本研究身體組成參數與發炎細胞激素之變化量經 Spearman 相關分析後，發現 Leptin 變化量與體重變化量達顯著相關，Leptin 變化量與 BMI 變化量亦達顯著相關 (表 10)。
相關研究已發現到瘦素與身體質量指數之間的關聯性，國外研究調查了肥胖受試者 的身體質量指數、瘦素與發炎之間的關係。導致肥胖受試者發炎狀態之促發炎細胞激素 瘦素以及 TNF-α和 IL-6 是源自於脂肪組織，隨著體重增加，瘦素濃度亦會增加，使發 炎狀態增強 (Van Dielen et al., 2001)。
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Ruhl 等(2007) 指出，評估高齡者的體脂肪時，同時使用血清瘦素濃度以及身體質 量指數可以精確的估計總脂肪含量。本研究以體脂率與發炎細胞激素作為實驗主要依變 項，相較於 TNF-α跟 IL-6，瘦素或許更能反應高齡者身體質量指數與發炎狀態的變化。
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第陸章 結論
運動訓練降低高齡者發炎狀態有許多可能的機制，未來也值得繼續探究。本研究以 12 週漸進式阻力訓練的運動處方介入健康高齡者，在未改變體重的前提下，達到降低體 脂肪效果，這可以說明阻力訓練有效延緩伴隨老化而來的肥胖問題，進而抑制隨著老化 增加的發炎狀態。阻力訓練除了改善高齡者肌肉功能以外，還能降低罹患慢性疾病的風 險，為高齡者的健康帶來更多福祉。
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引用文獻
李水碧, & 李志雄. (2004). 阻力運動與骨質疏鬆症. 中華體育季刊, 18(4), 48-57.
Afoke, A., Eeg‐Olofsson, O., Hed, J., Kjellman, N. I., Lindblom, B., & Ludvigsson, J. (1993).
Seasonal variation and sex differences of circulating macrophages, immunoglobulins and lymphocytes in healthy school children. Scandinavian Journal of Immunology,
37(2), 209-215.
Anderson, T., & Kearney, J. T. (1982). Effects of three resistance training programs on muscular strength and absolute and relative endurance. Research Quarterly for
Exercise and Sport, 53(1), 1-7.
Argiles, J. M., Busquets, S., Stemmler, B., & Lopez-Soriano, F. J. (2015). Cachexia and sarcopenia: mechanisms and potential targets for intervention. Current Opinion in
Pharmacology, 22, 100-106.
Arnold, P., Njemini, R., Vantieghem, S., Gorus, E., Pool-Goudzwaard, A., Buyl, R., &
Bautmans, I. (2018). Reaction time in healthy elderly is associated with chronic low-grade inflammation and advanced glycation end product. Experimental
Gerontology, 108, 118-124.
Arnott, C. H., Scott, K. A., Moore, R. J., Hewer, A., Phillips, D. H., Parker, P., . . . Owens, D.
M. J. O. (2002). Tumour necrosis factor-α mediates tumour promotion via a PKCα-and AP-1-dependent pathway. Oncogene, 21(31), 4728-4738.
Bautmans, I., Njemini, R., Vasseur, S., Chabert, H., Moens, L., Demanet, C., & Mets, T.
(2005). Biochemical changes in response to intensive resistance exercise training in the elderly. Gerontology, 51(4), 253-265.
Bodine, S. C., & Baehr, L. M. (2014). Skeletal muscle atrophy and the E3 ubiquitin ligases MuRF1 and MAFbx/atrogin-1. American Journal of Physiology-Endocrinology and
Metabolism, 307(6), E469-E484.
Bonaccio, M., Di Castelnuovo, A., Pounis, G., De Curtis, A., Costanzo, S., Persichillo, M., . . . Iacoviello, L. (2016). A score of low-grade inflammation and risk of mortality:
prospective findings from the Moli-sani study. Haematologica, 101(11), 1434-1441.
