人體體型與社區居民老化研究團隊

研究團隊成員：

長庚大學

許光宏教授		邱月暇副教授

團隊主持人：許光宏教授

研究專長：流行病學、健康促進、統計學、生技產業研究

長庚醫院

簡榮南醫師、張慧朗醫師、林仁德醫師、吳逸文醫師、丁明國醫師、崔克宏醫師、陳濘宏醫師。

研究架構圖

研究計畫：

說明

隨著台灣逐步邁入高齡化社會，65歲以上老人所占總人口比例持續攀升，其所衍生出的諸多問題值得進一步討論，包含醫療保健、居家照護、社會經濟等。本研究透過社區世代樣本及醫院世代樣本的建立，進行老化相關疾病及生物特徵分析，以了解族群老化之多面向需求與決定因素及機轉。藉由世代的建立，透過實證研究法，探討銀髮族經濟來源與財務規劃，從老年人不同的生活型態、個人之健康狀態、經濟來源與家庭背景與資金需求之相關性，希望找尋影響老年人生、心理表徵的變項，進而連結健康狀態的產生，企圖建立較為完整的銀髮族健康模型。除了社區世代的建立外，因應時代進步，人類對於疾病之研究及了解已越來越趨於完整，包括目前基因及其遺傳性研究，因此對於以家族性為基礎之大規模族群資料庫需求越來越高且重要，不僅是因應基因解密探索需求，而對於基因與環境交互作用之研究其重要性更不可忽略，所以建構一基因與環境暴露相關因子之大規模族群家族 (population-based and family-based) 資料庫來形成預防醫學之策略目標。另外，老化之一項重要生物標誌為體型之改變，本研究亦利用3D掃描數位人模為基礎結合體脂分佈，建構3D數位人模的體型變化，分析其與代謝症候群之關聯性，建立老化之外觀體型之連結預測模式。

背景

繼日本之後，台灣是亞洲第二個邁入高齡化社會的國家，台灣人口的老化速度是全球最快的，人口的老化將對社會帶來許多衝擊。依照目前的統計，大約有80%老年人至少患有一種慢性疾病，50%至少患有兩種慢性疾病，這些慢性疾病會使得老人家處於失能、疼痛、甚至喪失生活基本能力，不僅老年人生活品質受到很大的影響，亦增家人與照護者的負擔，此外，預估2030年時，台灣醫療照護成本會增加25%，因此，許多控制醫療成本的方式應運而生，例如：預防醫學，經由維持功能與避免傷害，我們能夠幫助老年人盡可能保持更久的獨立生活能力，且可以增進老年人生活品質，與延後老年人對長期照護的需求。由於老年人大多喪失或缺乏勞動力，且醫療與生活上的費用相對較高，因此老年人收入、支出等財物，將可能影響其生理與心理表徵，進而對其健康狀態有所影響。

研究發現社會經濟狀態與健康狀態呈現正向關係，亦即高社經地位的老年人其健康狀態比低社經地位的老年人來得好。老年人社會經濟特徵對健康狀態的影響可能並非立即效應或直接作用，有可能透過生、心理表徵間接影響健康狀態，亦即社會經濟特徵、生心理表徵與健康狀態三者間，可能存在著連環交互關係。

故本研究擬以社區為單位，透過社區世代樣本的建立，進行老化相關疾病及生物特徵分析，藉以瞭解多元族群之老化需求與決定因素及其機轉。在社區世代平台之建立上，藉由對不同社區成人進行初步與廣泛性的健康檢測，得以進一步分析成人不同生活型態、個人健康狀態、社會經濟危險因子之相關性。透過現有研究資料，建立完整健康老化資料庫，達到積極預防疾病發生之功效。

