健診データを用いたメタボリックシンドロームに対する生活習慣行動プロファイルの作成―樹形モデルの応用

Profiling Metabolic Syndrome from Routine Physical Examinations Based on Health Behabior Items on a Life-style Questionnaire：Application of Tree-Based Methods

要旨

　【目的】 近年，注目されているメタボリックシンドローム（MS）に対する有効な保健指導を目指し，健診時に得られる問診データを用いて，健診受診者に対してMSに関する特徴づけを行った．

　【方法】 健診センター受診者30歳以上18,849名の健診データを用い，樹形モデルを用いた生活習慣行動プロファイル作成を行い，プロファイル間の相対的なリスク評価，再現性の評価を統計的に検討した．

　【結果】 各性別年齢階級において，「食べ過ぎたと思うことがよくある」が共通のリスク因子であった．その他「早食いである」，「歯磨きの回数」および「歩行以外の運動」がリスク因子として挙がった．テストデータによる評価において，男性のプロファイルは適用可能性が高いことが示された．

　【結論】 作成されたプロファイルは，現場での保健指導に適用しやすく，解釈可能であり，樹形モデルによる探索的データ解析手法は，健診データを保健指導に利用するための方法として有用である可能性が高いことが示された．

Abstract

　Purpose: Metabolic syndrome (MS) has become one of the major health concerns of this century, and profiling MS based on life-style conditions could lead to the successful development of preventative programs useful for public health nurses and professionals. In order to achieve this, life-style profiles for characterizing MS were constructed using 16 health behavior items on life-style questionnaires obtained during routine physical examinations.

　Methods: Tree-based models were employed to construct health behavior profiles on the 18,849 examinees who were at least 30 years of age at the time of their exam. The risk of MS among different behavioral profiles was evaluated using odd ratios obtained by logistic regression models. Predictive utilities were assessed by estimating prediction error based on cross-validation methods.

　Results: “I often think I eat too much” emerged as a common risk factor throughout all profiles. In addition, “frequency of oral care,” “speed of eating,” and “exercise other than walking” appeared as important behavioral risk factors. Upon evaluation using the test data, it was shown that the possibility for application was high in men's profiles.

　Conclusion: Exploratory data analysis using the tree-based model on life-style data obtained from routine physical examinations revealed several health behavior profiles. These profiles may provide many practical and potentially useful methods for developing preventive programs for MS.