Bruunsgaard, H., Bjerregaard, E., Schroll, M., & Pedersen, B. K. (2004). Muscle strength after resistance training is inversely correlated with baseline levels of soluble tumor necrosis factor receptors in the oldest old. Journal of the American Geriatrics Society,
52(2), 237-241.
Bruunsgaard, H., Skinhøj, P., Pedersen, A. N., Schroll, M., & Pedersen, B. K. (2000). Ageing, tumour necrosis factor‐alpha (TNF‐α) and atherosclerosis. Clinical & Experimental
Immunology, 121(2), 255-260.
Córdova, C., Lopes-e-Silva Jr, F., Pires, A. S., Souza, V. C., Brito, C. J., Moraes, C. F., . . .
42
Nóbrega, O. T. (2011). Long-term resistance training is associated with reduced circulating levels of IL-6, IFN-gamma and TNF-alpha in elderly women.
Neuroimmunomodulation, 18(3), 165-170.
C.E. Ruhl, T. B. H., J. Ding, B.H. Goodpaster, A.M. Kanaya, S.B. Kritchevsky, et al. . (2007).
Body mass index and serum leptin concentration independently estimate percentage body fat in older adults. The American Journal of Clinical Nutrition, 85(4),
1121-1126.
Campbell, W. W., Crim, M. C., Young, V. R., & Evans, W. J. (1994). Increased energy
requirements and changes in body composition with resistance training in older adults.
The American Journal of Clinical Nutrition, 60(2), 167-175.
Candow, D. G., Forbes, S. C., Little, J. P., Cornish, S. M., Pinkoski, C., & Chilibeck, P. D.
(2012). Effect of nutritional interventions and resistance exercise on aging muscle mass and strength. Biogerontology, 13(4), 345-358.
Chupel, M. U., Direito, F., Furtado, G. E., Minuzzi, L. G., Pedrosa, F. M., Colado, J. C., . . . Teixeira, A. M. (2017). Strength training decreases inflammation and increases
cognition and physical fitness in older women with cognitive impairment. Frontiers in
Physiology, 8, 377.
Cornish, S. M., Myrie, S. B., Bugera, E. M., Chase, J. E., Turczyn, D., & Pinder, M. (2018).
Omega-3 supplementation with resistance training does not improve body
composition or lower biomarkers of inflammation more so than resistance training alone in older men. Nutrition Research, 60, 87-95.
Delshad, M., Ghanbarian, A., Mehrabi, Y., Sarvghadi, F., & Ebrahim, K. (2013). Effect of strength training and short-term detraining on muscle mass in women aged over 50 years old. International Journal of Preventive Medicine, 4(12), 1386.
El-Kader, S. M. A., & Al-Shreef, F. M. (2018). Inflammatory cytokines and immune system modulation by aerobic versus resisted exercise training for elderly. African Health
Sciences, 18(1), 120-131.
Fatouros, I., Tournis, S., Leontsini, D., Jamurtas, A., Sxina, M., Thomakos, P., . . . Mitrakou, A. (2005). Leptin and adiponectin responses in overweight inactive elderly following resistance training and detraining are intensity related. The Journal of Clinical
Endocrinology & Metabolism, 90(11), 5970-5977.
Franceschi, C., & Campisi, J. (2014). Chronic inflammation (inflammaging) and its potential contribution to age-associated diseases. Journals of Gerontology Series A: Biomedical
Sciences and Medical Sciences, 69(Suppl_1), S4-S9.
Frontera, W. R., Meredith, C. N., O'Reilly, K. P., Knuttgen, H. G., & Evans, W. J. (1988).
Strength conditioning in older men: skeletal muscle hypertrophy and improved function. Journal of Applied Physiology, 64(3), 1038-1044.
Ghaben, A. L., & Scherer, P. E. (2019). Adipogenesis and metabolic health. Nature Reviews
43
Molecular Cell Biology, 20(4), 242-258.
Gleeson, M., Bishop, N. C., Stensel, D. J., Lindley, M. R., Mastana, S. S., & Nimmo, M. A.
(2011). The anti-inflammatory effects of exercise: mechanisms and implications for the prevention and treatment of disease. Nature Reviews Immunology, 11(9), 607-615.