目的

本研究目標為建立社區世代，以健康老化為研究主軸，進行社區居民之世代追蹤，從中歸納健康老化居民特徵，定義影響老化的重要因子，並結合長庚大學與長庚醫院資源，產生具突破性及創新性之健康照護模式，作為未來老化疾病預防及醫療或衛教介入方案的設計，而不同族群的界定，亦可作為未來疾病早期診斷指標的建立，以預防疾病之發生。再者，經濟財務與老年人身、心理表徵或健康狀態之相關性探討，則有助於未來政府政策擬定之參考，達到健康老化之最終目的。透過體型型態及體脂肪分佈檢測，歸納代表性之體脂分佈形態，並分析其與代謝症候群之關聯性，建立理論預測模型。

方法

本研究將以醫院及社區分別建立研究世代，以疾病演進的三個階段切入，探討影響疾病的各個構面（生理、心理、社會經濟、遺傳、生活習慣與環境）與健康老化之關係，共有12項子計畫同步執行。針對社區研究世代實施問卷調查，其內容包含人口變項（年齡、性別、教育程度、婚姻狀況、宗教、經濟來源、飲食習慣）、生活習慣（抽菸、喝酒、嚼檳榔、喝茶、咖啡）、職業史、活動量、藥物史、個人病史、家族病史以及自覺健康狀態等。

主要成果

1.  Hsu, C.L., Tseng, K.C., and Chuang, Y.H. . “A Secure IRB System for Assisting the Development of Intelligent Medical Devices.” Expert Systems With Applications, Vol. 39, No. 15, November, 2012, pp. 12512-12521.

2.  Chuang, Y.H., Shu, W., Hsu, K.C., and Hsu, C.L. “A Novel Communication Protocol of Wireless Sensor Networks for a Home Healthcare System in Aging Society,” Advanced Science Letters (ASL)(Accepted).

3.  Chia-Lin Li, Yi-Chen Chiu, Hsing-Yi Chang, Kuang-Hung Hsu, Yuh-Bin Bai and Hui-Hsuan Wang."Association of geriatric conditions and cardiovascular diseases with disability in older adults with diabetes: Findings from a nationally representative survey".Geriatrics & Gerontology International.2012.

4.  Tsao CY , Liu CC.“Asian Options with Credit Risks: Pricing and Sensitivity Analysis. “Emerging Markets Finance and Trade.2012

5.  Chiou WK, Hwang JS, Hsu KH, Lin  JD. “Diabetes mellitus increased mortality rates more in gender-specific than in non-gender-specific cancer patients: a retrospective study of 149,491 patients.” Experimental Diabetes Research.2012 (701643).

6.  Chiu SY, Chen LS, Yen AM, Chen HH. “Population-based proband-oriented pedigree information system: application to hypertension with population-based screening data (KCIS No. 25).” J Am Med Inform Assoc. 2012; 19: 102-110.

7.   Liao PJ,Chen CH, Chan HY,Tan KL,Hsu KH.” Serum Lipid Profile Could Predict the Inception and Impacts of Violent Behaviors among Acute Psychiatric Inpatients.” Chang Gung Medical Journal. 2012; 35:432-41

8.  Chang YC, Ng CJ, Wu CT, Chen LC, Chen JC, Hsu KH. “Effectiveness of a five-level Pediatric Triage System: an analysis of resource utilisation in the emergency department in Taiwan.” Emerg Med J. 2012. (Epub ahead)

9.   Liao PJ , Shih CP, Mao CT, Deng ST, Hsieh MC, Hsu, KH. The cutaneous adverse drug reactions: risk factors, prognosis, and economic impacts" Int J Clin Pract. 2013 Jun;67(6):576-84

10. Liao PJ, Shih CP, Mao CT, Deng ST, Hsieh MC, Hsu KH*. The cutaneous adverse drug reactions: risk factors, prognosis and economic impacts. International journal of clinical practice. 2013; 67(6):576-584. (SCI)

11. Shih CP, Lin YC, Chan YY, Hsu KH*.Employing infectious disease physicians affects clinical and economic outcomes in regional hospitals: Evidence from a population-based study. Journal of Microbiology, Immunology and Infection. 2013. (SCI)

12.  Hsu KH, Shih CP, Liao PJ. Waist-to-thigh ratio is a predictor of internal organ cancers in humans: findings from a cohort study. Annals of Epidemiology. 2013;23(6):342-348.(SCI)

