臺灣博碩士論文加值系統

中文摘要
青春期的青少年正值生長發育期，營養需求較高，尤其維生素B6是蛋白質代謝的輔脢，因而會影響維生素B6營養狀況。國人維生素B6營養狀況的研究很少，尤其青少年期尚付厥如。因此，本研究主要目的以維生素B6攝取量與血漿、紅血球以及尿液生化指標來探討台南市青少年維生素B6最適需求量。研究對象，以台南市中學 (國中27所，高中19所) 之中學生為母群體，經分層隨機取樣法 (stratified random sampling)，徵求291名 (男146及女145位) 中學生。利用3天飲食記錄分析維生素B6與蛋白質攝取量。以HPLC分析血漿PLP 濃度，以及24小時尿中4-PA排除，當作維生素B6營養狀況生化指標。以EALT-AC與EAST-AC偵測維生素B6生化功能。由體位測量 (身高、體重、上臂中圍、體脂肪百分比、身體質量指數與上臂肌肉環圍) 來評估生長狀況。根據美國膳食攝取參考值 (DRI) 定義，以維生素B6各項生化指標的滿足切點求得維生素B6攝取量之估計平均需要量 (EAR)，最後由EAR之120%計算出台南市青少年維生素B6飲食建議攝取量(RDA)。
本研究收集體位測量資料完整者共計291位 (男146及女145位) 。受試者藉由體位測量 (身高、體重、BMI、MAC及MAMC) 評估皆與82-85年國民營養健康狀況變遷調查 (NAHSIT, 1993-1996) 相近或較高，顯示受試者皆為生長發育正常之青少年。飲食、生化資料完整者共計230位 (男110及女120位) 。本研究受試者PLP濃度均 ＞ 20 nmol/L。若以尿液4-PA ＞ 3 mmol/day為維生素B6營養狀況足夠的切點，男女缺乏比例分別為5.0與12.0 ﹪。若以EALT-AC ＜ 1.25為維生素B6營養狀況足夠的切點，則EALT-AC男女缺乏比例分別為20.0 與28.0 ﹪。若以EAST-AC ＜ 1.8為維生素B6營養狀況足夠的切點，則EAST-AC男女缺乏比例分別為24.0 與40.0 ﹪。依性別顯示，13-18歲男生之熱量、蛋白質與維生素B6每日平均攝取量皆顯著比女生高。男生血漿PLP與24小時尿液4-PA排除量亦顯著比女生高；女生EALT-AC與EAST-AC缺乏比例顯著比男生高。依年齡層顯示，13-15與16-18歲之熱量與蛋白質每日平均攝取量皆無顯著差異，但16-18歲之維生素B6攝取量顯著比13-15歲高。13-15與16-18歲血漿PLP無顯著差異，但16-18歲之24小時尿液4-PA排除量顯著比13-15歲高；13-15歲的EALT-AC與EAST-AC缺乏比例顯著比16-18歲高。
綜合以上結果，台南市13-18歲青少年維生素B6營養狀況顯示，5-12 %青少年尿液4-PA排除有缺乏之現象反映出短期內維生素B6攝取量可能偏低。而血漿PLP皆為正常，顯示維生素B6攝取量仍足以應付約7-10天的生理反應代謝。然而約20至40 %青少年EALT-AC與EAST-AC不足顯示，長期 (6-8週) 維生素B6營養狀況有缺乏現象。本研究以各項生化指標 (血漿PLP、尿中4-PA、EALT-AC及EAST-AC) 大於足夠量切點之健康個體與其每日維生素B6攝取量，根據美國膳食攝取參考值 (DRI, 1998) 定義，建議台南市青少年每日維生素B6的飲食攝取量 (RDA) 13-15與16-18歲之男生為1.20與1.27 mg/day，而13-15與16-18歲女生分別為1.04與1.16 mg/day。

