本研究主要目的是探討不同減重成效對於荷爾蒙及免疫反應的影響，
所得的結論如下：
一、 未限制飲食控制的情況下，有氧運動能確實減低肥胖者脂肪量；
此外，日常身體活動量亦是維持減重成效的重要關鍵。
二、 瘦體素濃度隨著脂肪量增減而變化；胰島素敏感度與體重、脂肪 量呈現顯著正相關，但變化情形未達統計上的顯著水準，可能是 由於前測值已在正常範圍內。然而，與脂肪量之間的關係仍值得 探討。
三、 減重介入造成白血球總數上升，但其值仍在正常範圍內，可能是 免疫反應強化的現象。往後可加入各種白血球種類作為監測指 標，以能夠更準確地評估免疫功能的變化。
四、 IL-6 和 TNF-α 的分泌來源與功能皆不只一種，兩者濃度提升是否 為幫助脂肪細胞分解的主因，以及有無先後調節的作用存在，將 來可加入其餘指標協助判斷其主要功用。
五、 減重過程中，儘管減重成效的差異並未造成荷爾蒙與免疫反應太 大不同，但其趨勢仍值得進一步探討。建議往後可增加受試者人 數，並加入控制組比較；延長減重計畫時間、以及增加運動頻率，
以期減重成效達到更大差異。
引用文獻
王聖予、陳建和（譯）（2002）。
免疫學
。臺北縣：藝軒。(Ivan Roitt, Jonathan Brostoff, & David Male, 1998)行政院衛生署（2006）。
如何定義成人肥胖標準
。2009 年 5 月 1 日，衛生署，食品衛生處網址 http://www.doh.gov.tw/CHT2006/index_populace.aspx
行政院衛生署（2009）。97
年死因統計結果分析
。2009 年 9 月 24 日，衛生 署，統計公佈欄http://www.doh.gov.tw/CHT2006/DM/DM2_2.aspx?now_fod_list_no=10642&class _no=440&level_no=3
林作慶、傅正思（2005）。維持體重避免復胖的關鍵因素之一：重量訓練。
中華體育季刊，
19（1），30-37。林益安、許美智（2008）。不同身體活動量對 C 反應蛋白之影響及其相關機 制。
中華體育季刊，
22（4），1-12。祝年豐（2004）。臺灣國小學童肥胖及其相關合併症流行病學。
臺灣地區國 小學童營養健康狀況調查
2001-2002學術研討會
（頁283-296）。臺 北市：行政院衛生署。陳元和、林正常（2004）。運動訓練和飲食控制對高中超重女生血清瘦身蛋 白濃度及肥胖相關指標之影響。
運動生理暨體能學報，
1，151-163。薛淑琳、甘能斌、劉介仲與林俊宏（2005）。六週中等強度密集性慢跑訓練 對肥胖者減重後體組成及免疫系統的影響。
文化體育學刊，
3，67-71。劉明佩（2005）。別傻了！當心“快速”減肥會要了你的命。
健康世界，
238，35-39。
Andersen, R. E., Wadden, T. A., Bartlett, S. J., Zemel, B., Verde, T. J., &
Franckowiak, S. C. (1999). Effects of lifestyle activity vs structured aerobic exercise in obese women. The Journal of the American Medical Association, 281 (4), 335-340.
Bastard, J. P., Maachi, M., Nhieu, J. T. V., Jardel, C., Bruckert, E., Grimaldi, A., et al. (2002). Adipose tissue IL-6 content correlates with resistance to insulin activation of glucose uptake both in vivo and in vitro. The Journal of Clinical Endocrinology and Metabolism, 87 (5), 2084-2089.
Berggren, J. R., Hulver, M. W., & Houmard, J. A. (2005). Fat as an endocrine organ: influence of exercise. Journal of Applied Physiology, 99 (2), 757-764.
Botion, L. M., Brasier, A. R., Tian, B., Udupi, V., & Green, A. (2001). Inhibition of proteasome activity blocks the ability of TNFα to down-regulate Gi
proteins and stimulate lipolysis. Endocrinology, 142 (12), 5069-5075.
Brown, M. D., Moore, G. E., Korytkowski, M. T., McCole, S. D., & Hagberg, J.
M. (1997). Improvement of insulin sensitivity by short-term exercise training in hypertensive African American women. Hypertension, 30 (6), 1549-1553.
