臺灣博碩士論文加值系統

近年來肥胖患者有日益增加的趨勢，且國人十大死因中罹患慢性疾病佔居為主要型態，然而體內堆積過多的皮下脂肪與內臟組織，其造成罹患代謝性疾病之風險提高，以致慢性代謝疾病危害國人的健康程度更加被重視。
本研究使用腹部電腦斷層掃描分析60名受試者影像，使用手動圈選位於第三腰椎、小腸、肝臟、腸骨棘與骨盆之軸向切面影像，測量皮下脂肪面積與內臟脂肪面積以得到內臟脂肪與皮下脂肪組織面積比。使用SPSS 22.0進行統計分析並評估與肥胖併發症之空腹血糖、腰圍、高密度膽固醇、收縮壓及三酸甘油脂等生理檢查結果之相關性。
結果顯示，可利用電腦斷層影像評估腹部第三腰椎切面以及在女性小腸、腸骨棘與骨盆切面之內臟脂肪面積及內臟脂肪與皮下脂肪組織面積比與肥胖併發症之代謝危險因子具有顯著差異性(p<0.01)。上腹部進行測量與分析時其所獲得之脂肪面積與肥胖併發症之代謝危險因子關聯性明顯高於下腹部脂肪面積具有較顯著相關性。

In recent years, there has been an increasing trend of obesity patients, and chronic diseases are the main cause of death among Chinese people. However, excessive accumulation of subcutaneous fat and visceral tissues in the body increase the risk of developing metabolic diseases,
showing the degree of chronic metabolism which is a disease that endangers the health of the people in our country, we must pay more attention on this.
In this study, the abdominal computed tomography was used to analyze the images of 60 subjects, and manually circled the third lumbar vertebra(L3), small intestine, iliac and pelvis axial section images, in order to measure subcutaneous fat area(SFA) and visceral fat area(VFA) to obtain VSR(the area ratio of visceral fat to subcutaneous fat tissue. SPSS 22.0 was used to perform the statistical analysis and evaluate the correlation between fasting blood glucose(FBG), waist circumference(WC), high-density cholesterol(HDL), systolic blood pressure(SBP) and triglyceride(TG) test results of obesity complications.
The results showed that computed tomography images can be used to evaluate the abdominal L3 view, and the VFA and VSR with liver, small intestine, iliac and pelvis views in female had a significant difference with the metabolic risk factors of obesity complications (p<0.01). When the upper abdomen was measured and analyzed, the correlation between the fat area and the metabolic risk factors of obesity complications was significantly higher than lower abdomen fat area.

目錄
中文摘要 I
ABSTRACT II
目錄 III
圖目錄 VI
表目錄 VII
第一章 前言 1
1.1研究背景 1
1.2研究動機 1
1.3研究目的 2
1.4論文架構 3
第二章 文獻回顧 4
2.1代謝症候群之演進 4
2.1.1代謝症候群之診斷標準 5
2.2肥胖對人體的傷害 8
2.3電腦斷層的應用 9
第三章 材料與方法 11
3.1實驗流程 11
3.2實驗架構 14
3.3實驗設備 14
3.3.1 ImageJ圈選ROI 14
3.3.2 RadiAnt DICOM Viewer影像閱讀器 15
3.3.3統計分析方法 15
3.4實驗方法 16
3.4.1受試者樣本數蒐集與影像收集來源 16
第四章 結果 20
4.1受試者脂肪面積量測 20
4.2代謝性危險因子與代謝症候群之關聯性 20
4.3代謝症候群之不同代謝性危險因子 21
4.4腹部器官之脂肪面積分佈 22
第五章 討論 34
5.1評定代謝症候群的標準是否影響內臟脂肪面積和皮下脂肪面積的關聯 34
5.2影像圈選的變異性 35
5.3檢驗數據收集的完整性 35
5.4脂肪含量與代謝症候群之探討 35
5.5代謝性危險因子之探討 37
第六章 結論 39
第七章 未來展望 40
參考文獻 41
附件一、人體試驗委員會(IRB)證明書 45

圖目錄
圖 一、研究流程 13
圖二、ImageJ之脂肪面積圈選示意圖 14
圖三、RadiAnt DICOM Viewer (64-bit)之器官切面示意圖 15
圖四、第三腰椎 (a)對照器官切面之影像(b)橫切面之內臟脂肪面積(c)腹部內層脂肪面積(d)全腹部脂肪面積 17
圖五、小腸 (a)對照器官切面之影像(b)橫切面之內臟脂肪面積(c)腹部內層脂肪面積(d)全腹部脂肪面積 17
圖六、肝臟 (a)對照器官切面之影像(b)橫切面之內臟脂肪面積(c)腹部內層脂肪面積(d)全腹部脂肪面積 18
圖七、腸骨棘 (a)對照器官切面之影像(b)橫切面之內臟脂肪面積(c)腹部內層脂肪面積(d)全腹部脂肪面積 18
圖八、骨盆 (a)對照器官切面之影像(b)橫切面之內臟脂肪面積(c)腹部內層脂肪面積(d)全腹部脂肪面積 19
圖九、性別比較之脂肪面積分佈(a)內臟脂肪面積分佈(b)皮下脂肪面積分佈 23

表目錄
表一、受試者的分層特徵 24
表二、受試者依據性別的分層特徵 25
表三、性別在代謝症候群的受試者之間的代謝性危險因子進行比較 26
表四、代謝性危險因子與代謝症候群的差異性 27
表五、性別在代謝性危險因子與代謝症候群的差異性 28
表六、第三腰椎脂肪含量與代謝症候群的差異性 29
表七、性別在第三腰椎脂肪含量與代謝症候群的差異性 29
表八、小腸脂肪含量與代謝症候群的差異性 30
表九、性別在小腸脂肪含量與代謝症候群的差異性 30
表十、肝臟脂肪含量與代謝症候群的差異性 31
表十一、性別在肝臟脂肪含量與代謝症候群的差異性 31
表十二、腸骨棘脂肪含量與代謝症候群的差異性 32
表十三、性別在腸骨棘脂肪含量與代謝症候群的差異性 32
表十四、骨盆脂肪含量與代謝症候群的差異性 33
表十五、性別在骨盆脂肪含量與代謝症候群的差異性 33

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