背景：雖然規律且適度的運動有益身心健康，但仍有不少國人缺少運動習慣，以致增加罹患代謝症候群的風險。目的：探討身體活動量變化對中年男子身體適能與代謝症候群危險因子之影響。方法：以北部某家健康檢查醫院124位年齡約在40 ~ 64歲之健檢者為研究對象，根據兩次檢測時之身體活動量變化狀況分成兩組：體能活動量增加組 (increase group, IG)與體能活動量沒增加組 (no increase group, NIG)，每組各62位。所有受試者於兩次檢查中皆接受身體適能檢測及代謝症候群危險因子之分析。所得資料以混合設計二因子變異數分析檢驗身體活動量變化介入的效果。結果：(1)在第一次檢測時，IG組的身體活動量明顯低於NIG組；而第二次檢測時，IG組的身體活動量則明顯高於NIG組。(2)身體活動量變化對身體適能沒有造成明顯的改變，但所有受試者在第二次檢測時的體脂率及體脂重明顯較第一次檢測時來的低。(3)不同組MS盛行率沒有明顯的不同，但所有受試者第二次檢測時的MS盛行率明顯較第一次檢測時來的低。(4) 身體活動量變化對MS危險因子沒有造成明顯的改變，但所有受試者在第二次檢測時的TG及HDL較第一次檢測時有明顯的正向改變。結論：雖然身體活動量的變化無法明顯對中年男子身體適能及MS危險因子造成明顯的正向改變，但規律從事輕度身體活動即能有效減少MS盛行率，因此，為了維護身體健康，中年男子仍應規律從事適度的運動。

Purpose: to investigate the effects of changes in physical activity on physical fitness and metabolic syndrome (MS) risk factors in middle-aged men. Methods: 124 (aged about 40 to 64 years of age) dealt with health check in the northern part of a health examination hospital for the study. According to the change of physical activity, participants were assigned into physical activity increase group (IG, n=62) and physical activity no increase group (NIG, n=10). Physical activity and MS risk factors were measured. Data were analyzed by a mixed design two-way ANOVA. Results: (1) Physical activity amount of IG was significantly lower than NIG (p< .05) at first test, while physical activity amount of IG was significantly higher than NIG (p< .05) at second test. (2) Changes in physical activity on the physical fitness without causing significant changes (p> .05), but the percentage of body fat and the mass of body fat test were significantly higher at the second than at the first test of all subjects (p< .05). (3) MS prevalence of different groups did not differ significantly (p> .05), but the prevalence of MS were significantly lower at the second test than at the first test for all subjects (p< .05). (4) Changes in physical activity for MS risk factors caused no significant change (p> .05), but TG and HDL were significantly lower at the second test than at the first test of all subjects (p< .05). Conclusions: Although the changes in physical activity can’t cause significant positive change on physical fitness and MS risk factors in middle-aged men, but the lower physical activity life style can effectively reduce the prevalence of MS. Therefore, in order to maintain well health, middle-aged men should remain engaged in moderate exercise.

參考文獻

行政院衛生署國民健康局。2010。健康體能相關實證文獻。取自https://101.health.gov.tw/upload/2011726105428_%E5%81%A5%E5%BA%B7%E9%AB%94%E8%83%BD%E7%9B%B8%E9%97%9C%E5%AF%A6%E8%AD%89%E6%96%87%E7%8D%BB.pdf

朱嘉華 (2007)。身體活動與代謝症候群。中華體育季刊，21(1)，7-17。

李龍騰、張玉坤、黃國晉、潘文涵、陳慶餘 (2005) 。台灣地區老年人代謝症候群之盛行率調查。台灣老年醫學雜誌，1(1)，9-17。

林晉榮、曾建興 (2007)。身體活動不足對代謝症候群之影響。中正體育學刊，(1)，57-64。

林瑞興、賴映帆、滕文豹 (2008) 。運動訓練介入對降低腹部內臟脂肪量的效果。屏東教大運動科學學刊，4，1-13。

張昌堯、郭雅音、陳佑寧、洪錦墩、陳榕生、廖朝財（2009）。南投地區中老年人代謝症候群盛行率。Journal of Biomedical & Laboratory Sciences，20(3&4)，40-46。

