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研究生:賴瑩潔
研究生(外文):Ying-Jie Lai
論文名稱:配方食品改善不同肥胖體型的體脂肪指標之效應
論文名稱(外文):Effect of a food formula on the parameters of body fat in different body shapes
指導教授:蔡敬民蔡敬民引用關係金亭佑
指導教授(外文):Jimmy TsaiTing-Yu, Chin
學位類別:碩士
校院名稱:中原大學
系所名稱:生物科技研究所
學門:生命科學學門
學類:生物科技學類
論文種類:學術論文
論文出版年:2014
畢業學年度:102
語文別:中文
論文頁數:161
中文關鍵詞:肥胖蘋果型梨型皮下脂肪內臟脂肪
外文關鍵詞:Obesityapple-shapedpear-shapedvisceral fatsubcutaneous fat
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代謝症候群隨著肥胖之盛行率的增加也逐漸愈來愈高,而有代謝症候群的肥胖者大多為中廣型肥胖。許多研究認為在代謝症候群的5項指標因子中,腹部脂肪是誘發代謝症候群的主要危險因子。本實驗重點在於希望瞭解某些食品是否確實能有抑制體脂肪的形成或增進體脂肪的代謝之保健功效?若有,那針對「內臟油」或「皮下油」的脂肪代謝是否可有不同的影響力?
本實驗招募身體質量指數(Body Mass Index, BMI)≧27 Kg/m2,腰圍男性≧95 cm、女性≧85 cm之成人,按腰臀比分成蘋果型(多內臟脂肪)或梨型(多皮下脂肪)二體型,再隨機分配到安慰劑組或試驗樣品組。試驗樣品組每天攝取依據先前動物實驗結果而設計之洛神花、綠藻及苦瓜之配方保健食材;而安慰劑組則攝取與代謝症候群不相關的安慰劑膠囊。實驗為期12週,於第0、8及12週時收集受試者之體位測量(體重、腰圍、腰臀比等)、身體組成測定(體脂肪、內臟脂肪、皮下脂肪等)等數據,比較受試者實驗前後的差異、試驗組不同體型之間的差異、試驗組受試者內臟脂肪減少與體重減少之相關性,以及試驗組受試者內臟脂肪、皮下脂肪的變化情形對於體重變化的影響,以瞭解此複方食材是否能對體位或脂肪的代謝產生改變。
結果顯示在身高、體重、BMI都相近的條件下,腰圍愈大及腰臀比愈大者,其內臟脂肪含量相對愈高;而受試者攝取配方食品12週後,體位測量的結果顯示:梨型男性的體重、BMI、腰圍及腰臀比非常顯著的減少(p<0.01),臀圍則也有明顯的減少(p<0.05);蘋果型男性的體重、BMI、腰圍、臀圍及腰臀比皆非常顯著的減少(p<0.01);梨型女性的腰圍非常顯著的減少(p<0.01),體重、BMI、臀圍及腰臀比則顯著的減少(p<0.05);蘋果型女性的腰圍及腰臀比非常顯著的減少(p<0.01),體重、BMI及臀圍則顯著的減少(p<0.05)。而安慰劑組則在實驗前後,體位測量的各項測量項目皆無顯著差異(p>0.10)。
本實驗以立式體脂儀(Tanita body composition analyzer BC-418型)測量身體組成,測定結果顯示:受試者攝取試驗配方食品12週之後,梨型和蘋果型男性的總體脂肪百分比、內臟脂肪、右腿脂肪百分比、左腿脂肪百分比、右手脂肪百分比、左手脂肪百分比及軀幹脂肪百分比皆非常顯著的減少(p<0.01);梨型女性的總體脂肪百分比及右腿脂肪百分比非常顯著的減少(p<0.01),內臟脂肪、左腿脂肪百分比、右手脂肪百分比、左手脂肪百分比及軀幹脂肪百分比顯著的減少(p<0.05);蘋果型女性的總體脂肪百分比、內臟脂肪、右手脂肪百分比、左手脂肪百分比及軀幹脂肪百分比顯著的減少(p<0.05),左腿脂肪百分比些微顯著的減少(p<0.10)。
