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系統識別號 U0026-1107201213374500
論文名稱(中文) 六個月有氧運動訓練對代謝症候群患者在心血管代謝危險因子與生活品質之影響
論文名稱(英文) Effects of 6-Month Aerobic Exercise Training on the Cardiometabolic Risk Factors and Qualities of Life in Patients with Metabolic Syndrome
校院名稱 成功大學
系所名稱(中) 物理治療研究所
系所名稱(英) Department of Physical Therapy
學年度 100
學期 2
出版年 101
研究生(中文) 吳柏翰
研究生(英文) Po-Han Wu
學號 t66981091
學位類別 碩士
語文別 英文
論文頁數 48頁
口試委員 指導教授-洪菁霞
口試委員-陳郁文
口試委員-林克隆
中文關鍵字 代謝症候群  腫瘤壞死因子-α  介白質素-6  運動訓練 
英文關鍵字 metabolic syndrome  TNF-α  IL-6  exercise training 
學科別分類
中文摘要 背景與目的:在全球目前以慢性疾病為最主要導致死亡原因尤其是心血管疾病 (cardiovascular disease)。近年來研究發現,有代謝症候群 (metabolic syndrome)患者其罹患心血管疾病與第二型糖尿病的機率較高。代謝症侯群患者通常伴隨有腹部肥胖 (central obesity)、血脂、血壓代謝異常以及胰島素阻抗 (insulin resistance)增加與發炎反應增加的情況,而這些都是罹患心血管的危險因子。規律運動除了能增強心肺功能以外,近年來研究還發現運動也可以降低血清中的發炎反應。由此我們假設代謝症侯群之患者經過長時間運動訓練後,可減少其血清中發炎因子濃度,減少發炎反應,預防心血管疾病產生,並改善其體能、自我效能及疲憊感。方法:此研究徵求20位代謝症候群患者,隨機分為運動組及對照組,運動組以60%~75% 最大心率之運動強度於固定式腳踏車上進行訓練,每週訓練三天,訓練六個月,而對照組維持一般日常活動量,於運動前、訓練中 (第四個月)、訓練結束後,量測身高、身體質量指數、生活品質量表SF-36等基本資料,並進行抽血檢驗及運動心肺功能測試,運動心肺功能測試 (最大攝氧量、血壓、最大心跳數)。血液檢查則檢測血脂肪 (總膽固醇, 三酸甘油脂, 低密度脂蛋白, 高密度脂蛋白)、禁食血糖 (fasting plasma glucose)、胰島素 (insulin)、糖化血色素 (HbA1c)、發炎反應 (C反應蛋白、介白質素-6、腫瘤壞死因子-α)。結果:經過六個月有氧運動訓練後,運動組在血糖、糖化血色素、最大攝氧量與腰圍,比坐式生活型態組有明顯改善 (P<0.05)。在血清腫瘤壞死因子-α表現,運動組比坐式生活型態組有顯著降低 (P<0.05),然而介白素-6有下降趨勢但無統計顯著差異。另外,關於生活品質方面,運動組比坐式生活型態組,在因生理功能角色受限、因情緒角色受限、活力、心理健康、一般健康跟社會功能領域有顯著改善 (P<0.05)。結論:本實驗顯示六個月有氧運動訓練可以有效改善代謝症候群患者之血糖、糖化血色素、腰圍、最大攝氧量、腫瘤壞死因子-α與生活品質。
英文摘要 Background and Purpose: In the world the cause of death is chronic disease, especially cardiovascular disease (CVD). Recent studies showed the increase risk for type 2 diabetes and cardiovascular disease in patients with metabolic syndrome (MetS). The constellation of metabolic abnormalities includes insulin resistance, central obesity, dyslipidaemia, and hypertension, inflammation, all are related to the risk factors of CVD. Regular exercise not only improves cardiopulmonary function, but also decreases level of inflammatory cytokine in serum. We hypothesize that long term exercise training may improve cardiopulmonary functions, self-efficacy of activities of daily living and reduce the risk of CVD via decreasing serum inflammatory cytokine level in patient with metabolic syndrome. Methods: Twenty MetS participants were randomly assigned to sedentary control and exercise group. The exercise groups were trained on a stationary bicycle 3 days/week at 60%-75% maximal heart rate (max HR) for 6 months, sedentary group were instructed to maintain their habitual activities. The data were collected before training, at the 4th month during training and the end of exercise training, we measured the Short Form-36 scale, body mass index (BMI), and cardiopulmonary exercise test (including peakVO2, BP, max HR) and inflammatory factors (C-reactive protein, Interleukin-6, Tumour necrosis factor-α), insulin, total cholesterol fasting plasma glucose (FPG), triglyceride, high density lipoprotein, and low density lipoprotein, hemoglobin A1c (HbA1c) in the blood. Results: In comparison with sedentary group, fasting plasma glucose, HbA1c, exercise capacity (VO2 peak) and waist circumference were improved (P<0.05). In exercise group after 6 month aerobic exercise training, plasma TNF-α decreased significantly (P<0.05), whereas interlukine-6 tended to decrease (P=0.085). In addition, with regard to health-related qualities of life, the exercise groups showed significantly improvements in role limitations due to physical health, role limitations due to emotional problems, vitality, mental health, general health and social functioning (P<0.05). Conclusion: The present study showed that 6-month aerobic exercise training improves on FPG, HbA1c, waist circumference, VO2 peak, TNF-α and quality of life in patients with metabolic syndrome.
