臺灣博碩士論文加值系統

基於堆積過量脂肪的脂肪細胞會分泌脂肪激素(adipokines)而傷害細胞的胰島素訊息傳遞作用，引起胰島素敏感性(insulin sensitivity)下降，進而誘發血糖、總膽固醇(TC)、高密度脂蛋白膽固醇(HDL-C)、低密度脂蛋白膽固醇(LDL-C)、血脂(TG)等下游代謝症候群相關之血液生化值變差，而這些作用是否會發生在兒童身上，以及是否會因年齡增長而作用加劇？乃本研究極力想探討之目的。
為了去除遺傳因子的影響，本研究共招募36對父子（42.86 ± 4.57歲、11.67± 0.75 歲），以BMI 23 kg/㎡為分野，分成BMI＜23 kg/㎡正常體重之兒童與成人、及BMI≧23 kg/m2過重之兒童與成人四組。研究結果如下：
1.胰島素敏感性指數方面：BMI正常兒童與成人McAuley指數分別為5.97 ± 0.98及5.01 ± 0.59，過重兒童與成人分別為4.51 ± 0.84及3.85 ± 0.75。以獨立樣本單因子變異數分析考驗此四項變數，結果達顯著差異（p＜.05）。進一步以最小顯著差異法事後比較，結果發現BMI正常兒童之McAuley指數顯著優於其它三組、過重兒童顯著優於過重成人、BMI正常體重成人顯著優於過重成人、而BMI正常成人與過重兒童之間則無顯著差異。
2.代謝症候群有關的血液生化值方面：TG、TC及LDL-C在BMI正常兒童與過重兒童有顯著差異（p＜.05），在成人方面則是TG及HDL-C達顯著差異；此外，BMI正常兒童與成人方面在TG、TC及LDL-C達顯著差異，過重兒童與成人僅TG及HDL-C達顯著差異。
本研究結論：本研究以36對父子為對象，以BMI 23 kg/㎡為分野分成四組，以單因子變異數分析考驗四組之胰島素敏感性及代謝症候群相關血液生化值，經討論後得到以下結論：
1.無論是中年男子或兒童，體重過重是引起胰島素敏感性顯著下降及TG、TC、
LDL-C及血壓等代謝症候群下游相關之血液生化值顯著較差的重要因子。
2.胰島素敏感性顯著下降及TG、血壓顯著較兒童差的老化現象已見諸於無論
是BMI正常或是過重的中年男子。

The adipocyte which accumulated abundant of fat might impair insulin signal transduction function by secreting adipokines or cytokines to cause drop of insulin sensitivity and furthermore make the downstream of blood profiles concerning the metabolic syndrome like blood glucose, total cholesterol (TC), high density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C) and triglycerides (TG) worse. The purpose of this research was to observe whether these effects occur on the child, as well as because of aging to aggravate?
In order to remove the influence of gene, the research altogether recruits 36 pair of
fathers and sons（42.86 ± 4.57yrs、11.67± 0.75 yrs）, took BMI 23 kg/m2 as the dividing line, divided into four groups as normal-weight child and adult of BMI<23 kg/m2, and overweight child and adult of BMI≧23 kg/m2. The findings were as follows:
1.Insulin sensitive index aspect: Four groups of McAuley indices respectively were 5.97 ±
0.98, 5.01 ± 0.59, 4.51 ± 0.84 and 3.85 ± 0.75 in child and adult of normal-weight and overweight . By independent event of the one-way ANOVA analysis to test these four variables, the results all reached the level of significance (p<.05).It was found that normal-weight child whose McAuley index was significantly beteer than else three groups, overweight child whose McAuley index is significantly beteer than overweight adult, normal-weight adult whose McAuley index is significantly beteer than overweight adult but there is no significant difference between normal-weight adult and overweight child.
2.The blood profiles concerning the metabolic syndrome: TC, TG and LDL-C of normal-
weight child all reached the level of significance with overweight child (p<.05), TC and
HDL-C all reached the level of significance in adult.Besides, TG, TC and LDL-C of normal- weight child all reached the level of significance with normal-weight adult,TG and HDL-C ofoverweight child all reached the level of significance with overweight adult.
Conclusion:
1. Regardless of the middle-aged man or the child , overweight is important attribute to cause
the significant drop of insulin sensitivity and poor TG, TC, LDL-C those are the downstream of blood profiles concerning the metabolic syndrome.
2. Regardless of the middle-aged man whose body fat is excessive or normal,the aging phenomenon of significant drop of insulin sensitivity , poor TG and poor blood pressure has been seen.