張皓翔 (2009)。運動與代謝症候群。台大醫院北護分院院訊，49，1。取自http://w3srv.ntuh.gov.tw/bh/%E9%99%A2%E8%A8%8A/49.pdf

黃永任 (2012)。運動與代謝症候群。運動知識學報，9，27-33。

楊雅萍、王琪珍、楊雅婷、王振興、楊宜青 (2014)。隨身活動促進工具對於體重過重或代謝異常受試者介入成效之前驅性研究。臺灣家庭醫學雜誌，24( 2)，86-98。doi： 10.3966/168232812014062402004

劉秉一（2008）。中年人的危機-代謝症候群。Taiwan Critical Care Medical，9(1)，26-33。

劉秋松、黃亦潔、廖珮彤、林正介、李采娟、葉志清 (2012) 。代謝症候群危險因子探討。長庚科技學刊，16，1-14。

蔡崇煌、黃素雲、林高德 (2006) 。代謝症候群與其相關因子之研究－健檢資料分析。臺灣家庭醫學雜誌，16 ( 2)，112-122。

衛生福利部。(2007)。2007 台灣代謝症候群之判定標準。取自http://www.hpa.gov.tw/Bhpnet/Web/HealthTopic/TopicArticle.aspx?No=200712250123&parentid=200712250023
衛生福利部。(2007)。代謝症候群防治工作手冊。取自http://www.hpa.gov.tw/BHPNet/Web/Books/manual_content13.aspx

衛生福利部。(2007)。預防代謝症候群教學手冊。取自http://www.hpa.gov.tw/manual/common/Download/%E9%A0%90%E9%98%B2%E4%BB%A3%E8%AC%9D%E7%97%87%E5%80%99%E7%BE%A4%E6%95%99%E5%AD%B8%E6%89%8B%E5%86%8A.pdf

戴在松。(2007)。運動與新陳代謝症候群。嘉大體育健康休閒期刊，6(2)，110-118。

簡盟月、吳英黛（2006）。胰島素阻抗與運動訓練的效果－細胞與分子層面之探討。物理治療，31(2），130-141。

Alberti, K. G., Zimmet, P. Z. (1998). Definition, diagnosis and classification of diabetes mellitus and its complications. Part 1: Diagnosis and classification of diabetes mellitus provisional report of a WHO consultation. Diabetic Medicine, 15(7), 539-553. doi: 10.1002/(SICI)1096-9136(199807)15:7<539::AID-DIA668>3.0.CO;2-S

Carnethon, M. R., Loria, C. M., Hill, J. O., Sidney, S., Savage, P. J., & Liu, K. (2004). Risk factors for the metabolic syndrome: The Coronary Artery Risk Development in Young Adults (CARDIA) study, 1985-2001. Diabetes Care, 27, 2707-2715.

Carroll, S. E. A. N., Cooke, C. B., & Butterly, R. J. (2000). Metabolic clustering, physical activity and fitness in nonsmoking, middle-aged men. Medicine and science in sports and exercise, 32(12), 2079-2086.

Corbin, C. B., & Pancrazi, R. P. (1996). How much physical activity is enough? Journal of Physical Education, Recreation & Dance, 67(4), 33-37. doi:10.1080/07303084.1996.10607371

Deng, Y., & Scherer, P. E. (2010). Adipokines as novel biomarkers and regulators of the metabolic syndrome. Annals of the New York Academy of Sciences,1212, E1-E19.

Dengel, D. R., Hagberg, J. M., Pratley, R. E., Rogus, E. M., & Goldberg, A. P. (1998). Improvements in blood pressure, glucose metabolism, and lipoprotein lipids after aerobic exercise plus weight loss in obese, hypertensive middle-aged men. Metabolism, 47(9), 1075-1082.

Despre´s, J. P., Lemieux, I., Bergeron, J., Pibarot, P., Mathieu, P., Larose, E., Rode´s-Cabau, J., Bertrand, O. F., & Poirier, P. (2008). Abdominal obesity and the metabolic syndrome: contribution to global cardiometabolic risk. Arteriosclerosis, Thrombosis, and Vascular Biology, 28, 1039-1049.