論文目次 Abstract-----------------------------------------------------------------------------1
摘要---------------------------------------------------------------------------------3
致謝---------------------------------------------------------------------------------5
Contents----------------------------------------------------------------------------6
Abbreviations----------------------------------------------------------------------7
Introduction------------------------------------------------------------------------8
Methods---------------------------------------------------------------------------12
Results-----------------------------------------------------------------------------17
Discussion------------------------------------------------------------------------20
References------------------------------------------------------------------------26
Figure------------------------------------------------------------------------------30
Tables------------------------------------------------------------------------------31
Appendices-----------------------------------------------------------------------37
參考文獻 1. Grundy SM. Diagnosis and management of the metabolic syndrome: An american heart association/national heart, lung, and blood institute scientific statement. Circulation. 2005;112:2735-2752
2. Ford ES, Giles WH, Mokdad AH. Increasing prevalence of the metabolic syndrome among u.S. Adults. Diabetes Care. 2004;27:2444-2449
3. Ervin RB. Prevalence of metabolic syndrome among adults 20 years of age and over, by sex, age, race and ethnicity, and body mass index: United states, 2003-2006. Natl Health Stat Report. 2009:1-7
4. Pan WH, Yeh WT, Weng LC. Epidemiology of metabolic syndrome in asia. Asia Pac J Clin Nutr. 2008;17 Suppl 1:37-42
5. Yeh C-J, Chang H-Y, Pan W-H. Time trend of obesity, the metabolic syndrome and related dietary pattern in taiwan: From nahsit 1993-1996 to nahsit 2005-2008. Asia Pac J Clin Nutr. 2011;20:292-300
6. Deluca C, Olefsky J. Inflammation and insulin resistance. FEBS Letters. 2008;582:97-105
7. Eckel RH, Grundy SM, Zimmet PZ. The metabolic syndrome. The Lancet. 2005;365:1415-1428
8. Fernandez-Real JM, Ricart W. Insulin resistance and chronic cardiovascular inflammatory syndrome. Endocr Rev. 2003;24:278-301
9. Nishida M, Moriyama T, Ishii K, Takashima S, Yoshizaki K, Sugita Y, et al. Effects of il-6, adiponectin, crp and metabolic syndrome on subclinical atherosclerosis. Clin Chim Acta. 2007;384:99-104
10. Rizvi AA. Cytokine biomarkers, endothelial inflammation, and atherosclerosis in the metabolic syndrome: Emerging concepts. Am J Med Sci. 2009;338:310-318
11. Kritchevsky S, Cesari M, Pahor M. Inflammatory markers and cardiovascular health in older adults. Cardiovascular Research. 2005;66:265-275
12. LaMonte MJ. Cardiorespiratory fitness is inversely associated with the incidence of metabolic syndrome: A prospective study of men and women. Circulation. 2005;112:505-512
13. Nicklas BJ, Brinkley TE. Exercise training as a treatment for chronic inflammation in the elderly. Exerc Sport Sci Rev. 2009;37:165-170
14. Levinger I, Goodman C, Hare DL, Jerums G, Selig S. Functional capacity and quality of life in middle-age men and women with high and low number of metabolic risk factors. Int J Cardiol. 2009;133:281-283
15. Kadoglou NPE, Iliadis F, Angelopoulou N, Perrea D, Ampatzidis G, Liapis CD, et al. The anti-inflammatory effects of exercise training in patients with type 2 diabetes mellitus. Eur J Cardiovasc Prev Rehabil. 2007;14:837-843
16. Expert Panel on Detection E, Treatment of High Blood Cholesterol in A. Executive summary of the third report of the national cholesterol education program (ncep) expert panel on detection, evaluation, and treatment of high blood cholesterol in adults (adult treatment panel iii). JAMA: The Journal of the American Medical Association. 2001;285:2486-2497
17. Katsuyama K. Differential inhibitory actions by glucocorticoid and aspirin on cytokine-induced nitric oxide production in vascular smooth muscle cells. Endocrinology. 1999;140:2183-2190
18. Kadoglou NPE, Iliadis F, Angelopoulou N, Sailer N, Fotiadis G, Voliotis K, et al. Cardiorespiratory capacity is associated with favourable cardiovascular risk profile in patients with type 2 diabetes. J Diabetes Complications. 2009;23:160-166
