â“ßµàÕ‰ª ‡æ◊ËÕ≈¥¿“«–‡¡µ“∫Õ≈‘°´‘π‚¥√¡π’È„π ¿“æ√«¡√–¥—∫ª√–‡∑» ´÷Ëß “¡“√∂∑”„Àâ≈¥Õ—µ√“ °“√‡°‘¥‚√§‡∫“À«“π ‚√§À≈Õ¥‡≈◊Õ¥À—«„®·≈– ‚√§À≈Õ¥‡≈◊Õ¥ ¡Õß ∑’ˬ—߇ªìπªí≠À“ ÿ¢¿“æ∑’Ë ”§—≠∑’ËÕ¬Ÿà„π “¡Õ—π¥—∫·√°¢Õߪ√–‡∑»‰∑¬„π ¢≥–π’È

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6. Lee WY, Park JS, Noh SY, Rhee EJ, Kim SW, Zimmet PZ. Prevalence of metabolic syndrome among 40,698 Korean metropolitan subjects. Diabetes Res Clin Pract 2004; 65: 143-9 7. Chan JC, Cheung JC, Lau EM, Wooa J, Chan AY, Swaminathan, et al. The metabolic syndrome in Hong Kong Chinese. The interrelationships among its components analyzed by structural equation modeling. Diabetes Care 1996; 19:953-9 8. Tan CE, Ma S, Wai D, Chew SK, Tai ES. Can we apply the National Cholesterol Education Program Adult treatment definition of the metabolic syndrome to Asians? Diabetes Care 2004;27:11821186 9. P Nestel, R Lyu, LP Low, WH-H Sheu, W Nittiyanant, I Saito, CE Tan. Metabolic syndrome: recent prevalence in East and Southeast Asian populations. Asia Pac J Clin Nutr 2007; 16(2):362-367 10. Lohsoonthorn V, Dhanamun B, Williams MA. Prevalence of Metabolic Syndrome among Professional and Office workers in Bangkok, Thailand. J Med Assoc Thai 2007;90(9):1908-15 11. Pongchaiyakul C, Nguyen TV, Wanothayaroj E, Karusan N, Klungboonkrong V. Prevalence of Metabolic syndrome and its Relationship to weight in the Thai population. J Med Assoc Thai;2007:90(3):459-67 12. Kaewtrakulpong L. Metabolic Syndrome: Prevalence in Si Chiang Mai District, Nong Khai Province, Thailand. J Trop Med Parasitol 2008;31:41-7 13. Pan WH, Yeh WT, Weng LC. Epidemiology of metabolic syndrome in Asia. Asia Pac J Clin Nutr 2008;17(S1):37-42 14. Tanomsup S, Aekplakorn W, Sritara P, Woodward M, Yamwong S, Tunlayakechanont S. Definitions of the metabolic syndrome Related to Cardiovascular Disease and all-cause Mortality in a Cohort Study in Thailand. Diabetes Care 2007;30:2138-2140 15. Fan JG, Peng YD. Metabolic syndrome and non-alcoholic fatty liver disease: Asian definitions and Asian studies. Hepatobiliary Pancreat Dis Int 2006;6:572-578 HEALTH

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