Calabro, P., Willerson, J. T., & Yeh, E. T. (2003). Inflammatory cytokines stimulated C-reactive protein production by human coronary artery smooth muscle cells. Circulation, 108 (16), 1930-1932.
Chandra, R. K., & Kutty, K. M. (1980). Immunocompetence in obesity. Acta paediatrica Scandinavica, 69 (1), 25-30.
Duncan, G. E., Perri, M. G., Theriaque, D. W., Hutson, A. D., Eckel, R. H., &
Stacpoole, P. W. (2003). Exercise training, without weight loss, increases insulin sensitivity and postheparin plasma lipase activity in previously sedentary adults. Diabetes Care, 26 (3), 557-562.
Elias, A. N., Pandian, M. R., Wang, L., Suarez, E., James, N., & Wilson, A. F.
(2000). Leptin and IGF-I levels in unconditioned male volunteers after short-term exercise. Psychoneuroendocrinology, 25 (5), 453-461.
Epstein, L. H., Coleman, K. J., & Myers, M. D. (1996). Exercise in treating obesity in children and adolescents. Medicine and Science in Sports and Exercise, 28 (4), 428-435.
Epstein, L. H., & Goldfield, G. S. (1999). Physical activity in the treatment of childhood overweight and obesity: current evidence and research issues.
Medicine and Science in Sports and Exercise, 31 (11), 553-559.
Flier, J. S. (1998). What’s in the name? In search of leptin’s physiologic role.
Journal of Clinical Endocrinology and Metabolism, 83 (5), 1407-1413.
French, S. A., Folsom, A. R., Jeffery, R. W., Zheng, W., Mink, P. J., & Baxter, J.
E. (1997). Weight variability and incident disease in older women: the Iowa Women's Health Study. International journal of obesity and related metabolic disorders: journal of the International Association for the Study of Obesity, 21 (3), 217-223.
Ghroubi, S., Elleuch, H., Chikh, T., Kaffel, N., Abid, M., & Elleuch, M. H.
(2009). Physical training combined with dietary measures in the treatment of adult obesity. A comparison of two protocols. Annals of Physical and Rehabilitation Medicine, 52 (5), 394-413.
Gleeson, M., McDonald, W. A., Cripps, A. W., Pyne, D. B., Clancy, R. L., &
Fricker, P. A. (1995). The effect on immunity of long-term intensive training in elite swimmers. Clinical and Experimental Immunology, 102 (1), 210-216.
Goldberg, Y., Boaz, M., Matas, Z., Goldberg, I., & Shargorodsky, M. (2009).
Weight loss induced by nutritional and exercise intervention decreases arterial stiffness in obese subjects. Clinical Nutrition, 28 (1), 21-25.
Gregoire, F. M., Smas, C. M., & Sul, H. S. (1998). Understanding adipocyte differentiation. Physiological Reviews, 78 (3), 783-809.
Houmard, J. A., Cox, J. H., MacLean, P. S., & Barakat, H. A. (2000). Effect of short-term exercise training on leptin and insulin action. Metabolism clinical and experimental, 49 (7), 858-861.
Hu, G., Jousilahti, P., Tuomilehto, J., Antikainen, R., Sundvall, J., & Salomaa, V.
(2009). Association of serum C-reactive protein level with sex-specific type 2 diabetes risk: a prospective Finnish study. The Journal of Clinical Endocrinology and Metabolism, 94 (6), 2099-2105.
Jung, S. H., Park, H. S., Kim, K. S., Choi, W. H., Ahn, C. W., Kim, B. T., et al.
(2008). Effect of weight loss on some serum cytokines in human obesity:
increase in IL-10 after weight loss. Journal of Nutritional Biochemistry, 19 (6), 371-375.
Kraemer, R. R., Kraemer, G. R., Acevedo, E. O., Hebert, E. P., Temple, E., Bates, M., et al. (1999). Effects of aerobic exercise on serum leptin levels in obese women. European Journal of Applied Physiology, 80 (2), 154-158.
LaPerriere, A., Antoni, M. H., Ironson, G., Perry, A., McCabe, P., Klimas, N., et al. (1994). Effects of aerobic exercise training on lymphocyte
subpopulations. International Journal of Sports Medicine, 15 (3), 127-130.