13.  Wu IW, Hsu KH, Lee CC, Sun CY, Hsu HJ, Hung MJ, Wu MS. Re-evaluating the predictive roles of metabolic complications and clinical outcome according to eGFR levels – A four-years prospective cohort study in Taiwan. BMC Nephrology. 2013;14(92).(SCI)

14.   Hung MY, Hsu KH, Hu WS, Chang NC, Huang CY, Hung MJ. Gender-Specific Prognosis and Risk Impact of C-Reactive Protein, Hemoglobin and Platelet in the Development of Coronary Spasm. Int. J. Med. Sci. 2013; 10(3):255-264.(SCI)

15.  Maa SH,Wang CH, Hsu KH, Lin HC, Yee B, MacDonald K, Abraham I. Acupressure Improves the Weaning Indices of Tidal Volumes and Rapid Shallow Breathing Index in Stable Coma Patients Receiving Mechanical Ventilation: Randomized Controlled Trial. Evidence-Based Complementary and Alternative Medicine. 2013.(SCI)

16.  Hung MJ, Hsu KH, Hu WS, Chang NC, Hung MY. C-Reactive Protein for Predicting Prognosis and Its Gender-Specific Associations with Diabetes Mellitus and Hypertension in the Development of Coronary Artery Spasm. PLoS One.2013;8(10): e77655

17.  Chia-Lin Li*, Yi-Chen Chiu, Hsing-Yi Chang, Kuang-Hung Hsu, Yuh-Bin Bai and Hui-Hsuan Wang. Association of geriatric conditions and cardiovascular diseases with disability in older adults with diabetes: Findings from a nationally representative survey. Geriatrics and Gerontology International.2013;13(3) 563-570. (SCI) 

18.  Chia-Lin Li, Hsing-Yi Chang, Chih-Cheng Hsu, Jui-fen Rachel Lu, Hsin-Ling Fang. 2013, 13: "Joint predictability of health related quality of life and leisure time physical activity on mortality risk in people with diabetes" BMC Public Health, 67. (SCI)

19.  Tseng, K.C., Hsu, C.L., and Chuang, Y.H., "Designing an Intelligent Health Monitoring System and Exploring User Acceptance for the Elderly," Journal of Medical Systems, Vol. 37:9967, No. 6, 2013. <SCI: 1.783 (2013), 36/83 in HEALTH CARE SCIENCES & SERVICES>

20.  Chen LS, Yen AM, Fraser CG, Chiu SY, Fann JC, Wang PE, Lin SC, Liao CS, Lee YC, Chiu HM, Chen HH. Impact of faecal haemoglobin concentration on colorectal cancer mortality and all-cause death. BMJ Open. 2013 Nov 7;3(11):e003740. doi: 10.1136/bmjopen-2013-003740.

21.   Yeh YP, Hu TH, Cho PY, Chen HH, Yen AM, Chen SL, Chiu SY, Fann JC, Su WW, Fang YJ, Chen ST, San HC, Chen HP, Liao CS; Changhua Community‐based Abdominal Ultrasonography Screening Group. Evaluation of abdominal ultrasonography mass screening for hepatocellular carcinoma in Taiwan. Hepatology. 2013 Aug 26. doi: 10.1002/hep.26703.

22.   Kevin C. Tseng, Bor-Shyh Lin*, Lun-De Liao and Yu-Te Wang. Development of wearable mobile electrocardiogram monitoring system by using novel dry foam electrodes.IEEE Systems Journal. 2013. Vol. 8, No. 3, pp. 900-906.

23.   Kevin C. Tseng, Alice M. Wong, Chien-Lung Hsu*, Tsai-Hsuan Tsai, Chang-Mu Han and Ming-Ren Lee. The iFit: An integrated physical fitness testing system to evaluate the degree of physical fitness of the elderly. IEEE Transactions on Biomedical Engineering. 2013. Vol. 60, No. 1, pp. 184-188.

