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完整後設資料紀錄
DC 欄位 | 值 | 語言 |
---|---|---|
dc.contributor.advisor | 陳鑫昌(Hsin-Chang Chen) | |
dc.contributor.author | Tzu-Sheng Fang | en |
dc.contributor.author | 方慈聲 | zh_TW |
dc.date.accessioned | 2021-06-16T05:38:01Z | - |
dc.date.available | 2020-08-26 | |
dc.date.copyright | 2020-08-26 | |
dc.date.issued | 2020 | |
dc.date.submitted | 2020-07-24 | |
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dc.identifier.uri | http://tdr.lib.ntu.edu.tw/jspui/handle/123456789/56616 | - |
dc.description.abstract | 均衡、多樣化之健康飲食可提供充分且完整的營養素幫助人體正常運作及代謝機制,以消除壓力所導致之自由基累積。然而在高度競爭力及工作負荷之職場環境易產生工作壓力而導致個人心理壓力增加,若再加上生活習慣不正常,例如飲食不均衡、睡眠不足、缺乏運動等,使身體無法獲得足夠休息及修復所需之營養素,易逐漸累積形成慢性疲勞且在體內產生自由基造成氧化壓力傷害,進而導致疾病發生。過去研究指出處於壓力環境之高科技業勞工被認為是造成不良健康效應的高風險族群。為了解高壓工作族群之飲食習慣、體內代謝情形及氧化壓力程度,本研究以職業壓力量表及過勞量表招募篩選國內3家電子零組件製造廠共94位壓力組及30位對照組參與者,採集尿液檢體以確效之極致效能液相層析串聯質譜法 (ultra-performance liquid chromatography-tandem mass spectrometry, UPLC-MS/MS) 分析粒線體能量代謝、維生素B群缺乏、神經傳導物質代謝及腸道菌相分佈等代謝相關之尿液有機酸指標,以及DNA損傷指標8-羥基2'-去氧鳥嘌呤核苷 (8-hydroxy-2'-deoxyguanosine, 8-OHdG),並採集血液分析脂質過氧化指標丙二醛 (malondialdehyde, MDA),搭配尿素氮、肌酸酐、尿蛋白、尿糖、膽紅素、白血球等尿液常規指標、結合職業壓力量表、過勞量表及飲食/生活型態問卷,探討工作壓力、飲食與生活型態之關係,找尋可反應身體疲勞情況的代表性尿液指標。 分析參與者之生物檢體檢測數據及問卷資料,初步結果顯示多數壓力組參與者尿中DNA氧化損傷的生物指摽8-OHdG濃度在工作後顯著增加 (p-value < 0.05),而低壓組的勞工則無顯著變化;尿液有機酸兩項指標與工作壓力呈現顯著相關,分別為神經傳導物代謝產物-香草基扁桃酸 (vanimandelic acid),可反應交感神經系統的過度活躍,以及腸道菌群失調相關指標-苯乙酸 (phenylacetic acid),為腸道微生物群的代謝產物。此結果可對未來人體生物監測計畫針對尿液中與人體慢性疲勞相關的生化指標提供參考依據,但仍需要更多研究探討此兩項指標與工作壓力及慢性疲勞間之生化機制。 本研究已成功開發並確校一套可同時定量與疲勞相關的13種尿液有機酸的UPLC-MS/MS分析方法,評估勞工的壓力與體內代謝物的狀況,並綜合參照主客觀資料後,藉由註冊營養師及研究人員對參與者勞工進行健康飲食衛教講座,使參與者了解體內慢性疲勞與氧化壓力之情形,希望經由個人之健康飲食攝取及生活型態的調整,緩解工作、疲勞及壓力所產生之健康影響,以達到早期診斷及飲食、生活習慣的改善,達到預防過勞、過負荷之健康促進目標。 | zh_TW |
dc.description.abstract | A balanced and diverse healthy diet can provide sufficient nutrients which are essential for body development, maintaining normal function and metabolization. In an occupational environment with highly competitive and intensive productivity request, however, workers may prone to suffer from work pressure and lead to an increase in psychological stress. If combined with lifestyle disorder, such as unbalanced diet, insufficient sleep time and lack of exercise, the body cannot get enough rest and the nutrients needed for repair and gradually accumulate to chronic fatigue. It can be followed by the generation of free radicals in the body, and cause oxidative stress damage, which can lead to disease. To understand the dietary habits, metabolic status and oxidative stress level of the stressful workers, this study recruited 94 participants as the stress group and 30 participants as the control group from 3 domestic electronic component manufacture factories using the Occupational stress scale and Overwork scale. Participant’s urine samples were collected and analyzed by the validated methods using ultra-performance liquid chromatography-tandem mass spectrometry (UPLC-MS/MS) for quantitating the biomarker of oxidative damage, i.e. 8-hydroxy-2'-deoxyguanosine (8-OHdG), and target urinary organic acids, including the metabolites of tricarboxylic acid in energy metabolism reaction, the indicators of vitamin B deficiency, neurotransmitters and gut bacteria imbalance. Additionally, the comprehensive assessment also combined with the analysis of the lipid peroxidative biomarker, malondialdehyde (MDA), routine urine test including urine glucose, urine protein, urea nitrogen, urinary white blood cells, total-bilirubin and creatinine, and the Occupational stress/ Overwork scales and diet / lifestyle questionnaire. The aims of this study was to investigate the relationship between work stress, diet and lifestyle, and to find the representative urinary biomarkers related to fatigue. Preliminary results indicated the concentrations of urinary 8-OHdG in most of the participants from the stress group revealed a