然而,以臥式腹部脂肪分析儀(Tanita AB-140M ViScan)測量的結果則顯示:梨型和蘋果型男性的內臟脂肪及軀幹脂肪百分比皆非常顯著的減少(p<0.01);梨型女性的軀幹脂肪百分比非常顯著的減少(p<0.01),內臟脂肪顯著的減少(p<0.05);蘋果型女性的內臟脂肪非常顯著的減少(p<0.01),軀幹脂肪百分比顯著的減少(p<0.05)。
皮下脂肪測量的結果顯示:梨型男性的上臂圍、肱三頭肌皮脂厚度、肩胛骨皮脂厚度、腸骨頂皮脂厚度、腹部皮脂厚度、大腿圍、大腿股前方皮脂厚度、小腿圍及小腿內側皮脂厚度非常顯著的減少(p<0.01),腕圍顯著的減少(p<0.05);蘋果型男性的上臂圍、肱三頭肌皮脂厚度、腕圍、肩胛骨皮脂厚度、腸骨頂皮脂厚度、腹部皮脂厚度、大腿圍、大腿股前方皮脂厚度、小腿圍及小腿內側皮脂厚度皆非常顯著的減少(p<0.01);梨型女性的上臂圍、肱三頭肌皮脂厚度、肩胛骨皮脂厚度、腸骨頂皮脂厚度、腹部皮脂厚度、大腿圍、大腿股前方皮脂厚度及小腿內側皮脂厚度非常顯著的減少(p<0.01),小腿圍顯著的減少(p<0.05);蘋果型女性的上臂圍、肱三頭肌皮脂厚度、肩胛骨皮脂厚度、腸骨頂皮脂厚度、腹部皮脂厚度、大腿圍及小腿內側皮脂厚度非常顯著的減少(p<0.01),大腿股前方皮脂厚度及小腿圍則為顯著減少(p<0.05)。上述身體組成測定的測量項目中,又以內臟脂肪的變化百分比、腸骨頂皮脂厚度減少量及腹部皮脂厚度減少量下降的最多。而安慰劑組則在實驗前後,身體組成測定之各項測量項目皆無顯著差異(p>0.10)。
比較試驗組「蘋果型與梨型二種體型間」各項指標的差異時,發現實驗8週後,蘋果型男性的「腰圍變化百分比」之降幅略顯著大於梨型男性(p<0.10),實驗12週後,則是顯著大於梨型男性(p<0.05);「腰臀比變化百分比」之降幅則是實驗8週及12週後,蘋果型男性皆顯著大於梨型男性(p<0.05),而其他的評估指標則不明顯(p>0.10)。蘋果型女性則在實驗12週後,其「軀幹脂肪變化百分比」之降幅略顯著大於梨型女性(p<0.10),然而,其他的評估指標則無法觀察到這二種體型間有任何差異(p>0.10)。
分析試驗組受試者實驗12週後其體重變化與內臟脂肪變化之相關性,結果發現梨型及蘋果型的男性受試者體重減少得愈多,其內臟脂肪也相對減少得愈多(p<0.01)。而分析試驗組受試者攝取配方食品後,內臟脂肪、皮下脂肪的變化情形對於體重變化的影響,結果發現男性受試者體重減少的主要原因為內臟脂肪減少(p<0.001)。然而,以上的現象在女性受試者中並不明顯(p>0.10)。
整體而言,本實驗使用之配方食品確實對於體位、體脂肪的改善有明顯的幫助;而男性受試者的蘋果型及梨型改善的情形較女性受試者明顯。
A rapid increase in the prevalence of obesity in all races and ages led to gradual increase of the prevalence of the metabolic syndrome. Central obesity was considered to a primary risk factor for the metabolic syndrome, the main reason was due to many studies had demonstrated that abdominal obesity was the most common characterization in metabolic syndrome. In this study, we want to know whether certain foods can indeed inhibit the formation of body fat or improve the body fat metabolism. Then we compared the effects of the test formula on metabolism of the visceral fat and subcutaneous fat.
