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標題: | 中老年人身體組成、有氧運動耐受力與肺功能之關連性研究 Association between body composition, aerobic exercise endurance and pulmonary function in middle-aged and elderly subjects |
作者: | Kao-Chih Peng 彭高治 |
指導教授: | 蘇大成(Ta-Chen Su) |
關鍵字: | 肺功能,身體組成,有氧耐受力,肌肉, pulmonary function,body composition,aerobic exercise endurance,muscle, |
出版年 : | 2017 |
學位: | 碩士 |
摘要: | 中文摘要
背景 隨著年紀增長身體功能會逐漸下降,包括肌肉量、肌肉功能、有氧運動耐受力會降低及體脂肪變高,同時肺臟功能也隨著年紀逐漸變差,而身體組成的改變被認為是影響肺功能變化的因子之一。有研究指出較差的肺功能會有較高的死亡率及手術後的併發症,但中老年人的肺功能與身體組成及有氧運動耐受力的相關研究在亞洲地區較少。 研究方法 本研究欲探討中、老年人肺功能的影響因子,共三個主題:一、性別差異之肺功能與身體組成的關聯性研究。二、年齡差異的肺功能與身體組成之關聯性研究。三、肺功能與有氧運動耐受力之關聯性研究。 收案時間從2015年3月至2015年8月,收案年紀範圍40至80歲間,男性84位及女性155位,年齡分別為60.8 ± 9.4及63.5 ± 7.1歲。每位受測者都會量測身高、體重、身體質量指數(body mass index, BMI)、腰圍、臀圍,而握力量測使用握力器TKK-5401(Takei, Niigata, Japan),而後使用TANITA專業型體組成計Model BC-418 (Tanita, Tokyo, Jape)進行身體組成計測,量測項目有、基礎代謝、體脂肪重量和比例(全身、上肢、下肢、軀幹)、非脂肪組織重(全身、上肢、下肢、軀幹)和預測肌肉質量(全身、上肢、下肢、軀幹)。受測者量測完後再進入另一診間內進行肺功能以及兩分鐘踏步測試,肺功能儀器使用Spirolab III® (Medical International Research; MIR, Roma, Italy) 進行肺功能測試。進行兩分鐘踏步前先進行肺功能的前測,前測完畢後請受測者坐著休息,一分鐘後開始進兩分鐘踏步測試,踏步結束後請受測者站著休息三分鐘,而後在進行肺功能後測,運動踏步包含運動前及休息時間總計共6分鐘,時間內都會進行心跳與血氧濃度的監測(Pulpas oximeter, SA-300, Rossmax, Taipei, Taiwan),結束後請受測者填寫問卷。 實驗結果 性別比較中,男性的非體脂肪質量及預測肌肉質量較女性高,女性在體脂率較男性高。多變項分析校正年紀與腰圍後,不論男性或女性,FVC、FEV1和PEF都與非體脂肪質量、全身預測肌肉質量、軀幹非體脂肪質量與軀幹預測肌肉質量呈顯著正相關,而只有男性的體脂率與FVC、FEV1與PEF有顯著負相關,握力也只在男性身上發現與上述肺功能呈顯著正相關。校正腰圍後發現男性的體脂率與肺功能呈顯著負相關,因此推論腹部脂肪堆積對於男性的肺功能影響較為顯著。 老年人定義為65歲以上共92位,以下為中年人共147位。分析時把男女性分開後再進行年紀的探討。校正過年紀與腰圍後,不論是中老年男性或女性, FVC、FEV1和PEF都與非體脂肪質量、全身預測肌肉質量、軀幹非體脂肪質量、軀幹預測肌肉質量及握力呈顯著正相關,但老年人的握力僅與FEV1和PEF有顯著關聯。 兩分鐘踏步反映整體的有氧運動能力,從低到高分成三組進行比較後發現,女性的FVC、FEV1及PEF在最差的組別與最好的組別有顯著差異,男性的FEV1及PEF同樣在最差的組別與最好的組別有顯著差異。握力以同樣的方式分組,女性只有FEV1在最弱的組別與最強的組別有顯著差異,而男性則在FVC、FEV1及PEF的最弱與最強的組別比較後有顯著差異。比較不同踏步次數組別在運動前中後的血氧濃度發現,運動前後期踏步次數最多與最少的組別有差異,而心跳則是運動後期的踏步次數最多與最少的組別有差異。 結論 不論性別或者年紀,肺功能都與非體脂肪質量、肌肉量及握力有顯著關聯性。因此如何減緩肌肉量及功能的衰減對於老年人的心肺健康是很重要的,同時男性的腰圍也是需要被注意的問題。本研究屬於橫斷型研究,因此若想進一步探討身體組成改變與肺功能的關聯性,就需要再做更深入的追蹤研究。 Abstract Background People with aging have been linked to sarcopenia and deterioration of pulmonary function that often leads to progressive disability and loss of independence. The decline of free-fat mass (FFM) and increasing fat mass (FM) are associated with deterioration of pulmonary function. In addition, subjects with poor pulmonary function have been linked to increased risk of mortality and operation comorbidity. This study aims to investigate the associations between body composition and pulmonary function in middle-aged and elderly subjects. We also evaluated the effects of aerobic exercise endurance on pulmonary function and oxyhemoglobin saturation (SpO2). Methods During May 2015 through August 2015, we enrolled 239 people (84 males and 155 female, with mean age of 60.82 ± 9.41 and 63.46 ± 7.13 