Donnelly, J. E., Blair, S. N., Jakicic, J. M., Manore, M. M., Rankin, J. W., & Smith, B. K. (2009). Appropriate Physical Activity Intervention Strategies for Weight Loss and Prevention of Weight Regain for Adults. Medicine and Science in Sports and Exercise, 41, 459-471.

Eckel, R. H., Grundy, S. M., & Zimmet, P. Z. (2005). The metabolic syndrome. Lancet, 365, 1415-1428.

Ekelund, U., Brage, S., Franks, P. W., Hennings, S., Emms, S., & Wareham, N. J. (2005). Physical activity energy expenditure predicts progression toward the metabolic syndrome independently of aerobic fitness in middle-aged healthy Caucasians the Medical Research Council Ely Study. Diabetes Care, 28(5), 1195-1200.

Executive summary of the third report of the national cholesterol education program (NCEP) expert panel on detection, evaluation, and treatment of high blood cholesterol in adults (adult treatment panel III). (2001). The Journal of the American Medical Association, 285 (19), 2486-2497. doi:10.1001/jama.285.19.2486.

Fogelholm, M., & Kukkonen-Harjula, K. (2000). Does physical activity prevent weight gain: A systematic review. Obesity Reviews, 1, 95-111.

Ford, E. S., Giles, W. H., & Dietz, W. H. (2002). Prevalence of the metabolic syndrome among US adults: findings from the third National Health and Nutrition Examination Survey. Journal of the American Medical Association, 287(3), 356-359.

Ford, E. S., Kohl III, H. W., Mokdad, A. H., & Ajani, U. A. (2005). Sedentary behavior, physical activity, and the metabolic syndrome among U.S. adults. Obesity Research, 13, 608-614.

Grundy, S. M., Cleeman, J. I., Daniels, S. R., Donato, K. A., Eckel, R. H., Franklin, B. A., ... & Costa, F. (2005). Diagnosis and management of the metabolic syndrome an American Heart Association/National Heart, Lung, and Blood Institute scientific statement. Circulation, 112(17), 2735-2752.

Han, T. S., & Lean, M. E. (2015). Metabolic syndrome. Medicine, 43(2), 80-87.

Irwin, M. L., Ainsworth, B. E., Mayer‐Davis, E. J., Addy, C. L., Pate, R. R., & Durstine, J. L. (2002). Physical Activity and the Metabolic Syndrome in a Tri‐ethnic Sample of Women. Obesity Research, 10(10), 1030-1037.Jurca, R. A. D. I. M., Lamonte, M. J., Church, T. S., Earnest, C. P., Fitzgerald, S. J., Barlow, C. E., ... & Blair, S. N. (2004). Associations of muscle strength and fitness with metabolic syndrome in men. Medicine and science in sports and exercise, 36(8), 1301-1307.

Katzel, L. I., Bleecker, E. R., Rogus, E. M., & Goldberg, A. P. (1997). Sequential effects of arobic exercise training and weight loss on risk factors for coronary disease in healthy, obese middle-aged and older men. Metabolism, 46(12), 1441-1447.

Katzmarzyk, P. T., Church, T. S., Janssen, I., Ross, R., & Blair, S. N. (2005). Metabolic syndrome, obesity, and mortality impact of cardiorespiratory fitness. Diabetes care, 28(2), 391-397.

Katzmarzyk, P. T., Leon, A. S., Wilmore, J. H., Skinner, J. S., Rao, D. C., Rankinen, T., et al. (2003). Targeting the metabolic syndrome with exercise: evidence from the HERITAGE Family Study. Medicine and Science in Sports and Exercise,35(10), 1703-1709.

Kawanaka, K., Nolte, L. A., Han, D. H., Hansen, P. A., & Holloszy, H. O. (2000).　Mechanisms underlying impaired GLUT4-translocation in glycogensupercompensated　muscles of exercise rats. American Journal Physiology Endocrinal Metabolism, 279, E1311-E1318.

Knowler, W. C., Barrett-Connor, E., Fowler, S. E., Hamman, R. F., Lachin, J. M., Walker, E. A., & Nathan, D. M. (2002). Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin. The New England journal of medicine, 346(6), 393-403.