Guerra, R., Amaral, T. F., Marques, E., Mota, J., & Restivo, M. (2010). Accuracy of Siri and Brozek equations in the percent body fat estimation in older adults. The Journal of
Nutrition, Health & Aging, 14(9), 744-748.
Hagstrom, A. D., Marshall, P. W., Lonsdale, C., Papalia, S., Cheema, B. S., Toben, C., . . . Green, S. (2016). The effect of resistance training on markers of immune function and inflammation in previously sedentary women recovering from breast cancer: a
randomized controlled trial. Breast Cancer Research and Treatment, 155(3), 471-482.
Hotamisligil, G. S., Arner, P., Caro, J. F., Atkinson, R. L., & Spiegelman, B. M. (1995).
Increased adipose tissue expression of tumor necrosis factor-alpha in human obesity and insulin resistance. The Journal of Clinical Investigation, 95(5), 2409-2415.
Hotamisligil, G. S., Peraldi, P., Budavari, A., Ellis, R., White, M. F., & Spiegelman, B. M.
(1996). IRS-1-mediated inhibition of insulin receptor tyrosine kinase activity in TNF-α-and obesity-induced insulin resistance. Science, 271(5249), 665-670.
Hotamisligil, G. S., Shargill, N. S., & Spiegelman, B. M. (1993). Adipose expression of tumor necrosis factor-alpha: direct role in obesity-linked insulin resistance. Science,
259(5091), 87-91.
Hunter, G. R., Wetzstein, C. J., Fields, D. A., Brown, A., & Bamman, M. M. (2000).
Resistance training increases total energy expenditure and free-living physical activity in older adults. Journal of Applied Physiology, 89(3), 977-984.
Hurley, B. F., & Roth, S. M. (2000). Strength training in the elderly. Sports Medicine, 30(4), 249-268.
Koh, K. K., Park, S. M., & Quon, M. J. (2008). Leptin and cardiovascular disease: response to therapeutic interventions. Circulation, 117(25), 3238-3249.
Kohrt, W. M., Landt, M., & Birge Jr, S. (1996). Serum leptin levels are reduced in response to exercise training, but not hormone replacement therapy, in older women. The Journal
of Clinical Endocrinology & Metabolism, 81(11), 3980-3985.
Kohut, M., McCann, D., Russell, D., Konopka, D., Cunnick, J., Franke, W., . . . Vanderah, E.
(2006). Aerobic exercise, but not flexibility/resistance exercise, reduces serum IL-18, CRP, and IL-6 independent of β-blockers, BMI, and psychosocial factors in older adults. Brain, Behavior, and Immunity, 20(3), 201-209.
Kraemer, W. J., Ratamess, N. A., & Komi, P. (2003). Endocrine responses and adaptations to strength and power training. Strength and Power in Sport, 2, 361-386.
Lechleitner, M. (2008). Obesity and the metabolic syndrome in the elderly–a mini-review.
Gerontology, 54(5), 253-259.
44
Lu, K., Yu, F., Shi, T., Shen, S., Li, L., Li, Y., . . . Wang, W. (2018). Seasonal variance of serum biomarker levels in osteoarthritis patients: a cross-sectional study of 104 patients. Int J Clin Exp Med, 11(10), 10774-10780.
Manolopoulos, K., Karpe, F., & Frayn, K. (2010). Gluteofemoral body fat as a determinant of metabolic health. International Journal of Obesity, 34(6), 949-959.
Martins, M. S., Farinha, J. B., Benetti, C. B., Courtes, A. A., Duarte, T., Da Silva, J. C. N., . . . dos Santos, D. L. (2015). Positive effects of resistance training on inflammatory parameters in men with metabolic syndrome risk factors. Nutrición Hospitalaria,
32(2), 792-798.
Matsuzawa, Y., Shimomura, I., Nakamura, T., Keno, Y., Kotani, K., & Tokunaga, K. (1995).
Pathophysiology and pathogenesis of visceral fat obesity. Obesity Research, 3(S2), 187s-194s.
