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研究生:陳妍蒨
研究生(外文):Yen-Chien
論文名稱:肥胖者經減重課程後血清生化值及代謝症候群危險因子的影響
論文名稱(外文):The effects of weight control program on serum biochemical characteristics and risk factor for metabolic syndrome in overweight subjects
指導教授:徐成金徐成金引用關係
學位類別:碩士
校院名稱:中山醫學大學
系所名稱:營養學研究所
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:2008
畢業學年度:96
語文別:中文
論文頁數:110
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近年來國人的肥胖盛行率有逐年增加的趨勢,在許多國家,肥胖症已儼然成為公共衛生上重要的問題。肥胖和許多慢性疾病有關,特別是腹部肥胖,罹患代謝症候群的風險高於一般人,而有代謝症候群者,罹患心血管疾病的危險遠較於沒有代謝症候群者高出許多。以營養科學觀點而言,熱量的攝取與消耗的不平均是造成肥胖的主要原因,故限制熱量的飲食控制與規律的運動,成為體重控制最重要的課題。
本研究以17位肥胖者,體重79.84±19.00公斤,BMI30.36 ±4.84 kg/m2,腰圍93.24±14.37公分,經過8週體重控制計畫後,比較減重前後體組成、血液生化值及代謝症候群指標的變化。結果顯示,在血液生化值方面,總膽固醇、HDL、LDL、GPT和Cr均有顯著的下降;在體組成方面,減重前後體重、BMI、體脂肪、皮下脂肪、內臟脂肪、瘦肉組織、腰圍和臀圍均有顯著性的差異;然而代謝症候群指標則在減重前是代謝症候群組明顯大於非代謝症候群組,減重後代謝症候群之各項指標並無統計上顯著的改變,非代謝症候群組則腰圍及HDL有顯著性的差異。經研究證實,肥胖確實易造成體組成及血液生化值的異常,增加慢性病的罹病率及致死率,若能以飲食控制,配合有氧運動及行為修正,可有效降低體重,改善體組成及血液生化值的異常現象,促進健康。


The prevalence of obesity is increasing in recent years. It has been important public health problem in many countries. Obesity is associated with risk factors of many diseases. Metabolic syndromes (MS) are linked with central obesity and may cause cardiovascular diseases (CVD). The energy intake and expenditure unbalancedly is the main cause of obesity. The most important of body weight control is to restrict calorie intake, modify dietary manner and keep doing exercise. The purpose of this study evaluated effect of 8-week body-weight-reduction program in 17 obesity subjects with body weight79.84±19.00kg,BMI30.36±4.84kg/m2, waist circumference 93.24±14.37cm,which preceded this approach by comparison of biochemical assessment, anthropometry, body weight and percentage of body fat, between pre and post weight reduction. The results showed that before the weight control program was administrated, After the weight control program, the biochemical characteristics which included total cholesterol,HDL,LDL,GPT and Cr were significantly improved;the body composition which included body weight, BMI, body fat, subcutaneous fat, isceral fat,lean body mass, waist circumference and hip circumference were also significantly improved. However, the improvement on indicators for metabolic syndromes before 8-week body-weight-reduction program is MS higher than, but after 8-week body-weight-reduction program MS subjects is no significantly improved ,non-MS subjects waist circumference and HDL were better than those in MS subjects. In conlusion, obesity could make abnormal of body composition and biochemical characteristics, and consider as a chronic disease with morbidity and motality. It is better to take diet control , exercise and modify intake behavior, could reduce body weight, improve body composition and biochemical characteristics, and more effects of psychological health.

中文摘要.................................................................................vii Abstract .........................................................................................ix
第一章 緒言...........................................................................1
第一節 研究背景與動機..........................................................………2
第二節 研究目的......................................................................………3
第二章 文獻探討..........................................................................………4
第一節 體重過重及肥胖的定義..............................................………4
第二節 體重過重及肥胖的成因..............................................………5
第三節 體重過重及肥胖的趨勢..............................................………6
第四節 體重過重及肥胖對健康的影響..................................………7
第五節 減重行為的相關概念..................................................……....9
第六節 影響減重行為之相關因素..........................................……..11
第七節 各種減重方法及對身體的影響..................................……..13
第三章 代謝症候群......................................................................……..19
第一節 代謝症候群的定義....................................................……..19
第二節 代謝症候群之盛行率..........................................20
第三節 代謝症候群對健康的影響.........................................21
第四節 腹部肥胖與代謝症候群. .......................................21
第五節 胰島素阻抗與代謝症候群………………………………..22
第四章 研究對象與方法..............................................................……..25
第一節 研究設計....................................................................……..25
第二節 實驗對象....................................................................……..27
第三節 研究方法....................................................................……..28
第四節 體位測量....................................................................……..30
第五節 血液檢測....................................................................……..31
第七節 統計方法....................................................................……..32
第五章 結果................................................................................……..33
第一節 受試者基本資料........................................................……..33
第二節 受試者減重過程中體組成的……………………………..34
第三節 受試者減重過程中血液生化值的變化…………………..35
第四節 比較代謝症候群與非代謝症候群於減重前後各項生理指標的變化…………………………………………………..36
第五節 不同的減重程度對各項生理指標的影響………………..38
第六節 減重對不同肥胖程度的影響……………………………..39
第六章 討論..............................................................................……....93
第七章 結論..............................................................................……..102
第八章 參考文獻……………………………………………………103












