要 防治慢性腎臟病已經成為醫界重大的醫療課題，然而台灣勞工的腎臟疾病相關危險因 子尚未被廣泛探討。藉由分析健康勞工於職場的體檢資料，來尋找影響健康勞工腎臟功能 下降的相關危險因子並進一步探討二者之間的相關與因果分析。 方法：本研究為回顧性、橫斷面的研究，所有數值屬類別變項以百分比(頻率)來表示， 若變項屬連續性變項則以平均數(+/-標準差)來表示。推論性統計方面則以獨立樣本T檢定和 卡方檢定來分析男女兩組間的差異性。進一步利用皮爾森相關係數分析各危險因子與腎功 能下降的關係，最後再以多變項線性回歸分析來建立危險因子對於腎功能影響的模型。 結果與討論：本研究收錄2007年在醫學中心體檢的勞工共23189人，結果發現肥胖、高 血壓、高膽固醇血症、高三酸甘油脂血症、及高尿酸血症都與腎功能下降相關。進一步以 多變項線性回歸分析，發現影響預估之腎絲球過濾率降低的因素包含收縮壓、腰圍身高 比、膽固醇總量/高密度脂蛋白比值、尿酸；其中影響力最高的是尿酸(β=-0.393)，其次依 序為收縮壓(β=-0.098)、膽固醇總量/高密度脂蛋白比值(β=-0.088) 、腰圍身高比(β =0.081)。 結論：醫師進行勞工體檢時，若受檢者有上述危險因子，即應進行相關衛教以降低該 勞工罹患腎臟病的風險。

Background: Prevention of chronic kidney disease had been the major issue in the medical community and government of Taiwan. Our aims were to study the effects of specific risk factors on renal function and analyze correlation and causal relationship between risk factors and renal function decline by analyzing occupational healthy workers. Method: The laboratory and anthropometric data from occupational health examination in 2007 in a medical center in Taiwan were extracted in this cross-sectional study. The categorical variables present with frequency (percentage), and continuous variables present with mean (+/- standard deviation). Independent-Samples T Test was used to compare the demographic and clinical characteristics between male group and female group, and chi-square test was used to compare the categorical variables. Pearson correlations were conducted to assess the relationship between estimated Glomerular Filtration Rate (eGFR) and risk factors. Finally, multiple linear regression analysis was used to infer causal relationships. Results and discussion: 23189 healthy workers were enrolled. Multiple linear regression analysis was used to determine the causal relationship between eGFR and systolic blood pressure, waist circumference-to-height ratio, cholesterol-to-HDL ratio, and serum uric acid. Our study revealed that central obesity, hypertension, hypercholesterolemia, hypertriglyceridemia, hyperuricemia were all related to the decline of eGFR level. Of which, serum uric acid affect eGFR the most (β=-0.393), then followed by systolic pressure (β=-0.098), cholesterol-to-HDL ratio (β=-0.088), and waist circumference-to-height ratio (β=0.081). Conclusion: While performing occupational health examination, physicians should provide health education to those workers with associated risk factors in order to reduce their risk of developing chronic kidney disease in the future.