國科會授權書
國家圖書館授權書
考試委員會審定書
人體評估申請書
謝誌
中文摘要⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯Ⅰ
英文摘要⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯Ⅱ
目 次⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯III
表 次⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯VI
圖 次⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯VII

本文部分
第一章 緒論
一、問題背景⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯1
二、研究背景⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯3
三、研究目的⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯7
四、研究假設⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯8
五、操作性定義⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯8
六、研究範圍⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯9
七、研究限制⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯10
第二章 文獻探討
一、胰島素阻抗⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯11
二、肥胖和胰島素敏感性之相關⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯16
三、老化與胰島素阻抗⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯22
四、胰島素敏感性指數之探討⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯24
五、總結⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯26
第三章 研究方法與步驟
一、研究對象及取樣方法⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯27
二、實驗時間及地點⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯27
三、實驗設計⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯28
四、實驗步驟⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯29
五、實驗檢驗項目與方法⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯30
六、資料處理⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯32
第四章 結果
一、受試者基本資料⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯33
二、胰島素及胰島素敏感性指數之差異⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯36
三、血液生化值及血壓反應⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯39
第五章 討論與結論
一、胰島素敏感性指數McAuley之影響⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯49
二、代謝症候群相關血液生化值之影響⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯50
三、結 論⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯53

參考文獻
一、中文部分⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯54
二、外文部分⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯57
附錄
一、受試者同意書⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯64
二、家長同意書⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯65
三、免費健檢宣傳單⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯66
四、血液生化值檢測及計算方法⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯67
五、受試者實驗結果原始資料⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯76























表 次

表4-1 受試者基本資料與代謝症候群定義對照表⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯35
表4-2 受試者胰島素敏感性及代謝症候群相關之血液生化值相關一覽表⋯⋯⋯36
表4-3 胰島素單因子變異數分析摘要表⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯37
表4-4 McAuley指數單因子變異數分析摘要表⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯39
表4-5 McAuley指數事後比較結果⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯39
表4-6 血糖單因子變異數分析摘要表⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯40
表4-7 三酸甘油酯單因子變異數分析摘要表⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯41
表4-8 三酸甘油酯事後比較結果⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯41
表4-9 總膽固醇單因子變異數分析摘要表⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯42
表4-10 總膽固醇事後比較結果⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯43
表4-11 高密度脂蛋白膽固醇單因子變異數分析摘要表⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯44
表4-12 高密度脂蛋白膽固醇事後比較結果⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯44
表4-13 低密度脂蛋白膽固醇單因子變異數分析摘要表⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯45
表4-14 低密度脂蛋白膽固醇事後比較結果⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯45
表4-15 收縮壓單因子變異數分析摘要表⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯46
表4-16 收縮壓事後比較結果⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯47
表4-17 舒張壓單因子變異數分析摘要表⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯48
表4-18 舒張壓事後比較結果⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯48









圖 次

圖4-1 血液胰島素分布情形基本資料⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯37
圖4-2 血液胰島素敏感性指數MacAuley基本資料⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯38
圖4-3 血糖基本資料⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯40
圖4-4 三酸甘油酯基本資料⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯41
圖4-5 總膽固醇基本資料⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯42
圖4-6 高密度脂蛋白膽固醇基本資料⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯43
圖4-7 低密度脂蛋白膽固醇基本資料⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯45
圖4-8 收縮壓基本資料⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯46
圖4-9 舒張壓基本資料⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯⋯47