Lin, T. C., Yen, J. M., Gong, K. B., Kuo, T. C., Ku, D. C., Liang, S. F., et al.
(2006). Abnormal glucose tolerance and insulin resistance in polycystic ovary syndrome amongst the Taiwanese population- not correlated with insulin receptor substrate-1 Gly972Arg/Ala513Pro polymorphism. BMC Medical Genetics, 7, 36.
Martí, A., Marcos, A., & Martínez, J. A. (2001). Obesity and immune function relationships. Obesity Reviews, 2 (2), 131-140.
Matthews, D. R., Hosker, J. R, Rudenski, A. S., Naylor, B. A., Treacher, D. F., &
Turner, R. C. (1985). Homeostasis model assessment: insulin resistance and β-cell function from fasting plasma glucose and insulin
concentrations in man. Diabetologia, 28 (7), 412-419.
Mendoza-Núñez, V. M., García-Sánchez, A., Sánchez-Rodríguez, M.,
Galván-Duarte, R. E., & Fonseca-Yerena, M. E. (2002). Overweight, waist circumference, age, gender, and insulin resistance as risk factors
for hyperleptinemia. Obesity Research, 10 (4), 253-259.
Miller, Y. D., & Dunstan, D. W. (2004). The effectiveness of physical activity interventions for the treatment of overweight and obesity and type 2 diabetes. Journal of Science and Medicine in Sport, 7 (1), 52-59.
Mitchell, J. B., Paquet, A. J., Pizza, F. X., Starling, R. D., Holtz, R. W., &
Grandjean, P. W. (1996). The effect of moderate aerobic training on lymphocyte proliferation. International Journal of Sports Medicine, 17 (5), 384-389.
Miyazaki, Y., Pipek, R., Mandarino, L. J., & DeFronzo, R. A. (2003). Tumor necrosis factor α and insulin resistance in obese type 2 diabetic patients.
International Journal of Obesity and Related Metabolic Disorders, 27 (1), 88-94.
Moriguchi, S., Oonishi, K., Kato, M., & Kishino, Y. (1995). Obesity is a risk factor for deteriorating cellular immune functions decreased with aging.
Nutrition Research, 15 (2), 151-160.
Nakata, Y., Okura, T., Matsuo, T., & Tanaka, K. (2008). Factors alleviating metabolic syndrome via diet-induced weight loss with or without exercise in overweight Japanese women. Preventive Medicine, doi:10.1016/j.ypmed.2009.01.013
Nassis, G. P., Papantakou, K., Skenderi, K., Triandafillopoulou, M., Kavouras, S.
A., Yannakoulia, M., et al. (2005). Aerobic exercise training improves insulin sensitivity without changes in body weight, body fat, adiponectin, and inflammatory markers in overweight and obese girls. Metabolism
Clinical and Experimental, 54 (11), 1472-1479.
National Institutes of Health Technology Assessment Conference Panel (1993).
Methods for voluntary weight loss and control. Annals of Internal Medicine, 119, 764-770.
Nieman, D. C. (1994). Exercise, upper respiratory tract infection, and the immune system. Medicine and Science in Sports and Exercise, 26 (2), 128-139.
Nieman, D. C., Brendle, D., Henson, D. A., Suttles, J., Cook, V. D., Warren, B.
J., et al. (1995). Immune function in athletes versus nonathletes.
International Journal of Sports Medicine, 16 (5), 329-333.
Nieman, D. C., Henson, D. A., Nehlsen-Cannarella, S. L., Ekkens, M., Utter, A.
C., Butterworth, D. E., et al. (1999). Influence of obesity on immune function. Journal of the American Dietetic Association, 99 (3), 294-299.
Nieman, D. C., Nehlsen-Cannarella, S. L., Henson, D. A., Butterworth, D. E., Fagoaga, O. R., Warren, B. J., et al. (1996). Immune response to obesity and moderate weight loss. International journal of obesity, 20 (4),
353-360.
Nieman, D. C., Nehlsen-Cannarella, S. L., Henson, D. A., Koch, A. J.,
Butterworth, D. E., Fagoaga, O. R., et al. (1998). Immune response to exercise training and/or energy restriction in obese women. Medicine and Science in Sports and Exercise, 30 (5), 679-686.