significant increase after work (p-value < 0.05). However, those in the control group revealed no significantly changed. On the other hand, the results of urinary organic acids indicated that two urinary organic acids, i.e. vanimandelic acid (VMA) and phenylacetic acid (PAA), were significantly correlated with work pressure. VMA and PAA are the metabolites of neurotransmitter refers to sympathetic nervous system hyperactivity and gut microbiota associated with intestinal flora disorder, respectively. The results might provide a reference of biochemical indicators in urine related to chronic fatigue for human biomonitoring studies in future. Notably, advanced studies are needed to identify the relationship between these two indicators and work stress. A validated UPLC-MS/MS method for simultaneously quantifying 13 urinary organic acids associated to fatigue was successfully developed. After comprehensively referring to the subjective and objective data, a healthy diet workshop was held by a registered dietitian and researchers, so that participants can learn about the state of chronic fatigue and inflammation. It is expected that through the adjustment of individual healthy diet pattern and life style, the health effects of work, fatigue and stress will be alleviated, so as to achieve early diagnosis and improvement of diet and living habits, and to achieve the health promotion goal of preventing overwork and overload. | en |
dc.description.provenance | Made available in DSpace on 2021-06-16T05:38:01Z (GMT). No. of bitstreams: 1 U0001-2407202020223500.pdf: 5538531 bytes, checksum: 81f7221ba78c56026e54360fd196d21a (MD5) Previous issue date: 2020 | en |
dc.description.tableofcontents | 口試委員審定書…………………………………………………………………. i 中文摘要………………………………………………………………………….ii Abstract ………………………………………………………………………….iv Chapter 1 Introduction……………………………………………………... 1 1.1 Oxidative stress and its adverse health effect ..…..……………………… 2 1.1.1 Indicators of oxidative stress .……………………………………….… 3 1.1.2 Indicator of DNA oxidative damage: 8-OHdG …………...……………5 1.1.3 Indicator of lipid peroxidation: MDA …………...……………………..6 1.2 Monitoring of small molecule of urinary organic acids …...……………..7 1.2.1 Mitochondrial energy metabolism related indicators …..………………8 1.2.2 Vitamin B complex deficiency indicators …..…………………………10 1.2.3 Indicators of neurotransmitters …..…………………………………….11 1.2.4 Indicators of gut bacteria imbalance …..……………………………….12 1.3 Research motivation……..………………………………………………….15 Chapter 2 Material and methods……..…………………………………………17 2.1 Chemicals and reagents ……..……………………………………………...17 2.2 Participants recruitment……..……………………………………………..17 2.3 Questionnaire……..…………………………………………………………19 2.3.1 Occupational stress and overwork scales……..………………………...19 2.3.2 Food Frequency and lifestyle questionnaire……..……………………...20 2.4 Sample collection and pretreatment……..…………………………………21 2.4.1 Sample pretreatment of 8-OHdG……..…………………………………21 2.4.2 Sample pretreatment of urinary organic acids……..…………………... 22 2.5 UPLC-MS/MS analysis ……..……………………………………………... 22 2.5.1 Analysis of 8-OHdG……..…………………………………………….. 22 2.5.2 Analysis of 13 urinary organic acids……..…………………………….. 23 2.5.3 Method Validation……..……………………………………………….. 24 2.6 Statistical analysis ……..…………………………………………………….26 Chapter 3 Results……..…………………………………………………………..28 3.1 Participants recruitment and screening……..……………………………..28 3.1.1 Screening criteria and sequence of high-stress group (case group) ….…28 3.1.2 Screening criteria and sequence of low-stress group (control group).