臺灣博碩士論文加值系統

背景與目的：根據國家統計結果發現近年來十大死因以慢性疾病為主，慢性疾病的產生則與老化、身體不活躍、肥胖和體內長期低程度的慢性發炎有關係。慢性疾病除了危害國人的身體健康與生活品質之外，也成為國家醫療上的負擔。然而，有研究指出適度的運動能夠提升身體的免疫機制，可能對慢性發炎反應有正面的效果。因此本研究探討六週規律阻力運動訓練介入對於坐式生活族群體內慢性發炎反應之影響。方法：本研究採用隨機實驗設計，分為運動組與控制組，總共為期10週。所有受測者必須完成3次血液樣本採集，分別於第0週、第4週以及第10週。運動組在第4週完成樣本採集後，開始進行6週的阻力運動訓練，訓練頻率為每週2次，強度為50 % 的最大肌力值，反覆次數為10至12下，總共執行兩回合阻力訓練。控制組則在第4週完成樣本採集後，維持原本的生活型態。結果從血球變化量來看，白血球、淋巴球、嗜中性球在各組與各時間點上無顯著變化。細胞激素變化率C-反應蛋白、腫瘤壞死因子-α、介白素-1β、介白素-6在各組與各時間點上無顯著變化。血液生化分析值阻力組訓練後高密度脂蛋白膽固醇有顯著增加，而三酸甘油酯、葡萄糖、總膽固醇都沒有顯著變化。結論：六週規律的阻力運動訓練介入，無明顯改變血漿中白血球、嗜中性球、淋巴球的數量；血漿中促發炎因子CRP與TNF-α、IL-6、IL-1β濃度皆無顯著變化；而血漿高密度脂蛋白膽固醇濃度有顯著增加 ( P< 0.05 ) 。

Background & Purpose: Top ten leading causes of death in Taiwan 2016 were mainly chronic diseases, which associated with aging, physical inactivity, obesity, and low-grade systemic inflammation. Chronic diseases affect people’s health and quality of life, also increase national medical expenses. However, many studies indicated that moderate exercise might improve immune system. It may positively influence effect on chronic inflammation. Therefore, this study was aimed to investigate the effect of six-week regular resistance exercise training on chronic inflammation in sedentary population. Methods: a randomized experimental design with the subjects divided into exercise and the control group. With a total of 10 weeks, participants completed blood sample collection three times in week 0, week 4 and week 10 respectively. After the second sampling at week 4, exercise group started 6-week resistance exercise training twice a week. The intensity of exercise was 50% of 1RM with 10-12 repetitions, a total of 2 sets. Control group remained normal lifestyle. Results: the white blood cells, lymphocytes, neutrophils had no significant changes in each group at different time span. Change rate of cytokines was not significant among CRP, TNF-α, IL-1β, IL-6 in each group at different time span. Blood biochemistry after the resistance training showed a significant increase in high-density lipoprotein cholesterol, and triglycerides. However, glucose, total cholesterol did not change significantly. Conclusion: After 6 weeks regular resistance exercise training, although there was no significant effect on chronic inflammatory responses and the associated cytokines, including CRP, TNF-α, IL-1β, IL-6, the concentration of plasma high density lipoprotein cholesterol significantly increased.

中文摘要 i
ABSTRACT ii
目次 iii
表目次 v
圖目次 vi
第一章 緒論 1
第一節 研究背景 1
第二節 研究目的 2
第三節 重要名詞解釋 2
一、 細胞激素 ( Cytokine ) 2
二、 C-反應蛋白 3
三、 代謝症候群 ( Metabolic Syndrome ) 4
第二章 文獻探討 6
第一節 慢性發炎反應與疾病的關係 6
第二節 運動與免疫反應 7
一、 身體活動度與免疫反應 7
二、 運動對免疫功能急性與慢性反應影響 7
三、 阻力運動訓練與低程度發炎反應 8
第三節 總結 9
第三章 研究方法與步驟 10
第一節 實驗對象 10
第二節 實驗設計與流程 10
一、 實驗流程 10
二、 阻力運動訓練方式 11
第三節 血液樣本採集與生化分析 11
一、 血液樣本採集 11
二、 血液生化分析 12
第四節 血漿中細胞激素分析 13
第五節 統計分析 14
第四章 結果 15
第一節 受測者基本資料 15
第二節 阻力運動訓練對血球之影響 15
第三節 阻力運動訓練對CRP之影響 16
第四節 阻力運動訓練對促發炎細胞激素之影響 16
第五節 阻力運動訓練對血液生化值之影響 17
第五章 討論 18
第一節 阻力運動訓練對血球的影響 18
第二節 阻力運動訓練對促發炎反應細胞因子的影響 19
第三節 阻力運動訓練對血液生化值的影響 20
第六章 結論 21
參考文獻 22

行政院衛生福利部統計處。(2015)。103年國人死因統計結果。行政院衛生福利部。台北市。
行政院衛生福利部中央健康保險署。(2015)。103年各年齡層藥費及醫療費用分布情形。行政院衛生福利部。台北市。
王雯靜, 方世華, 洪千惠, 湯智昕, 賴怡琪, & 賴志河. (2007). 免疫學, 第二版.