中文部分：
王海俊、馬軍、阿部都艾尼．吾布力、潘永平與高愛鈺（2007）。北京市不同營養狀況
中學生胰島素抵抗狀況分析。中國學校衛生，28（3），197－198。
行政院衛生署國民健康局（2005）。衛生統計資訊網--中華民國九十四年死因統計結果摘要。2006年12月7日，取自http://www.doh.gov.tw/statistic/index.htm
行政院衛生署國民健康局（2006）。代謝症候群臨床診斷準則（2003台灣）。2006年9
月15日，取自
http://www.bhp.doh.gov.tw/BHP/do/www/themeParkDocRead?themeParkDocument
Id=59416&type=document&themeParkId=826
行政院衛生署國民健康局（2007）。修正我國代謝症候群之判定標準。2007年3月31日，取自 http://www.doh.gov.tw/CHT2006/infonews/news_main01_p01.aspx?class_no=25&now_fod_list_no=8714&array_fod_list_no=&level_no=2&doc_no=48380&show=&qy=2007
邱啟嫻、李淑婷（1998）。高雄市四十歲以上民眾中老年病防治概況調查。高雄醫學大
學護理系。
房宜軍（2006）。高胰島素血症與肥胖。湖北體育科技，25（1），33-34。
金憲權、祝年豐、申慕韓與吳德敏（2007）。台北市國中生代謝症候群盛行率及相關因
素研究。台灣家醫誌，17（1），27-37。
柳家勛、陳亮恭、陳稚均、陳振文、黃信彰與邱淑媞（2005）。宜蘭地區中老年民衆
身體質量指數與胰島素抗性相關性之探討。北市醫學雜誌，2（2），138-145。
姚建安、李龍騰、陳慶餘與黃國晉（2005）。健檢老年人代謝症候群之相關研究。台灣
老年醫學雜誌，1（1），18-25。
唐正乾、陳滄山、徐維信與許世元（2006）。胰島素、脂肪與癌症：藥理學觀點。內科
學誌，17，169-176。
唐正乾、郭傑、陳滄山與許世元（2007）。過氧小體增殖活化受體、代謝症候群與癌症。
內科學誌，18，244-255。
唐憶淨、李孟智與王玉潯（1999）。老年人自覺健康狀態及其影響因素。台灣家醫誌，9，31-42。
張徽、程然、張冰與王曉（2007）。單純性肥胖兒童醣脂代謝特點及胰島素抵抗分析。
溫州醫學院學報，37（3），280－281。
陳金柱、李思遠與郭宗正（2006）。胰島素阻抗之病理生理學。台灣醫界，49（9），
28-34。
陳國群（1997）。最新糖尿病精要（第一版）。台北市：藝軒圖書出版社。
陳嬿如、黃麗卿（2005）。胰島素敏感性及抗性之測定方法。基層醫學，20（10），253
-259。
陳人豪、郭旭格與嚴崇仁（2006）。老化之生理與檢驗數據變化。中華民國更年期協會2006年大會手冊 ＆ 17、18期會訊合訂本，18-30。
陳毓隆、廖光福、賴世偉與李彩娟（2005）。新陳代謝症候群流行病學：以台中市－醫學中心健檢者為例。Mid-Taiwan Journal of Medicine，10（4），196-203
馮世祥、羅慶徽、陳宏一、徐尚為、朱基銘與林金定（2007）。某醫學中心員工代謝症候群盛行率與影響因子初探。中華職業醫學雜誌 ，14（3），141-147。
彭仁奎、黃國晉與陳慶餘（2006）。肥胖與代謝症候群。基層醫學，21（12），367-
371。
葉滋穗、張文道、宋育民、周崇頌與劉丕華（2006）。兒童及青少年的新陳代謝症候群。
基層醫學，21（7），197-204。
傅振宗（2005）。新陳代謝症候群　致命四重奏：肥胖、糖尿病、高血壓、高血脂。健
康世界，238，41-44。
詹欣隆、黃麗卿（2006）。過重者代謝症候群與胰島素阻抗之相關性探討。台灣家庭醫
學雜誌，16（3），181-189。
溫宇（2007）。脂肪組織在炎症發生時的作用。生理科學進展，38（2），181-183。
潘恆嘉、黃國晉與陳慶餘（2006）。胰島素阻抗與代謝症候群。基層醫學，21（10），273－277。
蔡宏明、戴芳楟與顏裕庭（2001）。老年人的糖尿病。台灣醫界，44（3），27-28。
賴秀昀、黃國晉與陳慶餘（2006）。老年人與代謝症候群。基層醫學，21（9），239
－243。
錢凱平、黃名男、周昱劭與陳進明（2007）。醫院工作人員的代謝症候群流行病學研
究。中華職業醫學雜誌，14（2），97-104。
戴永利、王君霞與周少宏（2007）。兒童肥胖與胰島素敏感性的關係研究。中國現代
醫學雜誌，17（10），1227-1231。
鍾春芳、朱德明（2005）。代謝症候群--現代人的文明病。台灣醫界，48，306-308。
簡盟月、吳英黛（2006）。胰島素阻抗與運動訓練的效果－細胞與分子層面之探討。
物理治療，31（2），130-141。
顏郁晉、黃惠屏、薛夙君、李昭憲、許秀月、鍾蝶起、黃淑珠與楊燦（2007）。屏東地區中老年人肥胖指標與代謝症候群之相關探討。中華職業醫學雜誌，14(3)，149-
160。
劉秉一（2008）。中年人的危機 ─ 代謝症候群。重症醫學雜誌，9（1），26-33。


