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系統識別號 U0026-0308201817553100
論文名稱(中文) 中老年肌少症影響因子探討與營養介入成效
論文名稱(英文) Associated Factors and Effect of Nutritional Intervention for Sarcopenia in Middle-Aged and Old People
校院名稱 成功大學
系所名稱(中) 老年學研究所
系所名稱(英) Institute of Gerontology
學年度 106
學期 2
出版年 107
研究生(中文) 柯俊宏
研究生(英文) Chun-Hung Ko
學號 TC6054076
學位類別 碩士
語文別 中文
論文頁數 86頁
口試委員 指導教授-吳至行
口試委員-官大紳
口試委員-張家銘
口試委員-張秦松
召集委員-吳幸娟
中文關鍵字 肌少症  骨骼肌肉質量指數  支鏈胺基酸  營養補充 
英文關鍵字 Sarcopenia  branched-chain amino acid (BCAA)  nutritional supplement  skeletal muscle mass index 
學科別分類
中文摘要 目的:探討社區有肌少症前期或肌少症之中老年人比例與相關因子,並了解使用富含支鏈胺基酸營養品(BCAA)補充於肌少症前期或肌少症者的成效。
方法:本研究結合橫斷面與準實驗研究設計,收集40歲以上之中老年人,經由研究人員詢問完成問卷,內容包涵基本資料、 生活習慣及健康相關資料(如慢性疾病、身體活動量、認知功能等)及營養調查。以單頻八極生物電阻抗分析儀(Tanita, BC-418, Tokyo, Japan)分析身體組成,肌少症判定根據為2014年AWGS修訂版。以立意取樣選取肌少症前期與肌少症者給予BCAA(Amino VITAL® PRO),每日早晚各一包持續補充35天,接著受試者停止BCAA營養補充12週後進行追蹤檢測,補充與停用期間受試者不改變平日飲食與活動習慣。
結果:本研究共取得621位(男性210位、女性411位)受測者之完整資料,平均年齡63.1歲。肌少症前期及肌少症比例於全體、男性、女性分別為7.0%及6.7%、5.7%及6.2%、7.8%及7.1%。多元邏輯斯迴歸分析全體個案發現身體質量指數為肌少症前期的獨立危險因子(勝算比(OR): 0.653, 95%信賴區間(CI): 0.972-1.062);肌少症的獨立危險因子為年齡(OR: 1.125, 95% CI: 1.067-1.187)及身體質量指數(OR: 0.739, 95% CI: 0.642-0.845)。
33位肌少症前期或肌少症者接受BCAA持續補充5週後,發現骨骼肌肉質量指數增加0.15公斤/公尺2 (p=0.008)、六公尺行走速度改善0.12公尺/秒(p<0.001)、手握力增加3.4公斤(p<0.001)。針對26位停止12週補充BCAA後與第5週分析比較發現六公尺行走速度與手握力有下降趨勢,骨骼肌肉質量指數呈現顯著下降(p<0.001)。
結論:社區40歲以上中老年人,年齡越高、較低的身體質量指數容易有肌少症。肌少症前期或肌少症者經由5週富含支鏈胺基酸的營養補充可以改善肌少症的相關指標,停用12週後則骨骼肌肉質量指數會顯著下降。
英文摘要 To explore the associated factors and the effect of enriched branched chain amino acids (BCAA) nutritional supplements for the middle-aged and old people with pre-sarcopenia or sarcopenia. The study combined cross-sectional and quasi-experimental study design. Sarcopenia was defined according to the modified 2014 consensus of the Asian Working Group on Sarcopenia. Subjects of pre-sarcopenia or sarcopenia were purposed to BCAA supplement (Amino VITAL® PRO) daily for five weeks and discontinued for 12 weeks subsequently. Skeletal muscle mass, grip strength (TKK 5101 Grip-D; Takey, Tokyo, Japan) and 6-meters gait speed were evaluated at baseline, after five weeks of nutritional supplement, and discontinued BCAA 12 weeks. All the study subjects maintained usual diet and activity habits during the period of intervention. The ratio of pre-sarcopenia and sarcopenia were 7.0% and 6.7% respectively. Those who are older and lower BMI were at higher risk of developing sarcopenia. Supplement with BCAA for 5 weeks, there are significant improvements in skeletal muscle mass index (SMI, +0.15 kg/m2, p=0.008), 6-meter gait speed (+0.12 m/s, p<0.001), and grip strength (+3.4 kg, p<0.001). After discontinued BCAA supplement 12 weeks, decline was found in SMI(p<0.05), 6-meter gait speed and grip strength. A 5-week intervention of oral BCAA nutritional supplement resulted in the improvements of SMI, muscle strength and gait speed in the middle-aged and old people with pre-sarcopenia or sarcopenia. Decrease of SMI was noted when discontinued BCAA for 12 weeks.
論文目次 論文口試合格證明 I
WHAT’S NEW II
中文摘要 III
ABSTRACT V
誌謝 VIII
第1章 、緒論 1
第1節 肌少症之背景發展 1
第2節 肌少症的重要性 2
第3節 研究目的 4
第2章 、文獻回顧 5
第1節 肌少症的定義 5
第2節 肌少症判定標準 6
第3節 肌少症的測量方式 8
第4節 肌少症的盛行率 12
第5節 肌少症的相關因子 15
第6節 營養介入與肌少症 16
第3章 、研究方法 20
第1節 研究設計與架構 20
第2節 研究地點與對象 21
第3節 研究流程 22
第4節 研究工具 25
第5節 統計分析 32
第4章 、研究結果 33
第1節 受測者基本資料與描述性統計 33
第2節 富含支鏈胺基酸補充前後之分析 37
第3節 停用富含支鏈胺基酸補充12週後之分析 38
第5章 、討論 54
第1節 肌少症之比率與相關因子 54
第2節 富含支鏈胺基酸之營養補充與停用後之影響 57
第3節 研究限制 60
第6章 、結論與研究建議 62
參考文獻 64
附錄 70
肌少症問卷研究工具 70
人體試驗委員會核准書 82
論文期刊發表證明 83
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