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肥胖婦女減重前後體組成及熱量代謝之變化.

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肥胖婦女減重前後體組成及熱量代謝之變化.

葉松鈴;劉美媛;陳維昭

Abstract

由於社會經濟之繁榮,國人近年來體重過重有逐年增加的趨勢,雖然大部分體重過重者都有減重 的意願,但減重後體重再度回昇的比例很高。由於在體重之控制中熱量代謝之調節是很重要之因 素,而目前國內並無關於減重前後熱量代謝變化之研究,因此本實驗之目的在比較停經前之肥胖 女性,減重前體位、體組成及熱量代謝與正常體重女性之差異,並比較肥胖女性減得前後體位、 體組成及熱量代謝變化之情形。將 67 名肥胖婦女依其肥胖程度將身體質量指數(BMI)值 26.4-30.8kg/m^2 者分為輕度肥胖組,而BMI>30.8 kg/m^2 以上者分為中度肥胖組,以飲食控制方 式減輕體重,追蹤半年。在受測者中選取體重減輕大於原體重 5%以上者 29 人,並選取與減重 者年齡身高相配合之正常體重者 18 人做為控制組,加以分析比較。結果顯示不同程度肥胖女性 之間,不管是體重(BW)、皮下脂肪厚度、上臂肌圍、瘦體組織(FFM)及脂肪組織重量皆有顯著之 不同,且中度肥胖組大於輕度肥胖組,輕度肥胖組又大於正常體重組。三頭肌皮下脂肪厚度與體 脂肪含量呈正相關,可做為減重後體脂肪是否減少之一項指標。在熱量代謝方面,不同肥胖程度 的休息狀態下之熱量代謝速率(RMR),肥胖者大於正常體重者,但每公斤瘦體組織的熱量代謝速 率(RMR/FFM)在正常體重組、輕度及中度肥胖三組間則沒有顯著差異。而每公斤體重之熱量代 謝速率(RMR/BW),肥胖組顯著低於正常體重組,顯示代謝活性較大之瘦體組織雖然隨體重上昇 而增加,但肥胖者瘦體組織所佔體重百分比仍較正常體重者低,因此肥胖者之熱量代謝速率相對 於正常體重者是屬於能量代謝低下的。減重後由於瘦體組織及脂肪組織亦相對降低,RMR亦會 隨之下降,故肥胖者體重若要持續下降熱量攝限可能需再降低。本實驗在減重後雖然瘦體組織明 顯減少,但由尿液肌酸酐和 3-甲基組胺酸之排出量並未顯示減重後肌肉組織有明顯流失之情形。

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