Mohamed-Ali, V., Goodrick, S., Rawesh, A., Katz, D., Miles, J., Yudkin, J., . . . Coppack, S.
(1997). Subcutaneous adipose tissue releases interleukin-6, but not tumor necrosis factor-α, in vivo. The Journal of Clinical Endocrinology & Metabolism, 82(12), 4196-4200.
Ogawa, K., Sanada, K., Machida, S., Okutsu, M., & Suzuki, K. (2010). Resistance exercise training-induced muscle hypertrophy was associated with reduction of inflammatory markers in elderly women. Mediators of Inflammation, 2010.
Ogden, C. L., Yanovski, S. Z., Carroll, M. D., & Flegal, K. M. (2007). The epidemiology of obesity. Gastroenterology, 132(6), 2087-2102.
Okosun, I. S., Liao, Y., Rotimi, C. N., Prewitt, T. E., & Cooper, R. S. (2000). Abdominal adiposity and clustering of multiple metabolic syndrome in White, Black and Hispanic Americans. Annals of Epidemiology, 10(5), 263-270.
Ouchi, N., Parker, J. L., Lugus, J. J., & Walsh, K. (2011). Adipokines in inflammation and metabolic disease. Nature Reviews Immunology, 11(2), 85.
Paz-Filho, G., Mastronardi, C., Franco, C. B., Wang, K. B., Wong, M.-L., & Licinio, J. (2012).
Leptin: molecular mechanisms, systemic pro-inflammatory effects, and clinical
implications. Arquivos Brasileiros de Endocrinologia & Metabologia, 56(9), 597-607.
Phillips, M. D., Flynn, M. G., McFarlin, B. K., Stewart, L. K., & Timmerman, K. L. (2010).
Resistance training at eight-repetition maximum reduces the inflammatory milieu in elderly women. Medicine & Science in Sports & Exercise, 42(2), 314-325.
Phillips, M. D., Patrizi, R. M., Cheek, D. J., Wooten, J. S., Barbee, J. J., & Mitchell, J. B.
(2012). Resistance training reduces subclinical inflammation in obese, postmenopausal women. Medicine & Science in Sports & Exercise, 44(11), 2099-2110.
Pikarsky, E., Porat, R. M., Stein, I., Abramovitch, R., Amit, S., Kasem, S., . . . Ben-Neriah, Y.
(2004). NF-κB functions as a tumour promoter in inflammation-associated cancer.
45
Nature, 431(7007), 461-466.
Ryan, A., Pratley, R., Elahi, D., & Goldberg, A. (2000). Changes in plasma leptin and insulin action with resistive training in postmenopausal women. International Journal of
Obesity, 24(1), 27-32.
Santos-Alvarez, J., Goberna, R., & Sánchez-Margalet, V. (1999). Human leptin stimulates proliferation and activation of human circulating monocytes. Cellular Immunology,
194(1), 6-11.
Seidell, J. C., & Visscher, T. L. (2000). Body weight and weight change and their health implications for the elderly. European Journal of Clinical Nutrition, 54(3), S33-S39.
Serra, M. C., Ryan, A. S., Ortmeyer, H. K., Addison, O., & Goldberg, A. P. (2018). Resistance training reduces inflammation and fatigue and improves physical function in older breast cancer survivors. Menopause (New York, NY), 25(2), 211.
Sethi, G., Sung, B., & Aggarwal, B. B. (2008). TNF: a master switch for inflammation to cancer. Front Biosci, 13(2), 5094-5107.
Silva, B. S., Lira, F. S., Rossi, F. E., Ramos, D., Uzeloto, J. S., Freire, A. P., . . . Ramos, E.
(2018). Inflammatory and metabolic responses to different resistance training on chronic obstructive pulmonary disease: a randomized control trial. Frontiers in
Physiology, 9, 262.
Singh, T., & Newman, A. B. (2011). Inflammatory markers in population studies of aging.
Ageing Research Reviews, 10(3), 319-329.