We recruited subjects with a body mass index (BMI) ≧27 Kg/m2, and males with a waist circumference ≧95 cm and females with a waist circumference ≧85 cm. Subjects were divided by different waist-to-hip ratios (WHR) into apple-shaped (have more visceral fat) or pear-shaped (have more subcutaneous fat). Then apple-shaped and pear-shaped subjects were randomly divided into the treatment or the placebo group. Subjects in the treatment group ingested the test formula daily for 12 weeks. The ingredients of the test formula containing roselle, chlorella and bitter gourd were designed according to our previous results of animal experiments. Subjects in the placebo group ingested placebo capsule daily also for 12 weeks. Data of anthropometric measurements - including weight, waist circumference (WC), WHR, etc. and body composition determination - including body fat, visceral fat levels, skinfold thickness, etc. from subjects were collected at 0, 8 and 12 weeks after ingestion of test formula or placebo. To understand the effects of test formula on the anthropometric measurement and body composition determination, we analyzed the autologous comparison, the difference between treatment groups, the correlation between weight change and visceral fat change in treatment groups, and effect of visceral fat and subcutaneous fat on the weight change in treatment groups.
The results showed that for a given level of height, weight and BMI, the higher visceral fat was associated with higher WC and WHR. After ingestion of test formula for 12 weeks, the results of anthropometric measurements showed that weight, BMI, WC and WHR were very significantly decreased at p<0.01 and hip circumference (HC) was significantly decreased at p<0.05 in the pear-shaped males; all weight, BMI, WC, HC and WHR were very significantly decreased (p<0.01) in the apple-shaped males. In females, WC was very significantly decreased at p<0.01 and weight, BMI, HC and WHR were significantly decreased at p<0.05 in the pear-shaped ones; WC and WHR were very significantly decreased at p<0.01 and weight, BMI and HC were significantly decreased (p<0.05) in the apple-shaped ones. No change on these parameters was found in the placebo group, in both males and females, during the experiment period (p>0.10).
The body compositions were determined by a standing body fat analyzer (Tanita body composition analyzer BC-418). After 12 weeks of ingestion of test formula, the data revealed that total body fat percentage, visceral fat rating, right leg fat percentage, left leg fat percentage, right arm fat percentage, left arm fat percentage and trunk fat percentage were very significantly decreased in both pear-shaped and apple-shaped males (p<0.01). Total body fat percentage and right leg fat percentage were reduced very significantly at p<0.01 and visceral fat rating, left leg fat percentage, right arm fat percentage, left arm fat percentage and trunk fat percentage were reduced significantly at p<0.05 in the pear-shaped females; total body fat percentage, visceral fat rating, right arm fat percentage, left arm fat percentage and trunk fat percentage were decreased very significantly at p<0.01 and left leg fat percentage was decreased slightly at p<0.10 in the apple-shaped females.
However, the data of supine abdominal fat analyzer (Tanita AB-140M Viscan) showed that visceral fat level and trunk fat percentage were very significantly decreased (p<0.01) in both pear-shaped and apple-shaped males; trunk fat percentage was very significantly decreased (p<0.01) and visceral fat level was significantly decreased (p<0.05) in the pear-shaped females; visceral fat level was very significantly decreased (p<0.01) and trunk fat percentage was significantly decreased (p<0.05) in the apple-shaped females.
