臺灣博碩士論文加值系統

主題一、台灣婦女FADS基因多型性與二十二碳六烯酸（DHA）攝取對母乳中DHA比例的影響（學校端 國際期刊）
本研究的目標是確立台灣婦女體內FADS（Fatty acid desaturase）基因變異和飲食攝取如何影響母乳中二十二碳六烯酸（Docosahexaenoic acid；DHA）的比例。受試者選入標準包括：健康、20至40歲、足月產、有計畫要哺餵母乳一個月以及有計畫參與本研究的婦女。透過食物頻率問卷評估DHA的攝入量，並在產後3至4週期間收集母乳樣品並分析脂肪酸。
依據完成本研究的164位母親的數據進行多元線性迴歸分析（Multiple linear regression），高遺傳風險相較於低遺傳風險婦女（按rs1535和rs174448中的次要等位基因總數目是否  3來分層）其母乳DHA降低了0.28%（FA%）；高DHA攝取量相較低DHA攝取量（DHA攝入量是否達到200 mg / d進行分層）其母乳升高0.45%。
基因與飲食之間存在顯著的交互作用關係，低遺傳風險的母親，若有較高的DHA攝入量，便會有較高的母乳DHA比例，但對於具有高遺傳風險的母親，飲食的效果十分有限。因此，對於台灣婦女的FADS單核苷酸多型性，增加高DHA攝取量將無法改變高遺傳風險基因型女性中低的DHA比例，飲食的效果只對低遺傳風險基因型的人有益處。本試驗已於2019年2月12日於ClinicalTrials.gov完成回顧性註冊（No.NCT03842891,https://clinicaltrials.gov/ct2/show/NCT03842891）。

主題二 開發孕產婦基因檢測與個人化飲食規劃之精準營養學應用平台（企業端 營運企劃書）
高齡孕婦在現代社會中越來越常見，在台灣每三位懷孕婦女就有兩位年齡達30歲以上，其中高齡孕婦更容易有妊娠糖尿病、高血壓和早產等健康風險，然而，這些疾病往往與基因息息相關，例如：影響長鏈脂肪酸代謝的FADS（Fatty acid desaturase）基因。根據每個人的基因差異，營養素的需要量也有所不同，目前市面上的基因檢測產品或公司，僅提供消費者檢測的結果，缺乏更進一步的個人化營養建議，使消費者檢測完後無所適從。
本計畫專為高齡孕婦設計營養基因檢測晶片，並結合團隊營養師的專業知識，給予孕婦適合的營養衛教，幫助胎兒生長發育，此外，也能依據消費者的需求提供適合的個人化營養懷孕餐點。

Topic 1
The objective of the current study was to determine how docosahexaenoic acid（DHA）proportions in human milk are modulated by maternal FADS gene variants and dietary intake in Taiwanese women. The inclusion criteria for the study subjects included being healthy, 20–40 y old, having had a full-term baby that they intended to breast feed for at least one month, and willingness to participate in this study. The intake of DHA was assessed by a food frequency questionnaire and fatty acids content was analyzed in human milk samples collected 3–4 weeks postpartum.
Based on multiple linear regression of data from 164 mothers that completed this study, there was a 0.28%（FA%）reduction in milk DHA in high versus low genetic risk（stratified by whether minor allele numbers were  3 in rs1535 and rs174448）and 0.45% reduction in low versus high intake（stratified by whether DHA intake reached 200 mg/d）.
There was a significant gene-diet interaction; the mothers with low genetic risk and high DHA intake had high milk DHA proportions, whereas dietary effects became quite limited for mothers with high genetic risk. These results indicate that for FADS single nucleotide polymorphism in Taiwanese women, increasing DHA intake did not correct low milk DHA proportions in those with a high-risk genotype. Diet only conferred benefits to those with a low-risk genotype. Trial registration: This trial was retrospectively registered（Feb 12, 2019）in ClinicalTrials.gov（No. NCT03842891, https://clinicaltrials.gov/ ct2/show/NCT03842891）

Topic 2
In modern society, elderly pregnant women have become more common. Two-thirds of pregnant women in Taiwan are over the age of 30. Among them, AMA（advanced maternal age）are more likely to have health risks such as gestational diabetes, high blood pressure, and premature birth. In addition, these diseases are often associated with genes related to fatty acid metabolism, for example, the FADS gene. The genetic difference will affect the nutrient required. Currently, the genetic screening products on the market only provide the test results of consumers and lack further personalized nutritional advice.
Therefore, the current program was designed to provide pregnant women of advanced age the nutritional, genetic testing chips, followed by nutritional consulting with a dietitian team, to ensure the average growth and development of the fetus. Ultimately, the program can also provide personalized nutrition meals to meet different pregnancy needs.