外文部分：
Ahmed, I., & Goldstein, B. J. (2006). Cardiovascular risk in the spectrum of type 2 diabetes
mellitus. The Mount Sinai Journal of Medicine, 73(5), 759-768.
Ahren, B., & Pacini, G. (1998). Age-related reduction in glucose elimination is accompanied
by reduced glucose effectiveness and increased hepatic insulin extraction in man. The
Journal of Clinical Endocrinology and Metabolism, 83, 3350-3356.
Alberti, K. G., & Zimmet, P. Z. (1998). Definition, diagnosis and classification of diabetes mellitus and its complications. Part 1: diagnosis and classification of diabetes mellitus provisional report of a WHO consultation. Diabetic Medicine : a Journal of the British Diabetic Association, 15(7), 554-557.
Alberti, G., Zimmet, P., & Shaw, J. (2005). A new IDF worldwide definition of the metabolic:
the rationale and the results. Diabetes Voice, 50(3), 31-33.
Aljada, A., Ghanim, H., Assian, E., & Dandona, P. (2002). Tumor necrosis factor-alpha
inhibits insulin-induced increase in endothelial nitric oxide synthase and reduces insulin
receptor content and phosphorylation in human aortic endothelial cells. Metabolism, 51,
487–491.
Arumugam, T. V., Gleichmann, M., Tang, S. C., & Mattson, M. P. (2006). Hormesis /
preconditioning mechanisms, the nervous system and aging. Aging Research Review, 5(2), 165-178.
Arias, E. B., Gosselin, L. E., & Cartee, G. D. (2001). Exercise training eliminates age-related
differences in skeletal muscle insulin receptor and IRS-1 abundance in rats. The Journals
of Gerontology. Series A, Biological Sciences and Medical Sciences, 56(10), B449-455.
Ascaso, J. F., Romero, P., Real, J. T., Priego, A., Valdecabres, C., & Carmena, R. (2001).
Insulin resistance quantification by fasting insulin plasma values and HOMA index in a non-diabetic population. Medicina Clinica.(Barc), 117(14), 530-533.
Ascaso, J. F., Pardo, S., Real, J. T., Lorente, R. I., Priego, A., & Carmena, R. (2003). Diagnosing insulin resistance by simple quantitative methods in subjects with normal
glucose metabolism. Diabetes Care, 26(12), 3320-3325.
Barter, P. (2005). The role of HDL-choleterol in preventing atherosclerotic disease. The European Society of Cardiology, 7, F4-F8.
Bergman, R. N., Finegood, D. T., & Ader, M. (1985). Asessment of insulin sensitivity in
vivo. Endocrine Reviews, 6, 45-86.
Bloomgarden, Z. T. (2003). American association of clinical endocrinologists(AACE) consensus conference on the insulin resistance syndrome: 25-26 August 2002, Washington, DC. Diabetes Care, 26(4), 1297-1303.
Bruce, C. R., & Hawley, J. A. (2004). Improvements in insulin resistance with aerobic
exercise training: a lipocentric approach. Medicine and Science in Sports and Exercise,
36(7), 1196-1201.
Beghin, I., Cap, M., & Dujarein, B. (1988). A guide to nutritional assessment. Geneva WHO.
Caterson, I. D. (1990). Management strategies for weight control, eating, exercise and behavior. Drugs, 39 (suppl 3), 20-32.
Davidson, M. B. (1979). The effect of aging on carbohydrate metabolism: a review of the English literature and practicial approach to the diagnosis of diabetes mellitus in the elderly. Metabolism, 28, 688-705.
Dandona, P., Aljada, A., & Bandyopadhyay, A. (2004). Inflammation: the link between insulin resistance, obesity and diabetes. Trends in Immunology, 25(1), 4-7.
DeFronzo, R. A. (1988). Lilly lecture 1987. The triumvirate: beta-cell, muscle, liver. A
collusion responsible for NIDDM. Diabetes, 37(6), 667-687.
Eckel, R. H., Grundy, S. M., & Zimmet, P. Z. (2005). The metabolic syndrome. The Lancet, 365(9468), 1415-1428.
Farese, R. V., Sajan, M. P., & Standaert, M. L. (2005). Insulin-sensitive protein kinases (a
typical protein kinase C and protein kinase B/Akt): actions and defects in obesity and Type II diabetes. Experimental Biology and Medicine, 230(9), 593-605.
Feinleib, M. (1985). Epidemiology of obesity in relation to health hazards. Annal of Internayional Medicine, 103, 1019-24.