Noland, R. C., Baker, J. T., Boudreau, S. R., Kobe, R. W., Tanner, C. J., Hickner,
R. C., et al. (2001). Effect of intense training on plasma leptin in male and female swimmers. Medicine and Science in Sports and Exercise, 33 (2), 227-231.
Ogilvie, A. C., Hack, C. E., Wagstaff, J., van Mierlo, G. J., Erenberg, A. J., Thomsen, L. L., et al. (1996). IL-1 beta does not cause neutrophil
degranulation but does lead to IL-6, IL-8, and nitrite/nitrate release when used in patients with cancer. Journal of Immunology, 156 (1), 389-394.
Ozcelik, O., Celik, H., Ayar, A., Serhatlioglu, S., & Kelestimur, H. (2004).
Investigation of the influence of training status on the relationship between the acute exercise and serum leptin levels in obese females.
Neuro Endocrinology Letters, 25 (5), 381-385.
Petersen, E. W., Carey, A. L., Sacchetti, M., Steinberg, G. R., Macaulay, S. L., Febbraio, M. A., et al. (2005). Acute IL-6 treatment increases fatty acid turnover in elderly humans in vivo and in tissue culture in vitro.
American Journal of Physiology - Endocrinology and Metabolism, 288 (1), 155-162.
Potteiger, J. A., Jacobsen, D. J., Donnelly, J. E., & Hill, J. O. (2003). Glucose and insulin responses following 16 months of exercise training in overweight adults: the Midwest exercise trial. Metabolism Clinical and Experimental, 52 (9), 1175-1181.
Reaven, G. (2005). All obese individuals are not created equal: insulin resistance is the major determinant of cardiovascular disease in overweight/obese individuals. Diabetes and Vascular Disease Research, 2 (3), 105-112.
Rhind, S. G., Shek, P. N., Shinkai, S., & Shephard, R. J. (1994). Differential expression of interleukin-2 receptor alpha and beta chains in relation to natural killer cell subsets and aerobic fitness. International Journal of Sports Medicine, 15 (6), 311-318.
Rokling-Andersen, M. H., Reseland, J. E., Veierød, M. B., Anderssen, S. A., Jacobs, D. R. Jr, Urdal, P., et al. (2007). Effects of long-term exercise and diet intervention on plasma adipokine concentrations. The American Journal of Clinical Nutrition, 86 (5), 1293-1301.
Ross, R., Janssen, I., Dawson, J., Kungl, A. M., Kuk, J. L., Wong, S. L., et al.
(2004). Exercise-induced reduction in obesity and insulin resistance in women: a randomized controlled trial. Obesity Research, 12 (5),
789-798.
Scanga, C. B., Verde, T. J., Paolone, A. M., Andersen, R. E., & Wadden, T. A.
(1998). Effects of weight loss and exercise training on natural killer cell activity in obese women. Medicine and Science in Sports and Exercise, 30 (12), 1666-1671.
Schwartz, M. W., & Seeley, R. J. (1997). Neuroendocrine responses to starvation and weight loss. New England Journal of Medicine, 336 (25),
1802-1811.
Shade, E. D., Ulrich, C. M., Wener, M. H., Wood, B., Yasui, Y., Lacroix, K., et al.
(2004). Frequent intentional weight loss is associated with lower natural killer cell cytotoxicity in postmenopausal women: possible long-term immune effects. American Dietetic Association, 104 (6), 903-912.
Shadid, S., Stehouwer, C. D., & Jensen, M. D. (2006). Diet/Exercise versus pioglitazone: effects of insulin sensitization with decreasing or increasing fat mass on adipokines and inflammatory markers. The Journal of Clinical Endocrinology and Metabolism, 91 (9), 3418-3425.
Södlerlund, A., Fischer, A., & Johansson, T. (2009). Physical activity, diet and behavior modification in the treatment of overweight and obese adults: a systematic review. Perspectives in Public Health, 129 (3), 132-142.
Thompson, P. D., Yurgalevitch, S. M., Flynn, M. M., Zmuda, J. M.,
Spannaus-Martin, D., Saritelli, A., et al. (1997). Effect of prolonged exercise training without weight loss on high-density lipoprotein
metabolism in overweight men. Metabolism Clinical and Experimental, 46 (2), 217-223.
