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研究生:林佳儀
研究生(外文):Jia Yi Lin
論文名稱:國中7-8年級男生身體脂肪對骨礦密度之雙重效果
論文名稱(外文):Dual Effect of Body Fatness on Bone Mineral Density among 7-8-grade Junior High Male Adolescents
指導教授:衛沛文衛沛文引用關係
指導教授(外文):Pui Man Wai
學位類別:碩士
校院名稱:國立體育大學
系所名稱:運動科學研究所
學門:民生學門
學類:運動科技學類
論文種類:學術論文
論文出版年:2013
畢業學年度:101
語文別:中文
論文頁數:94
中文關鍵詞:身體質量指數骨質健康皮下脂肪
外文關鍵詞:body mass index (BMI)bone healthsubcutaneous fat
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先前的研究指出過輕、過重或肥胖可能會導致低骨礦密度 (bone mineral density, BMD)。目的:藉由研究身體質量指數 (body mass index, BMI)、體圍、皮脂摺層厚度與骨礦密度的關係,來釐清國中男生其身體脂肪對骨礦密度的雙重效果。方法:受試者為39位7-8年級的國中男生,年齡13.9±0.7歲 (平均數±標準差),BMI 20.2±3.0 kg•m-2 (範圍14.7-31.0 kg•m-2)。以雙能量X-光儀 (Explorer, Hologic, Inc., Bedford, MA , USA) 測量腰椎 (lumbar spine, LS)、髖骨 (total hip, TH) 及股骨頸 (femur neck, FN) 的BMD。以Lange皮脂夾 (JohnsonDiversey Equipment, Cambridge, MD, USA) 測量皮脂摺層厚度。身體脂肪包括BMI、肱三頭、肩胛下,與髂骨上的皮脂摺層厚度、腰圍及上臂圍。受試者填寫問卷,包括生長發育、家族風險、身體活動及營養狀況。生理特徵包括年齡、生長發育等級、骨質疏鬆症家族病史或跌倒相關骨折史。身體活動包括中、高強度活動持續時間 (min•week-1)。飲食營養狀況有鈣攝取 − 牛奶或奶製品;維他命D攝取 (一般或深海魚類)、日光曝曬、咖啡因飲料 (汽水、咖啡、茶)。多元迴歸分析的依變項為BMD,自變項為身體脂肪 (model 1),依序增加生理特徵 (model 2)、身體活動 (model 3) 及營養狀況 (model 4);多元迴歸分析藉由身體脂肪來預測BMD。結果:身體脂肪與BMD的關係呈現倒U曲線。線性多元迴歸分析結果顯示肱三頭與肩胛下的皮脂摺層厚度之總和與LS-BMD皆為負相關 (model 1: adjusted r2, 0.53; SEE, 0.0724; model 4: adjusted r2, 0.69; SEE, 0.059; p < 0.05),而TH-BMD和FN-BMD則皆與身體脂肪無顯著相關。結論:在統計調整潛在影響因素後,青少年的身體脂肪過高或過低會有較低的腰椎、髖骨或股骨頸骨礦密度。

關鍵詞:身體質量指數、骨質健康、皮下脂肪

Previous studies indicate that underweight, overweight or obese may lead to low bone mineral density (BMD). Purpose: To clarify the dual effect of body fatness on BMD in school boys by studying the relationship among body mass index (BMI), body circumferences, skinfold thickness and BMD. Methods: Subjects were 39 grade 7-8 Chinese boys, age 13.9±0.7 years (mean±SD), and BMI 20.2±3.0 kg∙m-2 (range, 14.7-31.0 kg∙m-2). Dual x-ray absorptiometer (Explorer, Hologic, Inc., Bedford, MA , USA) was used to assess BMD at lumbar spine (LS), total hip (TH), and femoral neck (FN). Lange skinfold caliper (JohnsonDiversey Equipment, Cambridge, MD, USA) was used to measure skinfold thickness with standard procedure. Body fat indexes included BMI, skinfold thickness of triceps, subscapular, and suprailiac; waist circumference, and upper arm circumference. Subjects were interviewed for information on puberty, family risk, physical activities, and nutritional status. Physical characteristics included age, puberty category, and family history of osteoporosis or history of fall-related bone fractures. Physical activities included duration (min∙week-1) of moderate and vigorous activities. Nutritional status included calcium intake (milk or milk-equivalent products) (glasses per week); vitamin D intake (farm or deep sea fish) (occasions per week), sun exposure (min∙week-1); and caffeine-drinks (packs or glasses per week) (soda, coffee, tea, etc.) Multiple regression analyses were performed using BMD as dependent variable. For independent variables, body fat indexes were first introduced, (model 1), followed by adding physical characteristics (model 2), physical activities (model 3), and nutritional status (model 4). Polynomial regression analyses were performed to predict BMD by body fat. Result: The relationship between body fat indexes and BMD were curvilinear with an invert U shape. Linear regression analyses show that the sum of triceps and subscapular skinfold thickness was consistently inversely correlated with LS-BMD from model 1 to model 4 (model 1: adjusted r2, 0.53; SEE, 0.0724; model 4: adjusted r2, 0.69; SEE, 0.059; p < 0.05). For TH or FN, no body fat indexes were identified as significant correlators. Conclusions: We found that adolescent boys with too high or too low body fat indexes had lower bone mineral density at the lumbar spine, total hip, or femoral neck after adjusting for potential confounders.

Keywords: body mass index (BMI), bone health, subcutaneous fat

致謝 i
摘要 ii
Abstract iv
表目錄 ix
圖目錄 x
第壹章 緒論 1
一、 研究背景 1
二、 研究理由與問題 2
三、 研究目的 4
四、 研究範圍 4
五、 研究限制 4
六、 研究結果的意義與貢獻 4
第貳章 文獻探討 6
一、 骨質疏鬆症 6
(一) 骨質疏鬆症類型 6
(二) 臨床定義 6
(三) 骨質疏鬆症與骨折盛行率 7
(四) 風險因素 9
(五) 症狀與防治 11
二、 青少年骨礦密度 13
(一) 巔峰骨質量 13
(二) 骨礦密度測量 13
三、 肥胖與青少年骨礦密度 15
(一) 青少年肥胖盛行率 15
(二) 青少年肥胖與疾病、死亡風險 15
(三) 肥胖與骨礦密度 17
(四) 不同肥胖程度與骨礦密度 17
四、 身體活動與青少年骨礦密度 21
第參章 研究方法 23
一、受試者 23
二、實驗設計與研究過程 23
三、研究工具與方法 23
(一) 身體活動問卷 23
(二) 鈣與維生素D攝取問卷 24
(三) 自填式青春期發展量表 24
(四) 家族病史 (family history) 25
(五) 骨骼風險 (bone risk) 25
(六) 骨礦密度測量 25
(七) 肥胖度測量 25
四、資料處理與統計 28
第肆章 結果 29
一、 受試者基本特徵 29
二、 身體脂肪與骨礦密度之相關 29
三、 體脂指標與骨礦密度之迴歸分析 30
第伍章 討論 57
一、 身體脂肪對骨礦密度的雙重效果 57
二、 BMI與骨礦密度 59
三、 腰圍與骨礦密度 59
四、 上臂圍與骨礦密度 60
五、 皮脂摺層厚與骨礦密度 60
第陸章 結論 61
第柒章 建議 62
參考文獻 63
附錄一 68
附錄二 69
附錄三 70
附錄四 71
附錄五 72
附錄六 74
附錄七 75
附錄八 78
附錄九 81
附錄十 82

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網路資訊
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