The data of skinfold thickness showed that midarm circumference, tricep skinfold, subscapular skinfold, suprailiac skinfold, abdominal skinfold, thigh circumference, thigh skinfold, calf circumference and medial calf skinfold were very significantly decreased (p<0.01) and wrist circumference was significantly decreased (p<0.05) in the pear-shaped males; midarm circumference, tricep skinfold, wrist circumference, subscapular skinfold, suprailiac skinfold, abdominal skinfold, thigh circumference, thigh skinfold, calf circumference and medial calf skinfold were very significantly decreased (p<0.01) in the apple-shaped males. It was observed that midarm circumference, tricep skinfold, subscapular skinfold, suprailiac skinfold, abdominal skinfold, thigh circumference, thigh skinfold and medial calf skinfold were very significantly decreased (p<0.01) and calf circumference was significantly decreased (p<0.05) in the pear-shaped females; midarm circumference, tricep skinfold, subscapular skinfold, suprailiac skinfold, abdominal skinfold, thigh circumference and medial calf skinfold were very significantly decreased (p<0.01) and thigh skinfold and calf circumference were significantly decreased (p<0.05) in the apple-shaped females. Among the data of body composition determinations, the percent reduction on visceral fat level and the reductions on suprailiac skinfold and abdominal skinfold were more than ones on the other sites. No change on body composition determinations was noted in the placebo group during the experiment period (p>0.10).
Comparing the differences between apple-shaped and pear-shaped in treatment groups, the percent reduction of WC in the apple-shaped males was slightly significant at p<0.10 more than the ones in pear-shaped males after ingestion of test formula for 8 weeks and significantly at p<0.05 for 12 weeks. The percent reduction of WHR in the apple-shaped males was significant at p<0.05 more than the ones in pear-shaped males after ingestion of test formula for 8 weeks and 12 weeks. However, all the other evaluation indicators were not different (p>0.10) between apple-shaped and pear-shaped males. Between apple-shaped and pear-shaped female subjects, the percent reduction of trunk fat in the apple-shaped ones was slightly more than in the pear-shaped ones (p<0.10) after ingestion of test formula for 12 weeks. However, all the other evaluation indicators showed no difference between apple-shaped and pear-shaped females (p>0.10).
