臺灣博碩士論文加值系統

腹部肥胖容易導致體內代謝異常，造成高胰島素血症、胰島素抗性和血脂異常，進而增加第2型糖尿病、心血管疾病、高血壓等慢性病的發生率，但腹部肥胖的盛行率皆有逐年上升的趨勢。所以如何在疾病未發生前就改善腹部肥胖者的健康是非常重要的事。而透過生活型態改變課程可適度的減輕體重、改善飲食及活動量等生活習慣並提升健康相關知識，應有助於減少過多腹部脂肪的堆積。故本研究欲了解以生活型態改變為基礎之團體體重控制班對社區腹部肥胖婦女其體重控制、代謝症候群指標、生活習慣和健康相關知識的改善情形。針對社區中無高血壓、心血管疾病、糖尿病等慢性病的腹部肥胖婦女開設團體體重控制班，以登報方式招募18歲以上，腰圍大於80㎝的婦女18人，以生活型態改變課程為基礎進行為期十週的介入。研究結果顯示，受試者體重、身體質量指數和體脂肪率在介入後有顯著的改善（p < 0.05），而在代謝症候群指標中的腰圍、空腹血糖和高密度脂蛋白有顯著的改善，但血壓和三酸甘油酯則沒有顯著的變化。另外，代謝症候群指標異常人數百分比改善方面，腰圍、血壓、空腹血糖和高密度脂蛋白膽固醇異常人數百分比皆有下降，其中又以腰圍過大異常人數百分比改善最多。在運動習慣改善方面，在介入十週後受試者皆有培養出運動的習慣，在運動的強度、持續的時間和運動的頻率上皆有顯著的改善。飲食習慣方面，有不良飲食習慣的人數比例下降，健康飲食習慣的人數比例則是有所上升。經過十週的課程，受試者在健康知識方面有顯著的提升。綜合上述，以生活型態改善為基礎的團體體重控制班對於腹部肥胖婦女代謝症候群指標的改善有正面的效益，未來可應用在社區代謝症候群防治。

Abdominal obesity may induce hyperinsulinemia、insulin resistance and dyslipidemia while the prevalence of abdominal obesity was increasing year by year. Therefore, to improve health of abdominal obese subjects is an urgent work. Lifestyle modification program may improve over weight, lifestyle and nutrition knowledge, and help to reduce accumulation of abdominal adipose tissue. The aim of our study was to evaluate the effectiveness of lifestyle modification program on weight control, metabolic syndrome features, behavior and health-related knowledge. We recruited 18 women aged older than 18 years whose waistline more than 80 cm, and without chronic diseases such as hypertension, diabetes and cardiovascular disease via advertisement on newspaper. We formulated a group-based weight control project upon lifestyle modification program for women with abdominal obesity. The study period was 10 weeks. Results showed that the body weight, BMI and body fat were significantly reduced. The lifestyle modification program helped to improve the waist, fasting serum sugar and high density lipoprotein concentration（p < 0.05） among metabolic syndrome features, but blood pressure and triglyceride level were no significant changes. Besides, abnormal population percentages of waist, blood pressure, fasting serum sugar and high density lipoprotein were reduced, particularly abnormal population percentages of waist. The diet behavior, physical activity behavior and health knowledge were significantly improved through the intervention. In conclution, lifestyle modification based on group-base weight control project could ameliorate the metabolic syndrome markers in abdominal obese women, and can be further applied to prevent and cure metabolic syndrome in community.

中文摘要…………………………………………………………………I
英文摘要……………………………………………………………… II
目 錄………………………………………………………………III
圖 目 錄……………………………………………………………… VI
表 目 錄……………………………………………………………… VI

第一章 緒論 ……………………………………………………………1
第二章 文獻回顧 ………………………………………………………3
第一節 腹部肥胖……………………………………………………… 3
1-1腹部肥胖盛行率 ……………………………………………………3
1-2腹部肥胖與疾病的相關性………………………………………… 7
1-3腹部肥胖與代謝症候群的相關性………………………………… 9
第二節 體重控制對代謝症候群指標的影響 …………………………12
2-1體重控制對腰圍的影響……………………………………………14
2-2體重控制對血壓的影響……………………………………………15
2-3體重控制對空腹血糖的影響………………………………………16
2-4體重控制對血脂的影響……………………………………………17
第三節 生活型態改變課程……………………………………………18
3-1生活型態改變之內容………………………………………………18
3-2團體體重控制………………………………………………………18
第三章 研究目的………………………………………………………21
第四章 研究方法………………………………………………………22
第一節 研究架構………………………………………………………22
第二節 研究設計………………………………………………………23
第三節 研究對象………………………………………………………25
第四節 研究工具………………………………………………………26
第五節 資料處理與統計分析方法……………………………………32
第五章 研究結果………………………………………………………33
第一節 基本資料………………………………………………………33
第二節 生活型態改變之團體體重控制課程對體位及血液生化的影
響……………………………………………………………… 34
2-1體位及血液生化數值之變化………………………………………34
2-2 體位及血液生化值異常人數百分比改善情形 …………………35
2-3代謝症候群指標數目異常人數百分比改善情形…………………36
第三節 生活型態改變之團體體重控制課程對生活習慣及健康知識
的影響…………………………………………………………37
3-1介入後對生活習慣的影響…………………………………………37
3-2介入後對健康知識的影響…………………………………………38
第六章 討論 ……………………………………………………………49
第一節 生活型態改變對團體減重班中腹部肥胖婦女體位的影響…49
第二節 生活型態改變對團體減重班中腹部肥胖婦女代謝症候群
指標的影響……………………………………………………51
2-1 對腰圍的影響…………………………………………………… 51
2-2 對血壓的影響…………………………………………………… 52
2-3 對血糖的影響…………………………………………………… 53
2-4 對血脂的影響…………………………………………………… 54
第三節 生活型態改變對團體減重班中腹部肥胖婦女生活習慣及
健康知識的影響………………………………………………56
3-1 生活習慣的改變………………………………………………… 56
3-2 健康知識的改善………………………………………………… 57
第七章 結論……………………………………………………………58
參考文獻……………………………………………………………… 59





圖 目 錄
圖一、內臟脂肪導致胰島素抗性之機制………………………………11
圖二、腹部肥胖者適度減輕體重後對冠狀心臟病危險因子的影響…13
圖三、腰圍變化和體重變化的相關性…………………………………14
圖四、研究架構…………………………………………………………22
圖五、研究流程…………………………………………………………23

表 目 錄
表一、國內腹部肥胖盛行率相關研究…………………………………5
表二、國外腹部肥胖盛行率相關研究…………………………………6
表5.1受試者基本資料 ……………………………………………… 39
表5.2代謝症候群指標異常數分布情形…………………………… 40
表5.3代謝症候群指標異常症狀組合……………………………… 41
表5.4介入前後體位、血壓和血液生化值改善情形……………… 42
表5.5介入前後代謝症候群與非代謝症候群體位、血壓和血液生化
值改善情形…………………………………………………… 43
表5.6介入前後體位、血壓和血液生化值異常人數百分比改善情
形……………………………………………………………… 44
表5.7介入前後代謝症候群指標數目人數百分比改善情形……… 45
表5.8介入前後生活習慣改善百分比……………………………… 46
表5.9介入前後飲食習慣改善百分比……………………………… 47
表5.10介入前後健康知識改善百分比………………………………48

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