19. Tjonna AE, Lee SJ, Rognmo O, Stolen TO, Bye A, Haram PM, et al. Aerobic interval training versus continuous moderate exercise as a treatment for the metabolic syndrome: A pilot study. Circulation. 2008;118:346-354
20. Ware JE, Jr., Sherbourne CD. The mos 36-item short-form health survey (sf-36). I. Conceptual framework and item selection. Med Care. 1992;30:473-483
21. Oh EG, Bang SY, Hyun SS, Kim SH, Chu SH, Jeon JY, et al. Effects of a 6-month lifestyle modification intervention on the cardiometabolic risk factors and health-related qualities of life in women with metabolic syndrome. Metabolism. 2010;59:1035-1043
22. Stensvold D, Tjonna AE, Skaug E-A, Aspenes S, Stolen T, Wisloff U, et al. Strength training versus aerobic interval training to modify risk factors of metabolic syndrome. Journal of Applied Physiology. 2010;108:804-810
23. Dobbelsteyn CJ, Joffres MR, MacLean DR, Flowerdew G. A comparative evaluation of waist circumference, waist-to-hip ratio and body mass index as indicators of cardiovascular risk factors. The canadian heart health surveys. Int J Obes Relat Metab Disord. 2001;25:652-661
24. Potteiger JA, Claytor RP, Hulver MW, Hughes MR, Carper MJ, Richmond S, et al. Resistance exercise and aerobic exercise when paired with dietary energy restriction both reduce the clinical components of metabolic syndrome in previously physically inactive males. Eur J Appl Physiol. 2012;112:2035-2044
25. Matsuzawa Y, Nakamura T, Takahashi M, Ryo M. New criteria for 'obesity disease' in japan. Circ J. 2002;66:987-992
26. Matsuzawa Y, Funahashi T, Kihara S, Shimomura I. Adiponectin and metabolic syndrome. Arteriosclerosis, Thrombosis, and Vascular Biology. 2004;24:29-33
27. Reynolds THt, Brown MD, Supiano MA, Dengel DR. Aerobic exercise training improves insulin sensitivity independent of plasma tumor necrosis factor-alpha levels in older female hypertensives. Metabolism. 2002;51:1402-1406
28. Myers J, Prakash M, Froelicher V, Do D, Partington S, Atwood JE. Exercise capacity and mortality among men referred for exercise testing. N Engl J Med. 2002;346:793-801
29. Lewington S, Clarke R, Qizilbash N, Peto R, Collins R. Age-specific relevance of usual blood pressure to vascular mortality: A meta-analysis of individual data for one million adults in 61 prospective studies. The Lancet. 2002;360:1903-1913
30. Armutcu F, Ataymen M, Atmaca H, Gurel A. Oxidative stress markers, c-reactive protein and heat shock protein 70 levels in subjects with metabolic syndrome. Clinical Chemistry and Laboratory Medicine. 2008;46:785-790
31. Geffken DF, Cushman M, Burke GL, Polak JF, Sakkinen PA, Tracy RP. Association between physical activity and markers of inflammation in a healthy elderly population. Am J Epidemiol. 2001;153:242-250
32. Lambert CP, Wright NR, Finck BN, Villareal DT. Exercise but not diet-induced weight loss decreases skeletal muscle inflammatory gene expression in frail obese elderly persons. J Appl Physiol. 2008;105:473-478
33. Greiwe JS, Cheng B, Rubin DC, Yarasheski KE, Semenkovich CF. Resistance exercise decreases skeletal muscle tumor necrosis factor alpha in frail elderly humans. FASEB J. 2001;15:475-482
34. Petersen AMW. The anti-inflammatory effect of exercise. Journal of Applied Physiology. 2005;98:1154-1162
35. Mishima Y, Kuyama A, Tada A, Takahashi K, Ishioka T, Kibata M. Relationship between serum tumor necrosis factor-alpha and insulin resistance in obese men with type 2 diabetes mellitus. Diabetes Res Clin Pract. 2001;52:119-123
36. Halse R, Pearson SL, McCormack JG, Yeaman SJ, Taylor R. Effects of tumor necrosis factor-alpha on insulin action in cultured human muscle cells. Diabetes. 2001;50:1102-1109
37. Borst SE, Bagby GJ. Neutralization of tumor necrosis factor reverses age-induced impairment of insulin responsiveness in skeletal muscle of sprague-dawley rats. Metabolism. 2002;51:1061-1064
38. Levinger I, Goodman C, Hare DL, Jerums G, Selig S. The effect of resistance training on functional capacity and quality of life in individuals with high and low numbers of metabolic risk factors. Diabetes Care. 2007;30:2205-2210
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