…..29 3.2 Analysis of participant’s characteristics…………………………………...30 3.2.1 General data and occupation of participants…………………………….30 3.3 Analysis of the occupational stress scale data……………………………...32 3.4 Analysis of the overwork scale data………………………………………...36 3.5 Analysis of the lifestyle, health status, and dietary habit………………….39 3.5.1 Participant’s lifestyle……………………………………………………..39 3.5.2 Participant’s health status………………………………………………...43 3.5.3 Participant’s dietary habit………………………………………………...45 3.6 Analysis of biochemical results………………………………………………58 3.6.1 The indicator of oxidative DNA damage: 8-OHdG………………………58 3.6.2 The indicator of lipid peroxidation: MDA………………………………..62 3.6.3 Monitoring of urinary organic acids………………………………………66 3.6.4 Result of the routine urine test…………………………………………….85 Chapter 4 Discussion……………………………………………………………….87 4.1 Questionnaire data analysis…………………………………………………..87 4.1.1 Participant’s characteristics and occupation………………………………87 4.1.2 Occupational stress and Overwork scales…………………………………89 4.1.3 Lifestyle questionnaire…………………………………………………….90 4.2 Correlation analysis…………………………………………………………...92 4.2.1 Participant's characteristics and lifestyle versus the results of Occupational stress and Overwork scales…………………………………………………………92 4.2.2 Participant's biochemical markers versus the results of Occupational stress and Overwork scales……………………………………………………………….96 4.2.3 Participant's lifestyle versus the results of oxidative stress indicators…………………………………………………………………………...98 4.2.4 Impact of shift work patterns on workers………………………………99 4.3 Research limitations………………………………………………………..104 4.3.1 Limitations of participant’s sample size and age………………………104 4.3.2 Limitation of Occupational stress and overwork scales………………. 104 4.3.3 Limitations and recommendations of Food Frequency questionnaire…105 4.3.4 Specificity of biochemical markers…………………………………….106 4.3.5 The type of shift work…………………………………………………..107 Chapter 5 Conclusions and Recommendation………………………………….109 1. Validated analysis method for quantitating 13 urinary organic acids………...109 2. Oxidative stress indicator: urinary 8-OHdG………………………………….109 3. Stress-related biochemical markers and plasma MDA……………………….109 4. Evaluation and recommendation of worker’s dietary nutrients……………….110 5. Mitigation strategies………………………………………………………….. 111 Tables……………………………………………………………………………… 112 Figures……………………………………………………………………………...143 References………………………………………………………………………….145 Appendix 1 勞工職業壓力量表…………………………………………………..150 Appendix 2 過勞量表-測測看,你是否過勞了呢? ………………………… 158 Appendix 3「工作壓力對電子零組件製造業勞工健康狀況之影響」問卷……161 Appendix 4 個人飲食頻率………………………………………………………163 Appendix 5 臨床試驗/研究案審查核可證明…………………………………..168 List of figures Figure 1. The citric acid cycle (modified from book [36] ) ………………………143 Figure 2. The study design ………………………………………………………..144 Figure 3. The biomarkers / indictors analyzed in participant's biological samples ……………………………………………………………………………144 List of tables Table 1. Chemical name, abbreviation, CAS number, exact mass and structure of selected organic acid and 8-OHdG ………………………………........…112 Table 2. The explanation of total score and the suggestions in occupational stress subscale …………………………………………………………………113 Table 3. The explanation of total score and the suggestions in overwork…………..113 Table 4. MS/MS parameters for 8-OHdG…………………………………………..114 Table 5. MS/MS parameters for selected organic acid……………………………...114 Table 6. Number of participants from three factories in two-stage participant recruitment…………………………………………………………………..114 Table 7. Characteristics of the studied population…………………………………..115 Table 8. Score of occupational stress scale in Factory-A. ………………………….116 Table 9. Score of occupational stress scale in Factory-B. ………………………….116 Table 10. Score of occupational stress scale in Factory-C. ………………………...116 Table 11. Score of overwork scale in Factory-A. …………………………………..116 Table 12. Score of overwork scale in Factory- B. ………………………………….117 Table 13. Score of overwork scale in Factory- C. ………………………………….117 Table 14. Lifestyle data of workers in Factory-A, -B and -C ………………………118 Table 15. Basic health status data of workers in Factory-A, B and C………………119 Table 16. Description