毛祚彥, & 林貴福. (2007). 身體活動量, 體適能水準與代謝徵候群的關係. 中華體育季刊, 21(2), 33-41.
劉宏文, & 徐孟達. (2006). 運動後恢復期白血球數目變化之初探. 中華體育季刊, 20(2), 1-9.
Abramson, J. L., & Vaccarino, V. (2002). Relationship between physical activity and inflammation among apparently healthy middle-aged and older US adults. Archives of Internal Medicine, 162(11), 1286-1292.
Alexander, W. S. (2002). Suppressors of cytokine signalling (SOCS) in the immune system. Nature Reviews Immunology, 2(6), 410-416.
Akira, S. (1992). IL‐6 and NF‐IL6 in acute‐phase response and viral infection. Immunological Reviews, 127(1), 25-50.
Akira, S., Taga, T., & Kishimoto, T. (1993). Interleukin-6 in biology and medicine. Advances in Immunology, 54, 1-78.
Ahonen, T. M., Saltevo, J. T., Kautiainen, H. J., Kumpusalo, E. A., & Vanhala, M. J. (2012). The association of adiponectin and low-grade inflammation with the course of metabolic syndrome. Nutrition, Metabolism and Cardiovascular Diseases, 22(3), 285-291.
Aggarwal, B. B., Shishodia, S., Sandur, S. K., Pandey, M. K., & Sethi, G. (2006). Inflammation and cancer: how hot is the link?. Biochemical Pharmacology, 72(11), 1605-1621.
Asker Jeukendrup and Michael Gleeson (2010)"An Introduction to Energy Production and Performance." Sport Nutrition-2nd Edition.
Assmann, G., & Schulte, H. (1992). Relation of high-density lipoprotein cholesterol and triglycerides to incidence of atherosclerotic coronary artery disease (the PROCAM experience). The American Journal of Cardiology, 70(7), 733-737.
Blannin, A. K., Chatwin, L. J., Cave, R., & Gleeson, M. (1996). Effects of submaximal cycling and long-term endurance training on neutrophil phagocytic activity in middle aged men. British Journal of Sports Medicine, 30(2), 125-129.
Beavers, K. M., Brinkley, T. E., & Nicklas, B. J. (2010). Effect of exercise training on chronic inflammation. Clinica Chimica Acta, 411(11), 785-793.
Blair, S. N., Cheng, Y., & Holder, J. S. (2001). Is physical activity or physical fitness more important in defining health benefits?. Medicine and Science in Sports and Exercise, 33(6; SUPP), S379-S399.
Bruunsgaard, H., Galbo, H., Halkjaer-Kristensen, J., Johansen, T. L., MacLean, D. A., & Pedersen, B. K. (1997). Exercise-induced increase in serum interleukin-6 in humans is related to muscle damage. The Journal of Physiology, 499(Pt 3), 833.
Barzilay, J. I., Abraham, L., Heckbert, S. R., Cushman, M., Kuller, L. H., Resnick, H. E., & Tracy, R. P. (2001). The relation of markers of inflammation to the development of glucose disorders in the elderly the Cardiovascular Health Study. Diabetes, 50(10), 2384-2389.
Bastard, J. P., Maachi, M., Lagathu, C., Kim, M. J., Caron, M., Vidal, H., ... & Feve, B. (2006). Recent advances in the relationship between obesity, inflammation, and insulin resistance. European Cytokine Network, 17(1), 4-12.
Calle, M. C., & Fernandez, M. L. (2010). Effects of resistance training on the inflammatory response. Nutrition Research and Practice, 4(4), 259-269.
Cannon, J. G., & Pierre, B. A. S. (1998). Cytokines in exertion-induced skeletal muscle injury. Molecular and Cellular Biochemistry, 179(1-2), 159-168.
Dinarello, C. A. (2005). Interleukin-1β. Critical Care Medicine, 33(12), S460-S462.
Duncan, B. B., Schmidt, M. I., Pankow, J. S., Ballantyne, C. M., Couper, D., Vigo, A., ... & Heiss, G. (2003). Low-grade systemic inflammation and the development of type 2 diabetes the atherosclerosis risk in communities study. Diabetes, 52(7), 1799-1805.
Flynn, M. G., Fahlman, M., Braun, W. A., Lambert, C. P., Bouillon, L. E., Brolinson, P. G., & Armstrong, C. W. (1999). Effects of resistance training on selected indexes of immune function in elderly women. Journal of Applied Physiology, 86(6), 1905-1913.