years respectively) to participate the Tongtzu gymnastic exercise training, a slow exercise training program. Subjects with major operation, stroke, acute myocardial infarction, cancer, acute asthma or chronic obstructive pulmonary disease in recent 3 months were excluded. Before exercise training, every participant received body composition measurement and cardiovascular function studies at baseline examination, and standard pulmonary function test (PFT) before and after 2-min stepping exercise. PFT was measured by Spirolab III® ( Medical International Research; MIR, Roma, Italy) included force vital capacity (FVC), forced expiratory volume in one second (FEV1), and peak expiratory flow rate (PEF). Body composition was measured by bioelectrical impedance method (Tanita, Model BC-418, Tokyo, Japan). Hand grip strength was measured by TKK-5401(Takei, Niigata, Japan). SpO2 was measured by pulse oximeter (Rossmax SA310 Pulpas, Taipei, Taiwan) Results Participants included 147 middle-aged (< 65 years-old) and 92 elderly subjects (≥ 65 years-old), with mean age of 57.61 ± 5.63 and 70.36 ± 4.40 years respectively. Multiple linear regression analyses showed FVC, FEV1 and PEF were positively associated with FFM and total predicted muscle mass (PMS). However, fat percentage was negatively and hand grip strength was positively associated with FVC, FEV1 and PEF in men but not in women. Further analysis the association stratified by age group showed that after controlling age, sex and waist circumference, FVC, FEV1 and PEF were positively associated with FFM and total PMS in both middle-aged and elderly group. Hand grip strength was positively associated with FVC, FEV1 and PEF in middle-aged group, but only with FEV1 and PEF in elderly group. According to tertile grade of aerobic exercise endurance by 2-min stepping test and tertile strength of hand grip test, FVC, FEV1 and PEF increased with the higher tertile grade in both genders. Arterial saturation of oxyhemoglobin (SpO2) by pulse oximeter increased with higher aerobic exercise endurance by 2-min stepping test in both pre- and post- exercise status in all subjects by trend test. Conclusion Pulmonary function is positively associated with FFM and PMS independent of different gender and age groups. Higher aerobic exercise endurance is associated with higher SpO2 levels either in pre- or after-exercise. Prevention of muscle wasting is very important to maintain pulmonary function in aging population. Further study will track the same study subjects to know the association between muscle mass and pulmonary functions decline. |
URI: | http://tdr.lib.ntu.edu.tw/jspui/handle/123456789/59787 |
DOI: | 10.6342/NTU201700475 |
全文授權: | 有償授權 |
顯示於系所單位: | 職業醫學與工業衛生研究所 |
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