背景介紹
代謝症候群在臺灣的盛行率約三成左右，民國108 年衛福部十大死因排行裡，10 人裡就有3 人死於代謝症候群所造成的相關疾病，對國人的威脅不可小覷，相較於男性而言，女性更年期後的代謝症候群盛行率急遽升高。婦女的生產次數與晚年的健康有關，但是關於生產次數對婦女晚年的代謝症候群影響的相關研究，結論不一致。因此，本研究欲探討臺灣更年期後婦女生產次數與代謝症候群的相關性。
材料與方法
本研究為橫斷性研究(cross-sectional study)，利用國民營養健康狀況變遷調查(NAHSIT)1999-2000 年、2004-2008 年、2013-2016 年間所有參與此調查的全國代表性樣本，共有14002 名參加者，保留已停經婦女，最終有1388 名參加者。代謝症候群(Metabolic syndrome)依國家膽固醇教育暨成人治療計畫III National Cholesterol Education Program’s Adults Treatment Panel III (NCEP-ATP III)定義。在控制年齡、社會人口學變項、出生世代、生活習慣、生殖因子後，利用多變項邏輯斯迴歸(Multivariable logistic regression)來評估婦女生產次數與代謝症候群之間的關係。
結果與討論
在1388 名參加者中，平均年齡為66.10 歲，未生育有32 人(2.3%)、生1-2 胎者有289 人(20.8%)、生3-4 胎者有577 人(41.6%)、5 胎以上者有490 人(35.3%)。與對照組(生1-2 胎)相比，在調整年齡、出生世代、教育程度、婚姻狀態、家庭收入、抽菸、運動狀態、子宮切除、卵巢切除、停經年紀、初經年齡、荷爾蒙替代療法後， 生產次數為3-4 胎者肥胖(BMI ≥27kg/m2)的勝算比為(OR, 1.56; 95% confidence interval,1.04-2.34)；血糖升高的勝算比(OR, 1.50; 95% confidence interval, 1.09-2.07)；生5胎以上者，肥胖、腹部肥胖、高血糖、代謝症候群的風險最高，分別為肥胖的勝算比為(OR, 1.98; 95% confidence interval, 1.22-3.23)，腹部肥胖的勝算比為(OR, 1.68; 95%confidence interval, 1.13-2.50)，血糖升高的勝算比為(OR, 1.74; 95% confidence
interval, 1.18-2.57)，代謝症候群的勝算比為(OR, 1.66; 95% confidence interval,1.12-2.47)；額外調整身體質量指數(BMI)後減弱了這些關係，生產次數與高密度脂蛋白血中濃度偏低的方面，與對照組相比，只有在未調整前，生5 胎以上者有顯著較高的風險(OR, 1.42; 95% confidence interval, 1.04-1.94)。生產次數與高血壓、高三酸甘油酯(triglycerides)之間無發現關聯。
結論
臺灣停經後婦女中，生多胎者，有較高的代謝症候群盛行率，同時，也具有較高肥胖及腹部肥胖的風險，也表示他們具有較高的代謝異常風險；額外調整身體質量指數(BMI)後，生產次數與代謝症候群之間的風險降低，且未達統計顯著意義，表示體重或體重變化可能在其中扮演中介的角色。若能掌握婦女相關的生育史，例如：生產次數，並對生多胎的婦女給予常規的產後檢查，可能有助於預防未來心血管事件的發生。

This article was to investigate whether there was an association between parity and metabolic syndrome in postmenopausal women in Taiwan. This was a cross-sectional study and was based on data from the Nutrition and Health Survey in Taiwan, NAHSIT,conducted during 1999-2000 、2004-2008 and 2013-2016. Multivariable logistic regression was conducted to investigate the correlation between parity and metabolic syndrome, with adjustment of potential confounders. Among postmenopausal women in Taiwan, the grand multiparous women had a higher prevalence of metabolic syndrome, and also had a higher risk of obesity and abdominal obesity, which also indicates that they may have a higher risk of metabolic abnormalities. Further adjustment for body mass index (BMI) attenuated these associations, indicating that weight or the change of weight may be a mediator.

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