Freeman, D. J., Norrie, J., Caslake, M. J., Gaw, A., Ford, I., Lowe, G. D., ... & Sattar, N. (2002). C-reactive protein is an independent predictor of risk for the development of diabetes in the West of Scotland Coronary Prevention Study. Diabetes, 51(5), 1596-1600.
Feingold, K. R., & Grunfeld, C. (1992). Role of cytokines in inducing hyperlipidemia. Diabetes, 41(Supplement 2), 97-101.
Goldfine, H., Ward, A., Taylor, P., Carlucci, D., & Rippe, J. M. (1991). Exercising to health: What''s really in it for your patients?. The Physician and Sportsmedicine, 19(6), 80-93.
Gibala, M. J., Interisano, S. A., Tarnopolsky, M. A., Roy, B. D., MacDonald, J. R., Yarasheski, K. E., & MacDougall, J. D. (2000). Myofibrillar disruption following acute concentric and eccentric resistance exercise in strength-trained men. Canadian Journal of Physiology and Pharmacology, 78(8), 656-661.
Gleeson, M. (2007). Immune function in sport and exercise. Journal of Applied Physiology, 103(2), 693-699.
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.
Heffernan, K. S., Sosnoff, J. J., Fahs, C. A., Shinsako, K. K., Jae, S. Y., & Fernhall, B. (2008). Fractal scaling properties of heart rate dynamics following resistance exercise training. Journal of Applied Physiology, 105(1), 109-113.
Hotamisligil, G. S. (2006). Inflammation and metabolic disorders. Nature, 444(7121), 860-867.
Hirose, L., Nosaka, K., Newton, M., Laveder, A., Kano, M., Peake, J., & Suzuki, K. (2004). Changes in inflammatory mediators following eccentric exercise of the elbow flexors. Exerc Immunol Rev, 10(75-90), 20.
Halbert, J. A., Silagy, C. A., Finucane, P., Withers, R. T., & Hamdorf, P. A. (1999). Exercise training and blood lipids in hyperlipidemic and normolipidemic adults: a meta-analysis of randomized, controlled trials. European Journal of Clinical Nutrition, 53(7), 514-522.
Izquierdo, M., Ibañez, J., Calbet, J. A., Navarro-Amezqueta, I., González-Izal, M., Idoate, F., ... & Gorostiaga, E. M. (2009). Cytokine and hormone responses to resistance training. European Journal of Applied Physiology, 107(4), 397-409.
Kadoglou, N. P., Iliadis, F., Angelopoulou, N., Perrea, D., Ampatzidis, G., Liapis, C. D., & Alevizos, M. (2007). The anti-inflammatory effects of exercise training in patients with type 2 diabetes mellitus. European Journal of Cardiovascular Prevention & Rehabilitation, 14(6), 837-843.
Koerner, A., Kratzsch, J., & Kiess, W. (2005). Adipocytokines: leptin—the classical, resistin—the controversical, adiponectin—the promising, and more to come. Best Practice & Research Clinical Endocrinology & Metabolism, 19(4), 525-546.
Keast, D., Cameron, K., & Morton, A. R. (1988). Exercise and the immune response. Sports Medicine, 5(4), 248-267.
Lanham-New, S. A., Stear, S., Shirreffs, S., & Collins, A. (Eds.). (2011). Sport and Exercise Nutrition (Vol. 8).
Levinger, I., Goodman, C., Peake, J., Garnham, A., Hare, D. L., Jerums, G., & Selig, S. (2009). Inflammation, hepatic enzymes and resistance training in individuals with metabolic risk factors. Diabetic Medicine, 26(3), 220-227.
McCarthy, D. A., & Dale, M. M. (1988). The leucocytosis of exercise. Sports Medicine, 6(6), 333-363.
Mathur, N., & Pedersen, B. K. (2009). Exercise as a mean to control low-grade systemic inflammation. Mediators of Inflammation, 2008.
Mishima, Y., Kuyama, A., Tada, A., Takahashi, K., Ishioka, T., & Kibata, M. (2001). Relationship between serum tumor necrosis factor-α and insulin resistance in obese men with Type 2 diabetes mellitus. Diabetes Research and Clinical Practice, 52(2), 119-123.
Medzhitov, R., & Janeway, C. A. (1997). Innate immunity: the virtues of a nonclonal system of recognition. Cell, 91(3), 295-298.
Nash, M. S., Jacobs, P. L., Mendez, A. J., & Goldberg, R. B. (2000). Circuit resistance training improves the atherogenic lipid profiles of persons with chronic paraplegia. The Journal of Spinal Cord Medicine, 24(1), 2-9.
