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研究生:郭怡君
論文名稱:瘦素與免疫的相關性:綜論
論文名稱(外文):The relationship of leptin and immunity: An overview
指導教授:吳文勉
學位類別:碩士
校院名稱:輔仁大學
系所名稱:食品營養學系
學門:醫藥衛生學門
學類:營養學類
論文種類:學術論文
論文出版年:2004
畢業學年度:92
語文別:中文
中文關鍵詞:肥胖營養不良leptin免疫反應
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肥胖(obesity)儼然是全世界普遍存在的健康問題,與許多慢性疾病之罹患有密切關係,近幾年的研究顯示,脂肪組織所分泌的瘦素(leptin),對於調節營養狀態、內分泌荷爾蒙及免疫系統有關。血漿中leptin的濃度與體脂肪量成正相關,當leptin的濃度增加(如肥胖)時,會促使熱量成負平衡狀態消耗,也就是熱量消耗大於由食物攝取所提供之熱量;而當leptin的濃度減少(如飢餓或厭食)時,會促使熱量消耗成正平衡狀態,也就是食物攝取大於熱量消耗,藉此調節脂肪總量並維持恆定。在飢餓狀態或神經性厭食症(anorexia nervosa)患者可觀察到因營養不良而導致體重下降、血清leptin濃度減少,並伴隨著細胞主導之免疫力減弱,感染機會增加。Ob/ob基因突變老鼠所模擬之厭食動物模式中,腹腔注射leptin可保護其免於受到飢餓所引發之免疫抑制現象,可見leptin的消長對於調節營養狀態及免疫功能上扮演重要角色。肥胖者之先天性免疫(innate immunity)及適應性免疫(adaptive immunity)反應皆較正常體位者低下,適當減輕體重後,免疫反應可恢復的較為正常。現代人健康意識提高,在追求良好體態之餘,若以錯誤飲食方式節食,可能會引發免疫失調之危機,進而降低對感染的抵抗力。故建議肥胖者在減重時,宜減少飲食中之脂肪、但維持適當的總熱量攝取,即可達到體重減輕及維持良好免疫力,這對大眾的健康而言是非常恰當的。

中文摘要…………………………………………………………………Ⅰ
英文摘要…………………………………………………………………Ⅱ
目錄………………………………………………………………………Ⅲ
表目錄……………………………………………………………………Ⅴ
圖目錄……………………………………………………………………Ⅵ
縮寫表……………………………………………………………………Ⅷ
第一章 前言……………………………………………………………1
第二章 免疫系統介紹…………………………………………………3
第一節 先天性免疫反應………………………………………………3
第二節 適應性免疫反應………………………………………………5
第三節 抗原呈獻細胞與T細胞的作用………………………………6
第四節 輔助型T細胞分泌的細胞激素類型…………….……………7
第五節 細胞激素與其接受器的活化路徑……………….……..……9
第三章 何謂肥胖…………………………………………………………12
第一節 肥胖是全球的流行趨勢………………….………………………12
第二節 肥胖的定義……………………………………………………….14
3.2.1 身體質量指數………………………………………………….14
3.2.2 體脂肪率……………………………………………………….15
3.2.3 腰圍…………………………………………………………….16
第三節 肥胖的病理學、代謝及內分泌因子…………………………….18
3.3.1 肥胖與遺傳…………………………………………………….18
3.3.2 肥胖與代謝…………………………………………………….20
3.3.3 脂肪組織所產生之內分泌因子……………………………….24
第四節 肥胖與Leptin的關係…………………………………………….32
3.4.1 Leptin之簡介…………………………………………………...32
3.4.2 Leptin對調節食慾與食物攝取的相關作用…………………...37
3.4.3 Leptin與肥胖的關係……………………………………….…..39
第四章 肥胖對免疫系統之影響…………………………………………..41
第一節 肥胖與免疫………………………………………………………..41
4.1.1 遺傳型肥胖動物體內之免疫調節機制………………………..41
4.1.2 肥胖者體內之免疫調節機制…………………………………..43
4.1.3 限制熱量飲食或飢餓狀態對肥胖者免疫功能之影響………..52
4.1.4 肥胖者體內荷爾蒙變化對免疫系統之影響…………………..57
第二節 Leptin對 ob/ob 老鼠胸腺細胞之影響………………………….70
第三節 Leptin對各類淋巴細胞之影響…………………………………..72
4.3.1 T細胞…………………………………………………………..72
4.3.2 單核白血球及巨噬細胞……………………………………….74
4.3.3 自然殺手細胞………………………………………………….77
第四節 Leptin與發炎的相關性…………………………………………..78
第五章 其他影響肥胖與免疫的因素……………………………………100
第一節 影響leptin濃度的藥物………………………………….....100
第二節 營養狀態對免疫反應之影響…………………………….…..104
第六章 結論………………………………………………………………109
第七章 參考文獻…………………………………………………………111

第七章 參考文獻
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