論文口試委員審定書 I
無違反學術倫理聲明書 II
誌謝 III
中文摘要 V
Abstract VII
目錄 IX
表目錄 XIV
圖目錄 XV
縮寫對照表 XVII
主題一、台灣婦女FADS基因多型性與二十二碳六烯酸（DHA）攝取對母乳中DHA比例的影響（學校端 國際期刊） 1
第一章 文獻回顧 1
第一節 母乳 1
一、 何謂母乳 1
二、 母乳的脂肪酸組成 2
三、 母乳哺育之功效研究 3
1. 胃腸功能 3
2. 預防疾病感染 4
3. 死亡率與住院率 4
4. 神經系統發育相關功效 5
四、 母乳哺育的政策 5
第二節 二十二碳六烯酸 7
一、 關於二十二碳六烯酸（Docosahexaenoic acid；DHA） 7
二、 DHA之功效研究 8
1. DHA對神經發育的影響 9
2. DHA有助於降低早產發生率 10
3. DHA有助於減少過敏和相關疾病 11
4. DHA有助於降低高血壓風險 12
5. DHA有助於降低血漿TG與BMI 12
三、 母乳中DHA含量 13
四、 飲食來源的DHA 14
1. 何謂坐月子 14
2. 各種不同食物的DHA含量 16
五、 內源性生合成的DHA 20
第三節 FADS基因多型性 22
一、 何謂FADS 22
二、 FADS 單核苷酸多型性對LCPUFA的影響 23
第二章 研究目的 25
第三章 材料與方法 26
第一節 研究設計 26
一、 研究流程 26
二、 受試者招募 27
第二節 研究工具與收集過程 29
一、 飲食頻率問卷 29
二、 母乳收集 31
三、 母乳脂肪酸甲基酯化 31
四、 脂肪酸組成分析 32
五、 口腔黏膜採集與DNA萃取 34
六、 FADS單核苷酸多型性之挑選 36
七、 SNP基因分型 36
第三節 資料統計與分析方法 41
第四章 研究結果 42
第一節 受試者特徵 42
第二節 SNP基因分型實驗分析 44
第三節 SNP基因型與母乳脂肪酸組成相關性 45
第四節 基因-飲食交互作用與母乳DHA比例相關性 48
第五章 討論 50
第六章 結論與建議 56
第一節 結論 56
第二節 研究限制 57
第三節 應用與建議 58
第七章 附錄 59
第八章 參考文獻 98
主題二 開發孕產婦基因檢測與個人化飲食規劃之精準營養學應用平台（企業端 營運企劃書） 120
第九章 緒論 120
第一節 營運背景 120
第二節 營運動機與目的 121
第十章 營運方法 122
第一節 產品與服務內容 122
第十一章 營運結果與產品 124
第一節 基因檢測對應懷孕高風險疾病與餐點 124
第二節 營運模式 127
一、 產品服務流程說明 127
1. 基因檢測 127
2. 基因諮詢 127
3. 個人化餐點和建議 128
第三節 營收模式 129
一、 自售（B2C） 129
二、 代售（B2B2C） 130
第十二章 討論 131
第一節 市場分析 131
一、 市場特性與規模 131
1. 目標市場特性及觀察 131
2. 市場規模 133
二、 目標市場 134
1. 市場區隔 134
2. 市場定位 135
第二節 競爭對手與競爭策略分析 136
一、 競爭對手比較 136
二、 與競品之差異性 137
第三節 行銷策略 138
一、 目標消費族群 138
二、 行銷策略 139
1. 公司營運目標 139
2. 行銷4P 139
第四節 財務規劃 141
一、 銷售預估 141
二、 預估損益表 141
第十三章 結論與限制 143
第一節 結論 143
第二節 潛在風險與限制 143
第十四章 附錄 144

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