Abstract
The characteristic growth rate in adolescence raises requirement for nutrients, thus affecting the nutritional status, especially of vitamin B6 due to its role in the protein metabolism. Studies regarding vitamin B6 status are limited in Taiwan. None was conducted for the adolescents. Therefore, the purpose of this study was to evaluate the vitamin B6 requirement of adolescents aged 13-18 years in Tainan. The subjects participating in the study were 146 boys and 145 girls (a total of 291) who were recruited by stratified random sampling from 27 middle schools and 19 high schools. Daily intakes of vitamin B6 and protein were analyzed according to the 3-day dietary record including 2 weekdays and 1 weekend day. Plasma concentrations of pyridoxal-5-phosphate (PLP) and 24-hrs of urinary 4-pyridoxic acid (4-PA) excretion were analyzed by HPLC. Erythrocyte transaminases activity coefficients (EALT-AC and EAST-AC) were also analyzed. Anthropometric measurements of adolescents (height, body weight, midarm circumference and body fat percentage) were collected by a trained technical people. Recommendations for vitamin B6 intakes were suggested on the basis of the effects of vitamin B6 intake on plasma PLP, EALT-AC, EAST-AC and urinary excretion of adolescents. The Estimated Average Requirements (EAR) for vitamin B6 were determined and the Recommended Dietary Allowance (RDA) for vitamin B6 were calculated according to the methodology of Dietary Reference Intakes (RDIs).
Anthropometric measurements of 291 adolescents in this study were similar to or slightly higher than those of NAHSIT (Nutrition and Health Survey in Taiwan) 1993-1996, indicating the normal growth and development. Among these, 230 (110 boys and 120 girls) completed the dietary and biochemical study. All subjects had plasma PLP ＞ 20 n mol/L. Urinary 4-PA ≦3 mmol/ day were observed in 5.00 ﹪boys and 12.00 ﹪girls. EALT-AC≧1.25 were observed in 20.00 ﹪boys and 28.00 ﹪girls. EAST-AC≧1.80 were observed in 24.00 ﹪boys and 40.00 ﹪girls. These values are considered indicatives of vitamin B6 inadequacy. Mean daily intakes of energy, protein and vitamin B6 were significantly higher in boys than girls. Plasma PLP concentration and urinary 4-PA excretion of the boys were significantly higher than the girls. The percentages of inadequacy for EALT-AC and EAST-AC were significantly higher in girls than in boys. Mean daily intakes of energy and protein did not differ significantly between 13-15 and 16-18 years aged groups. Mean daily intake of vitaminB6 for 16-18 years was significantly higher than 13-15 years-aged. Plasma PLP concentration did not differ significantly between 13-15 and 16-18 years aged groups. Urinary 4-PA excretion of the adolescents aged 16-18 years was significantly higher than that of 13-15 years-aged. The percentages of inadequacy for EALT-AC and EAST-AC of 13-15 years were significantly higher than those of 16-18 years-aged.
In conclusion, vitamin B6 status of adolescents aged 13-18 years showed the inadequacy in the short-term intakes of vitamin B6 reflected by the inadequate urinary 4-PA excretion observed in 5-12 % of adolescents in this study. All subjects had plasma PLP ＞20 n mol/L indicating that vitamin B6 intakes were adequate to meet physiological metabolism within 7-10 days. However, vitamin B6 status was suggested to be inadequate for long-term (6-8 wks) due to the high percentages (20-40%) of inadequacy for EALT-AC and EAST-AC. The Estimated Average Requirements for vitamin B6 which of satisfy biochemical indicators in plasma, erythrocyte and urine were determined and used to calculate Recommended Dietary Allowances (RDAs) by multiplying 120%. This study suggested that RDAs for vitamin B6 were 1.20 mg and 1.28 mg for boys aged 13-15 and 16-18 years, respectively. The RDAs for vitamin B6 were 1.04 mg and 1.16 mg for girls aged 13-15 and 16-18 years, respectively.

目 錄
頁 數
中文摘要 I
英文摘要 IV
誌謝 VI
目錄 VII
表目錄 VIII
圖目錄 X
附表目錄 XI
附錄目錄 XII
第一章：前言 1
第二章：文獻探討 3
第三章：材料與方法 20
第四章：實驗結果 36
第五章：討論 51
第六章：參考文獻 65
表 78
圖 104
附表 110
附錄 124
自述 135

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