After ingestion of test formula for 12 weeks, the results of correlation between weight change and visceral fat change in treatment groups showed that the more weight loss, the more visceral fat loss in both pear-shaped and apple-shaped males (p<0.01). The results also showed that the weight loss in male subjects was mainly due to the reduction of visceral fat (p<0.001) comparing with subcutaneous fat loss. However, this phenomenon was not significant in female subjects (p>0.10).
In conclusion, ingestion of the test formula was significantly effective on reducing body fat and anthropometry measurements in this study. However, this effect between the apple-shaped and pear-shaped subjects was relatively more significantly in males than females.
目 錄
摘 要 I
Abstract IV
致 謝 VIII
目 錄 IX
圖 目 錄 XII
表 目 錄 XIII
附 錄 目 錄 XV
第一章 前言 1
第二章 文獻回顧 3
2.1 脂肪 3
2.1.1 脂肪的發育與形成 3
2.1.2 脂肪的增長 4
2.1.3 脂肪的分類及其功能 5
2.2 肥胖 7
2.2.1 肥胖的成因 7
2.2.2 肥胖的定義 8
2.2.3 肥胖與疾病 17
2.3 代謝症候群 18
2.3.1 代謝症候群之發展 18
2.3.2 代謝症候群之定義 18
2.3.3 代謝症候群之病因及致病機轉 22
2.4 食材介紹 30
2.4.1 洛神花 30
2.4.2 綠藻 31
2.4.3 苦瓜 32
第三章 研究目的 34
第四章 材料與方法 35
4.1 受試者 35
4.2 實驗食材 35
4.3 實驗用儀器設備 36
4.4 實驗設計 36
4.5 檢測方法 38
4.6 統計分析 50
第五章 結果 51
5.1 實驗對象 51
5.2 各項檢測值結果 52
5.2.1體位測量 52
5.2.2 身體組成測定 58
5.2.2-1 體脂肪測定(Tanita body composition analyzer BC-418型) 58
5.2.2-2 內臟脂肪、軀幹脂肪(Tanita AB-140M ViScan) 67
5.2.2-3 皮下脂肪測定 70
5.3試驗組受試者體重變化與內臟脂肪變化之相關性結果 80
5.4 配方食品對於內臟脂肪、皮下脂肪的影響 81
第六章 討論 111
6.1 體位、體脂肪的比較 111
6.1.1 蘋果型、梨形之間的比較 111
6.1.2 不同性別之間的比較 111
6.2配方食品對體位變化的影響 112
6.3 配方食品對身體脂肪變化的影響 113
6.4體重減少與內臟脂肪減少相關性之探討 117
6.5 配方食品對於內臟脂肪、皮下脂肪的影響 118
第七章 結論 120
第八章 參考文獻 121
附 錄 137

圖 目 錄
圖2.1.1、脂肪細胞分化作用途徑 3
圖2.1.2、脂肪組織的擴大─數目增加和體積增加 4
圖2.2.2-1、身體質量指數與死亡率的相關性 9
圖2.2.2-2、腰臀比與死亡率之相關性 12
圖2.2.2-3、腰臀比與各疾病之間的相關性 12
圖2.2.2-4、各年齡層男女之腰臀比百分比 13
圖2.2.2-5、白人男孩和女孩的身體脂肪百分位數曲線圖 15
圖2.2.2-6、成人體脂肪率建議值 16
圖2.3.3-1、肥胖引起胰島素阻抗之成因 23
圖2.3.3-2、β細胞分泌胰島素之機制 24
圖2.3.3-3、骨骼肌中過多的游離脂肪酸導致胰島素阻抗之作用機制 26
圖2.3.3-4、過多游離脂肪酸引起發炎反應及胰島素阻抗之機制 28
圖4.4、實驗流程 37