Fruhbeck, G., Gomez-Ambrosi, J., Muruzabal, F. J., & Burrell, M. A. (1985). The adipocyte: a model for integration of endocrin and metabolic signaling in energy metabolism regulation. American Journal of Physiology. Endocrinology and Metabolism, 280,
E827-47.
Fontbonne, A., Eschwege, E., Cambien, F., Richard, J. L., Ducimetiere, P., Thibult, N., et al. (1989). Hypertriglyceridaemia as a risk factor of coronary heart disease mortality in subjects with impaired glucose tolerance or diabetes. Results from the 11-year follow-up of the Paris Prospective Study. Diabetologia, 32(5), 300-304.
Ford, E. S., Giles, W. H., & Dietz, W. H. (2002). Prevalence of the metabolic syndrome among U. S. adults: Findings from the third national health and nutrition examination survey. The Journal of the American Medical Association, 287(3), 356-359.
Ginsberg, H. N. (2000). Insulin resistance and cardiovascular disease. The Journal of Clinical
Investigation, 106(4), 453-458.
Grundy, S. M., Brewer, H. B., Jr., Cleeman, J. I., Smith, S. C., Jr., Lenfant, C., & for the Conference, P. (2004). Definition of Metabolic Syndrome: Report of the National Heart, Lung, and Blood Institute/American Heart Association Conference on Scientific Issues Related to Definition. Circulation, 109(3), 433-438.
Greenberg, A. S., & Obin, M. S. (2006). Obesity and the role of adipose tissue in inflammation and metabolism. The American Journal of Clinical Nutrition, 83(2), 461S-465S.
Henry, R. R., & Mudaliar, S. (2003). Obesity and TypeⅡ Diabetes Mellitus. In R. H. Eckel (Ed.), Obesity Mechanisms and Clinical Management(pp. 229-272). Philadelphia, USA: Lippincott William & Wilkins.
Hrebicek, J., Janout, V., Malincikova, J., Horakova, D., & Cizek, L. (2002). Detection of
insulin resistance by simple quantitative insulin sensitivity check index QUICKI for epidemiological assessment and prevention. American Journal of Physiology. Endocrinology and Metabolism, 87(1), 144-.
Holloszy, J. O. (2005). Exercise-induced increase in muscle insulin sensitivity. Journal of Applied Physiology, 99(1), 338-343.
Ivy, J. L. (2004). Muscle insulin resistance amended with exercise training: role of GLUT4 expression. Medicine and Science in Sports and Exercise, 36(7), 1207-1211.
Isomaa, B., Almgren, P., Tuomi, T., et al. (2004). Cardiovascular morbidity and mortality associated with the metabolic syndrome. Diabetes Care, 24, 683-9.
Kasuga, M. (2006). Insulin resistance and pancreatic {beta} cell failure. The Journal of Clinical Investigation, 116(7), 1756-1760.
Katz, A., Nambi, S. S., Mather, K., Baron, A. D., Follmann, D. A., Sullivan, G., et al. (2000). Quantitative insulin sensitivity check index: A simple, accurate method for assessing insulin sensitivity in humans. American Journal of Physiology. Endocrinology and Metabolism, 85(7), 2402-2410.
Kahn, S. E., Larson, V. G., Schwartz, R. S., Beard, J. C., Cain, K. C., Fellinham, G. W., Stratton, J. R., Cerqueira, M. D., & Abrass, I. B. (1992). Exercise training delineates the importance of B-cell dysfuntion to the glucose intolerance of human aging. The Journal of Clinical Endocrinology and Metabolism, 74, 1336-1342.
Kendall, D. M., & Harmel, A. P. (2002). The metabolic syndrome, type 2 diabetes, and cardiovascular disease: Understanding the role of insulin resistance. American Journal of Managed Care, 8(20), S635-S653.
Ko, G. T., Cockram, C. S., Chow, C. C., et al. (2005). High prevalence of metabolic syndrome in Hong Kong Chinese-comparison of three diagnostic criteria. Diabetes Research and Clinical Practice, 69, 160-8.
Krook, A., Wallberg-Henriksson, H., & Zierath, J. (2004). Sending the signal: Molecular
mechanisms regulating glucose uptake. Medicine and Science in Sports and Exercise, 36(7), 1212-1217.
Kristina, M. Utzschneider., Darcy, B. Carr., Suzanne, M. Barsness., Steven, E. Kahn., &