Nieman, D. C., Johanssen, L. M., Lee, J. W., & Arabatzis, K. (1990). Infectious episodes in runners before and after the Los Angeles Marathon. J Sports Med Phys Fitness, 30(3), 316-328.
Nieman, D. C. (1994). Exercise, upper respiratory tract infection, and the immune system. Medicine and Science in Sports and Exercise, 26(2), 128-139.
Nieman, D. C. (1995). Upper respiratory tract infections and exercise. Thorax, 50(12), 1229-1231.
Olson, T. P., Dengel, D. R., Leon, A. S., & Schmitz, K. H. (2007). Changes in inflammatory biomarkers following one-year of moderate resistance training in overweight women. International Journal of Obesity, 31(6), 996-1003.
O''Donovan, G., Owen, A., Bird, S. R., Kearney, E. M., Nevill, A. M., Jones, D. W., & Woolf-May, K. (2005). Changes in cardiorespiratory fitness and coronary heart disease risk factors following 24 wk of moderate-or high-intensity exercise of equal energy cost. Journal of Applied Physiology, 98(5), 1619-1625.
Peake, J., Nosaka, K. K., Muthalib, M., & Suzuki, K. (2006). Systemic inflammatory responses to maximal versus submaximal lengthening contractions of the elbow flexors. Exercise Immunology Review, 12, 72 - 85
Peters, E. M., & Bateman, E. D. (1983). Ultramarathon running and upper respiratory tract infections. S Afr Med J, 64(15), 582-4.
Pedersen, B. K., Steensberg, A., Fischer, C., Keller, C., Ostrowski, K., & Schjerling, P. (2001). Exercise and cytokines with particular focus on muscle derived IL-6. Exercise Immunology Review, 7, 18-31.
Pedersen, B. K., Steensberg, A., Fischer, C., Keller, C., Keller, P., Plomgaard, P., ... & Saltin, B. (2003). Searching for the exercise factor: is IL-6 a candidate?. Journal of Muscle Research & Cell Motility, 24(2-3), 113-119.
Petersen, A. M. W., & Pedersen, B. K. (2005). The anti-inflammatory effect of exercise. Journal of Applied Physiology, 98(4), 1154-1162.
Pitsavos, C., Panagiotakos, D. B., Chrysohoou, C., Kavouras, S., & Stefanadis, C. (2005). The associations between physical activity, inflammation, and coagulation markers, in people with metabolic syndrome: the ATTICA study. European Journal of Cardiovascular Prevention & Rehabilitation, 12(2), 151-158.
Rall, L. C., Roubenoff, R. O. N. E. N. N., Cannon, J. G., Abad, L. W., Dinarello, C. A., & Meydani, S. N. (1996). Effects of progressive resistance training on immune response in aging and chronic inflammation. Medicine and Science in Sports and Exercise, 28(11), 1356-1365.
Ross, R. (1999). Atherosclerosis—an inflammatory disease. New England Journal of Medicine, 340(2), 115-126.
Ridker, P. M., Rifai, N., Rose, L., Buring, J. E., & Cook, N. R. (2002). Comparison of C-reactive protein and low-density lipoprotein cholesterol levels in the prediction of first cardiovascular events. New England Journal of Medicine, 347(20), 1557-1565.
Stewart, L. K., Flynn, M. G., Campbell, W. W., Craig, B. A., Robinson, J. P., Timmerman, K. L., ... & Talbert, E. (2007). The influence of exercise training on inflammatory cytokines and C-reactive protein. Medicine and Science in Sports and Exercise, 39(10), 1714.
Saghizadeh, M., Ong, J. M., Garvey, W. T., Henry, R. R., & Kern, P. A. (1996). The expression of TNF alpha by human muscle. Relationship to insulin resistance. Journal of Clinical Investigation, 97(4), 1111.
Swardfager, W., Lanctôt, K., Rothenburg, L., Wong, A., Cappell, J., & Herrmann, N. (2010). A meta-analysis of cytokines in Alzheimer''s disease. Biological Psychiatry, 68(10), 930-941.
Stouthard, J. M. L., Elferink, R. O., & Sauerwein, H. P. (1996). Interleukin-6 enhances glucose transport in 3T3-L1 adipocytes. Biochemical and Biophysical Research Communications, 220(2), 241-245.
Steensberg, A., Hall, G., Osada, T., Sacchetti, M., Saltin, B., & Pedersen, B. K. (2000). Production of interleukin‐6 in contracting human skeletal muscles can account for the exercise‐induced increase in plasma interleukin‐6. The Journal of Physiology, 529(1), 237-242.
Winkler, G., Salamon, F., Harmos, G., Salamon, D., Speer, G., Szekeres, O., ... & Cseh, K. (1998). Elevated serum tumor necrosis factor-alpha concentrations and bioactivity in Type 2 diabetics and patients with android type obesity. Diabetes Research and Clinical Practice, 42(3), 169-174.