圖 目 錄
圖1 第2型糖尿病與身體質量指數的關係.................................………8
圖2 心血管疾病的死亡率與身體質量指數的關係.................……….9
圖3 胰島素阻抗與代謝症候群....................................................……..22
圖4實驗設計流程圖.....................................................................……..26
圖5 17位受試者經過8週的體重控制後體重的變化………………42
圖6 GPT of all subjects before and after an 8-weeks weight-control program………………………………….………………………57
圖7 Effects of weight control program on body compositions in obese subjects with metabolic syndrome(MS) or NonMS…………..64
圖8 Effects of weight control program on biochemical characteristics in obese subjects with metabolic syndrome(MS) orNonMS ………………………………………………………..68
圖9代謝症候群指標變化差異比較…………………………………..71
圖10 MS與Non MS血脂變化差異比較……………………………..73
圖11 Effects of weight control on risk factors for coronary heart disease in obese subject…………………………………..75
圖12 BMI< 30 and BMI≧ 30分組減重前後各項變數的差異.…….81
圖13 BMI< 27 and BMI≧ 27分組減重前後各項變數的差異……...87






表 目 錄
表1行政院衛生署成人之肥胖定義……………………………………5
表2 各種運動的熱量消耗……………………………………………16
表3 運動30分鐘的熱量消耗(以體重70kg為例)………………17
表4受試者基本資料…………………………………………….…….41
表5 Effects of weight control program on body compositions in obesesubjects……………………………………………….……..43
表6 Body weight of all subjects before and after an 8-weeks weight-control program…..……………………………………..44
表7 BMI of all subjects before and after an 8-weeks weight-control program……….…………………………………………………45
表8 Body Fat of all subjects before and after an 8-weeks weight-control program………………………………….……..46
表9 Subcutaneous fat of all subjects before and after an 8-weeks weight-control program…..……………………………...……47
表10 Visceral fat of all subjects before and after an 8-weeks weight-control program..………………………………………48
表11 Waist of all subjects before and after an 8-weeks weight-control program………………………………….………………………49
表12 Hip of all subjects before and after an 8-weeks weight-control program………………………………….………………………50
表13 Lean mass of all subjects before and after an 8-weeks weight-control program………………………………….……..51
表14 Lean mass/Body fat of all subjects before and after an 8-weeks weight-control program………………………………………...52
表15 Waist/Hip of all subjects before and after an 8-weeks weight-control program……………………………………….53
表16 Effects of weight control program on biochemical characteristics in obese subjects………………………………..54
表17 Total cholesterol of all subjects before and after an 8-weeks weight-control program……………………………………….55
表18 HDL- cholesterol of all subjects before and after an 8-weeks weight-control program………………………………………..56
表19 GPT of all subjects before and after an 8-weeks weight-control program….………………………………………………………58
表20 Fasting plasma sugar of all subjects before and after an 8-weeks weight-control program..……..………………………………...59
表21 LDL- cholesterol of all subjects before and after an 8-weeks weight-control program……..………………………………...60
表22 Chol/HDL of all subjects before and after an 8-weeks weight-control program……………………………………….61
表23 Triglycerides (TG)of all subjects before and after an 8-weeks weight-control program……………………….………………62
`表24 Creatinine of all subjects before and after an 8-weeks weight-control program……………………………………….63
表25 Effects of weight control program on body compositions in obese subjects with metabolic syndrome(MS) or Non MS……………………………………………………………..67
表26 Effects of weight control program on biochemical characteristics in obese subjects with metabolic syndrome(MS) or Non MS……………………………………………………...70
表27代謝症候群指標變化差異比較…………………………………72
表28 MS與Non MS血脂變化差異比較……………………………74
表29 Effects of weight control on risk factors for coronary heart disease in obese subjects………………………….……………77
表30 減重變化<5 % and 減重變化≧ 5 %分組減重前後各項變數的差異…………………………………………………………….78.



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