Robert, S. Schwartz. (2004). Diet-induced weight loss is associated with an improvement in β-cell function in older men. The Journal of Clinical Endocrinology and Metabolism,
89(6), 2704-2710.
Lakka, H. M., Laaksonen, D. E., Lakka, T. A. et al. (2002). The metabolic syndrome and total cardiovascular disease mortality in middle-aged men. The Journal of the American Medical Association, 288, 2709-16.
Long, Y. C., & Zierath, J. R. (2006). AMP-activated protein kinase signaling in metabolic regulation. Journal of Clinical Investigation, 116(7), 1776-1783.
Ma, G. S., Li, Y. P., Hu, X. Q., Cui, Z. H., Yang, X. G., & Chen, C. M. (2006). Report on childhood obesity in China(2). Verification of BMI classification reference for overweight and obesity in Chinese children and adolescents. Biomedical ＆ Environmental Sciences, 19, 1-7.
McFarlane, S. I., Banerji, M., & Sowers, J. R. (2001). Insulin resistance and cardiovascular disease. The Journal of Clinical Endocrinology and Metabolism, 86(2), 713-718.
McAuley, K. A., Williams, S. M., Mann, J. I., Walker, R. J., Lewis-Barned, N. J., Temple, L. A., et al. (2001). Diagnosing insulin resistance in the general population. Diabetes Care, 24(3), 460-464.
Papadopoulou-Alataki, E. et al. (2004). Clinical and biochemical manifestations of syndrome X in obese children. European Journal of Pediatrics, 63, 573-9.
Paolisso, G., Gambardella, A., Amato, L., Tortoriello, R., D’Amore, A., Varricchio, M., & D’Onofrio, F. (1995). Opposite effects of short- and long-term fatty acid infusion on insulin secretion in healthy subject. Diabetologia, 38, 1295-1299.
Pessin, J. E., & Saltiel, A. R. (2000). Signaling pathways in insulin action: molecular targets of insulin resistance. The Journal of Clinical Investigation, 106(2), 165-169.
Raymond, I. Fink., Orville, G. Kolterman., Jennifer, Griffin., & Jerrold, M. Olefsky. (1983). Mechanism of insulin resistance in aging. The Journal of Clinical Investigation, 71,
1523-1535.
Rhodes, C. J., White, M. F. (2002). Molecular insights into insulin action and secretion.
European Journal of Clinical Investigation, 32(suppl. 3), 3-13.
Ritz-Laser, B., Meda, P., Constant, I., Klages, N., Carollais, A., Morales, A., Magnan, C.,
Ktorza, A., & Philippe, J. (1999). Glucose-induced preproinsulin gene expression is inhibited by the free fatty acid palmitate. Endocrinology, 140, 4005-4014.
Reaven, G. M. (1988). Role of insulin resistance in human disease. Diabetes, 37(12), 1595
-1607.
Recasens, M., Ricart, W., & Fernandez-Real, J. (2004). Obesity and inflammation. Revista
de Medicina de la Universidad de Navarra, 48(2), 49-54.
Saltiel, A. R. (2000). The molecular and physiological basis ofinsulin resistance: emerging implications for metabolic andcardiovascular diseases. Journal of Clinical Investigation, 106(2), 163-164.
Shoelson, S. E., Lee, J., & Goldfine, A. B. (2000). Inflammation and insulin resistance. The Journal of Clinical Investigation, 116(7), 1793-1801.
Short, K. R., Vittone, J. L., Bigelow, M. L., Proctor, D. N., Rizza, R. A., Coenen-Schimke, J. M., et al (2003). Impact of aerobic exercise training on age-related changes in insulin sensitivity and muscle oxidative capacity. Diabetes, 52(8), 1888-1896.
Swales, J. D., Sever, P. S., & Peart, S. T. (1991). Clinical atlas of hypertension. Singapore. Gower Medical Publishing.
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) Final Report. (2002). Circulation, 106(25), 3143-3421.
Weiss, R., Dziura, J., Burgert, T.S., et al. (2004). Obesity and the metabolic syndrome in children and adolescents. The New England Journal of Medicine, 350, 2362-74.
Wang, P. A. (1988). Rowe on insulin synthesis and secretion. Differential effects on preproinsulin messenger RNA levels, proinsulin biosynthesis, and secretion of newly made and preformed insulin in the rat. The Journal of Clinical Investigation, 81, 176-84.