24.   Tsai-Hsuan Tsai, Alice M. Wong, Chien-Lung Hsu and Kevin C. Tseng*. Research on a community-based platform for promoting health and physical fitness in the elderly community. PLOS One. 2013. Vol. 8, No. 2, pp. e57452.

25.   Hui-Hsuan Wang, Ji-Tian Sheu, Yea-Ing Lotus Shyu, Hsing-Yi Chang, Chia-Lin Li*. Geriatric conditions as predictors of increased number of hospital admissions and hospital bed days over one year: findings of a nationwide cohort of older adults from Taiwan. Archives of Gerontology and Geriatrics (2014 Jul)59(1): 169-174 (*Corresponding Author) (SCI)

26.   Chia-Lin Li†, Ji-Tian Sheu†, Ting-Ann Wang, Yu-Ping Wen, Minston Chao, Hsing-Yi Chang. The relationship between healthy lifestyle and hospital utilization among adults with diabetes: results from a national cohort in Taiwan. Asia-Pacific Journal of Public Health (2014, published online 24 February 2014) (†Equal contribution) (SSCI)

27.   Chiu SY, Lai H, Yen AM, Fann JC, Chen LS, Chen HH. Temporal sequence of the bidirectional relationship between hyperglycemia and periodontal disease: a community-based study of 5,885 Taiwanese aged 35-44 years (KCIS No. 32). Acta Diabetol. 2014 Jul 3. [Epub ahead of print]

28.   Yen AM, Chen SL, Chiu SY, Fann JC, Wang PE, Lin SC, Chen YD, Liao CS, Yeh YP, Lee YC, Chiu HM, Chen HH. A new insight into fecal hemoglobin concentration-dependent predictor for colorectal neoplasia. Int J Cancer. 2014 Sep 1;135(5):1203-12.

29.   Hsu CL, and Lin YL. Improved Migration for Mobile Computing in Distributed Networks. Computer Standards & Interfaces.2014;36(3) 577-584.

30.   Hsu, C.L., and Lin, H.Y. Convertible Authenticated Encryption Scheme with Hierarchical Access Control. Applied Mathematics & Information  Sciences. 2014;8(3) 1239-1246.

31.   Hsu, C.L. and Lin, H.Y. Universal Forgery Attack on a Strong Designated Verifier Signature Scheme. The International Arab Journal of Information Technology. 2014;11(5). 

32.   Hsu, C.L. and Lin, H.Y. Provably Secure Message Recovery Limited Verifier Signature Scheme with Low Cost. Information-An International Interdisciplinary Journal. 2014;17(4) 1187-199.

33.   Lu, C.F., Hsu, C.L., Lin, H.Y., and Su, C.H. A Robust Convertible Multi-Authenticated Encryption Scheme with One-Way Hash Function. International Journal of Future Computer and Communication.  2014;3(5) 315-318.

34.   Lin, Y.L., Hsu, C.L., and Chuang, Y.H. A Robust Time-Bound Hierarchical Key Assignment Scheme. International Journal of Future Computer and Communication. 2014;3(5) 337-340.

35.   Chien-Lung Hsu, Yu-Hao Chuang and Pei-Ling Tsai. Design of Pairing-Based Proxy Signcryption System Model for  Online Proxy Auctions. 2014;43(5) 381-389.

36.   Seal CJ, Ng CJ, Yen HT, Wong YC, Hsu KH*, Seak CY, Seak. Performance Assessment of SAPS II, APACHE II score and SOFA score in Predicting the Outcomes of Adult Patients with HPVG in the ED. American Journal of Emergency Medicine. 2014.

37.   Seak CJ, Hsu KH, Wong YC, Ng CJ, Yen HT, Seak CY, and Seak CK. The prognostic factors of adult patients with hepatic portal venous gas in the ED. American Journal of Emergency Medicine. 32(2014) 972-975.

38.   Chu SM, Yang MC, Hsiao HF, Hsu JF, Lien R, Chiang MC, Fu RH, Huang HR, Hsu KH, Tsai MH. One-week versus 2-day ventilator circuit change in neonates with prolonged ventilation: cost effectiveness and impact on ventilator associated pneumonia. Infection Control & Hospital Epidemiology. 2014.