圖4.5.1、腰圍測量方法 38
圖4.5.2.1、體脂肪測定 39
圖4.5.2.2、內臟脂肪級數、軀幹脂肪百分比測定 41
圖4.5.2.3-1、上臂圍、肱三頭肌皮脂厚度測定方式 43
圖4.5.2.3-2、腕圍測定方式 44
圖4.5.2.3-3、肩胛骨皮脂厚度測定方式 45
圖4.5.2.3-4、腸骨頂皮脂厚度測定方式 46
圖4.5.2.3-5、腹部皮脂厚度測定方式 47
圖4.5.2.3-6、大腿圍、大腿股前方皮脂厚度測定方式 48
圖4.5.2.3-7、小腿圍、小腿內側皮脂厚度測定方式 49

表 目 錄
表2.2.2-1、肥胖定義 9
表2.2.2-2、亞洲成人於不同程度之BMI及腰圍其發生併發症之風險 10
表2.2.2-3、各國腹部肥胖定義 11
表2.2.2-4、腰臀比與健康 13
表2.2.2-5、國人體脂肪─依性別、年齡比較(1993-1996 台灣營養健康調查) 15
表2.2.2-6、體脂肪率之建議值 16
表2.2.3、與肥胖有關的健康風險 17
表2.3.2、各組織之代謝症候群診斷標準 21
表5.1.1、各組受試者之代號 82
表5.1.2-1、男性受試者之基本資料 83
表5.1.2-2、女性受試者之基本資料 84
表5.2.1-1、男性受試者於實驗期間自體比較體重及身體質量指數之變化 85
表5.2.1-2、男性受試者於實驗期間自體比較腰圍、臀圍及腰臀比之變化 86
表5.2.1-3、女性受試者於實驗期間自體比較體重及身體質量指數之變化 87
表5.2.1-4、女性受試者於實驗期間自體比較腰圍、臀圍及腰臀比之變化 88
表5.2.1-5、試驗組於實驗期間之體位測量變化百分比 89
表5.2.2.1-1、以立式體脂儀所測男性受試者於實驗期間自體比較總體脂肪及內臟 脂肪之變化 90
表5.2.2.1-2、以立式體脂儀所測男性受試者於實驗期間自體比較右腿脂肪及左腿 脂肪之變化 91
表5.2.2.1-3、以立式體脂儀所測男性受試者於實驗期間自體比較右手脂肪、左手 脂肪及軀幹脂肪之變化 92
表5.2.2.1-4、以立式體脂儀所測女性受試者於實驗期間自體比較總體脂肪及內臟 脂肪之變化 93
表5.2.2.1-5、以立式體脂儀所測女性受試者於實驗期間自體比較右腿脂肪及左腿 脂肪之變化 94
表5.2.2.1-6、以立式體脂儀所測女性受試者於實驗期間自體比較右手脂肪、左手 脂肪及軀幹脂肪之變化 95
表5.2.2.1-7、以立式體脂儀所測試驗組於實驗期間各部位之脂肪含量變化百分比 96
表5.2.2.2-1、以臥式腹部脂肪分析儀所測男性受試者於實驗期間自體比較內臟脂 肪及軀幹脂肪之變化 97
表5.2.2.2-2、以臥式腹部脂肪分析儀所測女性受試者於實驗期間自體比較內臟脂 肪及軀幹脂肪之變化 98
表5.2.2.2-3、以臥式腹部脂肪分析儀所測試驗組於實驗期間內臟脂肪及軀幹脂肪 變化百分比 99
表5.2.2.3-1、男性受試者於實驗期間自體比較上臂圍、肱三頭肌皮脂厚度及腕圍 之變化 100
表5.2.2.3-2、男性受試者於實驗期間自體比較肩胛骨皮脂厚度、腸骨頂皮脂厚度 及腹部皮脂厚度之變化 101
表5.2.2.3-3、男性受試者於實驗期間自體比較大腿圍及大腿股前方皮脂厚度之變化 102
表5.2.2.3-4、男性受試者於實驗期間自體比較小腿圍及小腿內側皮脂厚度之變化 103
表5.2.2.3-5、女性受試者於實驗期間自體比較上臂圍、肱三頭肌皮脂厚度及腕圍 之變化 104
表5.2.2.3-6、女性受試者於實驗期間自體比較肩胛骨皮脂厚度、腸骨頂皮脂厚度 及腹部皮脂厚度之變化 105
表5.2.2.3-7、女性受試者於實驗期間自體比較大腿圍及大腿股前方皮脂厚度之變化 106
表5.2.2.3-8、女性受試者於實驗期間自體比較小腿圍及小腿內側皮脂厚度之變化 107
表5.2.2.3-9、試驗組於實驗期間各部位之皮脂厚度變化百分比 108
表5.3、試驗組受試者體重變化與內臟脂肪變化之相關性分析 109
表5.4.1、配方食品對於男性受試者脂肪減少部位影響之逐步迴歸分析摘要表 110
表5.4.2、配方食品對於女性受試者脂肪減少部位影響之逐步迴歸分析摘要表 110

附 錄 目 錄
人體試驗審查通過證書 137
附圖5.2.1-1、男性受試者於實驗期間體重及身體質量指數之變化 138
附圖5.2.1-2、男性受試者於實驗期間腰圍及腰臀比之變化 139
附圖5.2.1-3、女性受試者於實驗期間體重及身體質量指數之變化 140
附圖5.2.1-4、女性受試者於實驗期間腰圍及腰臀比之變化 141
附圖5.2.2.1-1、以立式體脂儀所測男性受試者於實驗期間總體脂肪及內臟脂肪 之變化 142
附圖5.2.2.1-4、以立式體脂儀所測女性受試者於實驗期間總體脂肪及內臟脂肪 之變化 143
附圖5.2.2.2-1、以臥式腹部脂肪分析儀所測男性受試者於實驗期間內臟脂肪之 變化 144
附圖5.2.2.2-2、以臥式腹部脂肪分析儀所測女性受試者於實驗期間內臟脂肪之 變化 145
附圖5.3、試驗組受試者體重變化與內臟脂肪變化之相關性分析 146
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