of dietary nutrient intake of participants in Factory-A……...120 Table 17. Description of dietary nutrient intake of participants in Factory-B……...122 Table 18. Description of dietary nutrient intake of participants in Factory-C……...123 Table 19. Results of participant’s dietary nutrient intake…………………………...124 Table 20. Urinary 8-OHdG concentration of workers in Factory-A. ………………125 Table 21. Urinary 8-OHdG concentration of workers in Factory-B. ………………125 Table 22. Urinary 8-OHdG concentration of workers in Factory-C. ………………125 Table 23. Blood MDA concentration of workers in Factory-A…………………….126 Table 24. Blood MDA concentration of workers in Factory-B…………………….126 Table 25. Blood MDA concentration of workers in Factory-C…………………….126 Table 26. The validation data of matrix-matched calibration curve………………..127 Table 27. The quality control of developed method for urinary organic acids……..127 Table 28. Results of urinary organic acid in Factory-A ……………………………129 Table 29. Results of urinary organic acid in Factory-B ……………………………130 Table 30. Results of urinary organic acid in Factory-C……………………………..131 Table 31. Results of routine urine test in Factory-A………………………………..132 Table 32. Results of routine urine test in Factory-B 132 Table 33. Results of routine urine test in Factory-C 133 Table 34. Statistical comparison of participant characteristics and occupation data between three factories 134 Table 35. Statistical comparison of the Occupational stress scale score between three factories 135 Table 36. Statistical comparison of the Overwork scale score between three factories 135 Table 37. Statistical comparison of the lifestyle between three factories 136 Table 38. Participant characteristics and lifestyle (continuous variables) versus the stress feeling and work related fatigue 136 Table 39. Participant characteristics and lifestyle (categorical variables) versus the stress feeling and work related fatigue 137 Table 40. The results of Occupational stress subscales of shift and non-shift participants 138 Table 41. The results of overwork subscales of shift and non-shift participants 138 Table 42. The correlation analysis of shift work and biochemical markers 138 Table 43. The correlation analysis of shift work and routine urine test 139 Table 44. The correlation analysis of shift work pattern and worker lifestyle 139 Table 45. The contingency table of shift work pattern and worker alcohol consumption habit 139 Table 46. The contingency table of shift work pattern and worker’s coffee consumption habit 139 Table 47. The correlation analysis of worker biochemical markers and stress feeling 140 Table 48. The correlation analysis of worker biochemical markers and work related fatigue 141 Table 49. The correlation analysis of worker stress feeling and routine urine test 141 Table 50. The correlation analysis of work related fatigue and routine urine test 142 Table 51. The correlation analysis of worker lifestyle and oxidative stress markers 142 | |
dc.language.iso | en | |
dc.title | 以生物代謝指標及8-OHdG 探討高壓工作族群之飲食及工作/生活型態對健康之影響 | zh_TW |
dc.title | Evaluating the health impact of diet and work/life style on stressful workers using urinary metabolic indicators and 8-OHdG | en |
dc.type | Thesis | |
dc.date.schoolyear | 108-2 | |
dc.description.degree | 碩士 | |
dc.contributor.oralexamcommittee | 黃鈺芳(Yu-Fang Huang),黃柏菁(Po-Ching Huang) | |
dc.subject.keyword | 尿液有機酸,8-羥基2'-去氧鳥嘌呤核苷,丙二醛,極致效能液相層析串聯質譜法,工作壓力,慢性疲勞, | zh_TW |
dc.subject.keyword | urinary organic acids,8-OHdG,MDA,UPLC-MS/MS,work stress,chronic fatigue, | en |
dc.relation.page | 168 | |
dc.identifier.doi | 10.6342/NTU202001842 | |
dc.rights.note | 有償授權 | |
dc.date.accepted | 2020-07-27 | |
dc.contributor.author-college | 公共衛生學院 | zh_TW |
dc.contributor.author-dept | 食品安全與健康研究所 | zh_TW |
顯示於系所單位: | 食品安全與健康研究所 |
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