Sloan, R. P., Shapiro, P. A., DeMeersman, R. E., McKinley, P. S., Tracey, K. J., Slavov, I., . . . Flood, P. D. (2007). Aerobic exercise attenuates inducible TNF production in humans.
Journal of Applied Physiology, 103(3), 1007-1011.
Spranger, J., Kroke, A., Möhlig, M., Hoffmann, K., Bergmann, M. M., Ristow, M., . . . Pfeiffer, A. F. (2003). Inflammatory cytokines and the risk to develop type 2 diabetes:
results of the prospective population-based European Prospective Investigation into Cancer and Nutrition (EPIC)-Potsdam Study. Diabetes, 52(3), 812-817.
Starkie, R., Ostrowski, S. R., Jauffred, S., Febbraio, M., & Pedersen, B. K. (2003). Exercise and IL-6 infusion inhibit endotoxin-induced TNF-α production in humans. The FASEB
Journal, 17(8), 884-886.
Stowe, R. P., Peek, M. K., Cutchin, M. P., & Goodwin, J. S. (2010). Plasma cytokine levels in a population-based study: relation to age and ethnicity. Journals of Gerontology Series
A: Biomedical Sciences and Medical Sciences, 65(4), 429-433.
Suganuma, M., Okabe, S., Marino, M. W., Sakai, A., Sueoka, E., & Fujiki, H. (1999).
Essential role of tumor necrosis factor α (TNF-α) in tumor promotion as revealed by TNF-α-deficient mice. Cancer Research, 59(18), 4516-4518.
Tomeleri, C. M., Ribeiro, A. S., Souza, M. F., Schiavoni, D., Schoenfeld, B. J., Venturini, D., . . . Cyrino, E. S. (2016). Resistance training improves inflammatory level, lipid
46
and glycemic profiles in obese older women: A randomized controlled trial.
Experimental Gerontology, 84, 80-87.
Tomeleri, C. M., Souza, M. F., Burini, R. C., Cavaglieri, C. R., Ribeiro, A. S., Antunes, M., . . . Sardinha, L. B. (2018). Resistance training reduces metabolic syndrome and
inflammatory markers in older women: A randomized controlled trial: 老年女性抗阻 训练可减少代谢综合征以及炎症标志物: 一项随机对照试验. Journal of Diabetes,
10(4), 328-337.
Toth, M. J., Matthews, D. E., Tracy, R. P., & Previs, M. J. (2005). Age-related differences in skeletal muscle protein synthesis: relation to markers of immune activation. American
Journal of Physiology-Endocrinology and Metabolism, 288(5), E883-E891.
Van Dielen, F., Van't Veer, C., Schols, A., Soeters, P., Buurman, W., & Greve, J. (2001).
Increased leptin concentrations correlate with increased concentrations of
inflammatory markers in morbidly obese individuals. International Journal of Obesity,
25(12), 1759-1766.
Van Gaal, L. F., Mertens, I. L., & Christophe, E. (2006). Mechanisms linking obesity with cardiovascular disease. Nature, 444(7121), 875-880.
Wanderley, F. A., Moreira, A., Sokhatska, O., Palmares, C., Moreira, P., Sandercock, G., . . . Carvalho, J. (2013). Differential responses of adiposity, inflammation and autonomic function to aerobic versus resistance training in older adults. Experimental
Gerontology, 48(3), 326-333.
Wannamethee, S. G., Tchernova, J., Whincup, P., Lowe, G. D., Kelly, A., Rumley, A., . . . Sattar, N. (2007). Plasma leptin: associations with metabolic, inflammatory and haemostatic risk factors for cardiovascular disease. Atherosclerosis, 191(2), 418-426.
Wieser, M., & Haber, P. (2007). The effects of systematic resistance training in the elderly.
International Journal of Sports Medicine, 28(01), 59-65.
Willoughby, D. S., & Rosene, J. (2001). Effects of oral creatine and resistance training on myosin heavy chain expression. Medicine & Science in Sports & Exercise, 33(10), 1674-1681.