39.   Lin CC, Liao SC, Shih CP, Hsu KH*. QTC prolongation as a useful prognostic factor in acute paraquant poisoning. The Journal of Emergency Medicine. Vol. 47,No. 4, pp401-407. 2014.

40.   Chang YC, Ng CJ*, Wu CT, Chen LC , Chen JC, Hsu KH*. Pediatric overtriage as a consequence of the tachycardia responses of children upon emergency department admission. American Journal of Emergency Medicine. 33(1). 2015. 1-6. (SCI)

41.   Liao PJ, Lin ZY, Huang JC, Hsu KH*. The relationship between type 2 diabetic patients' early medical care-seeking consistency to the same clinician and health care system and their clinical outcomes. Medicine. Feb 2015;94(7):e554. (SCI)

42.   Chia-Lin Li, Ji-Tian Sheu, Ting-Ann Wang, Yu-Ping Wen, Minston Chao, Hsing-Yi Chang. The relationship between healthy lifestyle and hospital utilization among adults with diabetes: results from a national cohort in Taiwan. Asia-Pacific Journal of Public Health (2015 Apr) 27(3): 303-313 (SSCI)

43.   Kevin C. Tseng, Bor-Shing Lin, Alice May-Kuen Wong and Bor-Shyh Lin* (2015/03) “Design of a mobile brain computer interface-based smart multimedia controller”. Sensors. Vol. 15, No 3, pp. 5518-5530. (SCI; IF=2.245, 2014) (10/56 in Instruments & Instrumentation, 2014, Q1)

44.   Chiung-Wei Huang, Yen-I Chiang, Chien-Lung Hsu,* Cheng-Yuan Chang,. Design and User Acceptance Evaluation of An Intelligent Electronic Navigation Crutches System for Elderly Mobile Healthcare. Submitted to International Journal of Distributed Sensor Network.

45.    Chiu, S. Y. H., Lai, H., Yen, A. M. F., Fann, J. C. Y., Chen, L. S., & Chen, H. H. (2015). Temporal sequence of the bidirectional relationship between hyperglycemia and periodontal disease: a community-based study of 5,885 Taiwanese aged 35–44 years (KCIS No. 32). Acta diabetologica, 52(1), 123-131.

46.    Hsu CL, Chuang YH , Kuo CL. A Novel Remote User Authentication Scheme from Bilinear Pairings via Internet Wireless Personal Communications.Wireless Personal Communications. 83:163-174, 2015. (SCI)

47.   Chien HY, Wu TC, Hsu CL. RFID Authentication with Un-traceability and Forward Secrecy in the Partial-Distributed-Server Model, IEICE TRANSACTIONS on Information and Systems, Vol. E98-D, No.4   pp.750-759, April 2015. (SCI)

48.    Kevin C. Tseng, Sung-Hui Tseng and Hsin-Yi Cheng*.“Design, development, and clinical validation of therapeutic toys for autistic children”. The Journal of Physical Therapy Science. Vol. **, No. *, pp. **-**.  (2016/04 Online) (SCI)

49.    Bor-Shyh Lin, Alice M. Wong, Kevin C. Tseng*.“Community-based ECG monitoring system for patients with cardiovascular diseases”. Journal of Medical Systems. Vol. **, No. **, pp. **-**.  (2016/01 Online) (SCI)

50.    Liao PJ, Lin TY, Wang TC, Ting MK,Wu IW, Huang HT, Wang FC, Chang HC, Hsu KH*. Long-term and interactive effects of pay-for-performance interventions among diabetic nephropathy patients at the early chronic kidney disease stage. Medicine.2016.(accepted) (SCI)

51.    Lin CC, Hung DZ, Chen HY, Hsu KH* The Effectiveness of Patient-tailored Treatment for Acute Organophosphate Poisoning. Biomedj. 2016.(accepted) (SCI)