Thong, F. S., Hudson, R., Ross, R., Janssen, I., & Graham, T. E. (2000). Plasma leptin in moderately obese men: independent effects of weight loss and aerobic exercise. American Journal of Physiology - Endocrinology and Metabolism, 279 (2), 307-313.
Tsai, W. L., Yang, C. Y., Lin, S. F., & Fang, F. M. (2004). Impact of obesity on medical problems and quality of life in Taiwan. American Journal of Epidemiology, 160 (6), 557-565.
van Hall, G., Steensberg, A., Sacchetti, M., Fischer, C., Keller, C., Schjerling, P., et al. (2003). Interleukin-6 stimulates lipolysis and fat oxidation in
humans. The Journal of Clinical Endocrinology and Metabolism, 88 (7), 3005-3010.
Visser, M., Bouter, L. M., McQuillan, G. M., Wener, M. H., & Harris, T. B.
(1999). Elevated C-reactive protein levels in overweight and obese adults.
The Journal of American Medical Association, 282 (22), 2131-2135.
Yudkin, J. S., Stehouwer, C. D. A., Emeis, J. J., & Coppack, S. W. (1999).
C-reactive protein in healthy subjects: associations with obesity, insulin resistance, and endothelial dysfunction. Arteriosclerosis, Thrombosis, and Vascular Biology, 19 (4), 972-978.
Zhang, Y., Proenca, R., Maffei, M., Barone, M., Leopold, L., & Friedman, J. M.
(1994). Positional cloning of the mouse obese gene and its human homologue. Nature, 372 (6505), 425-432.
附 錄 一 ： 受 試 者 須 知 及 同 意 書
壹 、 實 驗 目 的
本研究主要配合中原大學衛生保健組主辦體重控制班活動，進行減重計畫介入相 關因素探討，目的為探討減重後其荷爾蒙與免疫反應之變化情形。減重計畫包括：
1. 每週兩次各 50 分鐘的有氧運動。
2. 每日配戴計步器記錄每日步數以估測活動量。
3. 計畫前與計畫後分別檢測身體組成與血液分析。
4. 減重計畫為連續 12 週，請務必出席並堅持到底。
貳 、 測 驗 項 目 與 內 容
1. 身體組成：使用體脂計檢測體重、體脂率、肌肉率、基礎代謝率等各項資料。
2. 記錄步數：在減重計畫期間每日配戴計步器，並詳實記錄。
3. 採血分析：由合格醫護人員於減重計畫前後測時進行採血（約採血 10 ㏄，3/11、
6/3 及 6/24 各一次），並在採血前配合禁食 10 小時。
如在減重計畫中或檢測時感到不適，您有隨時退出本實驗的權利。為了維護參與者 的權益，本研究所獲得的資料除提供參與者本人參考外，其於資料僅供研究之用，絕對 保密。
本研究需要受試者的參與及配合，若您已經閱讀過以上注意事項，且同意遵守上述 各項規定，請在以下各欄填寫基本資料並簽名，感謝您的協助與合作！
受試者： 聯絡電話：
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日期：中華民國 年 月 日
研究單位：國立臺灣師範大學體育學系碩士班 研 究 生：黃幼龍
聯絡電話：0929-185006
附 錄 二 、 健 康 情 況 調 查 表
本調查表旨在幫助您瞭解自己身體的健康狀況，並提供測驗人員在實驗 前，是否需要建議受試者做更進一步的健康檢查。因此，請據實回答過去一年內，
醫師是否曾告訴您有下列的狀況:(請您在有、無或不確定欄中打 V)。
有 無 不確定
1.高血壓
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2.心臟病或血管硬化症
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3.糖尿病
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4.支氣管炎
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5.貧血
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6.心律不整
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7.藥物過敏
□ □ □
8.緊張，情緒或心理異常
□ □ □
9.氣喘
□ □ □
10.很快站起來時，會頭暈或輕微頭痛
□ □ □
11.昏倒或失去知覺
□ □ □
12.經常性胃痛
□ □ □
13.運動或跑步後，極端疲憊很難恢復
□ □ □
14.過去半年間是否有過其他病症發生?
說 明 ：_______________________________________________________
_______________ ________________________________________
受 試 者 ： ______________________________
填 表 日 期 ： 中 華 民 國 年 月 日