Wu, Y.-d., & Zhou, B. (2010). TNF-α/NF-κB/Snail pathway in cancer cell migration and invasion. British Journal of Cancer, 102(4), 639-644.
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10、是否曾經動過任何手術。
11、如果曾經被診斷出或使用藥物治療過下列疾病選項，請於左邊方格中勾選
高血壓高膽固醇糖尿病氣喘
癲癇腎臟問題膀胱問題貧血
心臟問題冠狀動脈疾病肺的問題慢性頭痛
12、是否曾在熱環境下運動而感到不適。(如: 熱衰竭、熱中暑、痙攣。)
13、是否曾經患有其他重大的疾病是上面沒有列出的。
14、最近是否患有任何疾病。
15、你知道是否有任何可能的原因造成你無法從事身體活動。
16、請列出你目前正在服用的所有藥物，包含避孕藥或任何非處方用藥(藥房) 。
藥名/增補劑/維他命 劑量 服用頻率(例：2 顆/天)
17、請列出你曾經所攝取過的營養增補劑(品) 。
藥名/增補劑/維他命 劑量 服用頻率(例：2 顆/天)
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18、請列出你所有的過敏反應:
過敏物質 過敏反應
19、是否抽菸/雪茄
是 否 量(支/天) 開始抽菸的年紀 如果戒菸了是在幾歲
__________ _____歲 __________歲 20、是否喝酒(含酒精飲料)
是 否 頻率(次數/星期) 每次喝多少(量)
__________ ______ml ______瓶 21、是否有下列家族病史，如果有，是誰罹患
高血壓 _________ 高膽固醇 ___________ 糖尿病_____________
腎臟問題 __________ 心臟問題 ________ 甲狀腺問題_________
22、過去曾經在下列選項的身體部位曾受過傷，如果有請勾選，並詳細說明細節:
頭 __________ 肩 ______ 頸 ______ 手肘 ______
上臂 ________ 手掌/指 ____ 胸腔 ______
髖部 ________ 軀幹 _______上背部 ______ 下背部 ______
膝蓋 ________ 腳踝 _______腳掌 ________ 大腿 是 否
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23、是否曾經有疲勞性骨折(stress fracture) 。
24、背部椎間盤是否曾經受傷過。
25、醫生是否因為你身體受傷而限制你的運動。
26、目前身體是否有任何傷痛並且困擾著你。
27、你覺得你的日常身體活動屬於
坐式生活型態(完全不運動) 少量的身體活動 (只走路等)
適量的身體活動 (規律跑步、健身等) 大量的身體活動 (比賽) 28、過去一年內是否曾經有進行規律的阻力運動(一週多於兩次)
是 否
29、請列出你常從事的身體活動或運動:
活動名稱 頻率 (天/周) 時間(分/次) 幾歲開始從事
參與者簽名：____________ 日期：____________
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附件(三) 身體活動問卷調查表
IPAQ 台灣活動量調查 短版問卷
問卷編號：__________
流 水 號：__________
受試者姓名：__________
訪員姓名：__________
訪視日期：__________
成 功：
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4、您通常一天花多少時間在中等費力的活動上？
一天______小時_______分鐘
□ 不知道/不確定
回想過去七天中，您花在走路上的時間有多久？包括工作、居家、和外出交通時的走路，
以及您純粹為了娛樂、運動及休閒而花在走路(不含上下樓梯、爬山) 上的時間。
5、過去七天中，您有多少天曾經走路持續10分鐘以上？
_______天
□ 沒有走路持續10分鐘以上 請跳答問題7 6、您通常一天花在走路上的時間有多久？
一天______小時_______分鐘
□ 不知道/不確定
最後一個問題是：過去七天的工作天中，您坐著的時間有多久？請將工作、居家、做功 課及休閒的時間都算進去，包括坐在桌前、打電腦、拜訪朋友、吃飯、閱讀、坐著或斜 躺著看電視，但請不要將睡著的時間算進去。
7、過去七天的工作天中，您一天坐著的時間有多久？
一天______小時_______分鐘
本問卷到此結束！謝謝！
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