Kullo, I. J., Hensrud, D. D., & Allison, T. G. (2002). Relation of low cardiorespiratory fitness to the metabolic syndrome in middle-aged men. The American journal of cardiology, 90(7), 795-797.

Laaksonen, D. E., Lakka, H. M., Salonen, J. T., Niskanen, L. K., Rauramaa, R., & Lakka, T. A. (2002). Low levels of leisure-time physical activity and cardiorespiratory fitness predict development of the metabolic syndrome. Diabetes care, 25(9), 1612-1618.

Lakka, T. A., Laaksonen, D. E., Lakka, H. M., Männikkö, N. I. K. O., Niskanen, L. K., Rauramaa, R. A. I. N. E. R., & Salonen, J. T. (2003). Sedentary lifestyle, poor cardiorespiratory fitness, and the metabolic syndrome. Medicine and science in sports and exercise, 35(8), 1279-1286.

Lin, C. C., Liu, C. S., Lai, M. M., Li, C. I., Chen, C. C., Chang, P. C., Lin, W. Y., Lee, Y. D., Lin, T., & Li, T. C. (2007). Metabolic syndrome in a Taiwanese metropolitan adult population. BioMed Central Public Health, 7, 239. doi:10.1186/1471-2458-7-239

Orchard, T. J., Temprosa, M., Goldberg, R., Haffner, S., Ratner, R., Marcovina, S., & Fowler, S. (2005). The effect of metformin and intensive lifestyle intervention on the metabolic syndrome: the Diabetes Prevention Program randomized trial. Annals of internal medicine, 142(8), 611-619.

Palaniappan, L., Carnethon, M. R., Wang, Y., Hanley, A. J. G., Fortmann, S. P., Haffner, S. M., & Wagenknecht, L. (2004). Predictors of the incident metabolic syndrome in adults: the Insulin resistance atherosclerosis study. Diabetes Care, 27(3), 788-793. doi: 10.2337/diacare.27.3.788

Rauramaa, R., & Leon, A. S. (1996). Physical activity and risk of cardiovascular disease in middle-aged individuals. Sports Medicine, 22(2), 65-69.

Reaven, G. M. (1988). Banting lecture 1988. Role of insulin resistance in human disease. Diabetes, 37, 1595-1607.

Saris, W. H., Blair, S. N., van Baak, M. A., Eaton, S. B., Davies, P. S., Di Pietro, L., Fogelholm, M., Rissanen, A., Schoeller, D., Swinburn, B., Tremblay, A., Westerterp, K. R., & Wyatt, H. (2003). How much physical activity is enough to prevent unhealthy weight gain? Outcome of the IASO 1st stock conference and consensus statement. Obesity Reviews, 4, 101-114.

Sarzani, R., Salvi, F., Dessì-Fulgheri, P., & Rappelli, A. (2008). Renin–angiotensin system, natriuretic peptides, obesity, metabolic syndrome, and hypertension: an integrated view in humans. Journal of Hypertension, 26(5), 831-843. doi: 10.1097/HJH.0b013e3282f624a0

Smutok, M. A., Reece, C., Kokkinos, P. F., Farmer, C., Dawson, P., Shulman, R., ... & Hurley, B. F. (1993). Aerobic versus strength training for risk factor intervention in middle-aged men at high risk for coronary heart disease. Metabolism, 42(2), 177-184.

Torjesen, P. A., Birkeland, K. I., Anderssen, S. A., Hjermann, I., Holme, I., & Urdal, P. (1997). Lifestyle changes may reverse development of the insulin resistance syndrome. The Oslo Diet and Exercise Study: a randomized trial. Diabetes care, 20(1), 26-31.

Wareham, N. J., Hennings, S. J., Byrne, C. D., Hales, C. N., Prentice, A. M., & Day, N. E. (1998). A quantitative analysis of the relationship between habitual energy expenditure, fitness and the metabolic cardiovascular syndrome. British Journal of Nutrition, 80(03), 235-241.

Watkins, L. L., Sherwood, A., Feinglos, M., Hinderliter, A., Babyak, M., Gullette, E., ... & Blumenthal, J. A. (2003). Effects of exercise and weight loss on cardiac risk factors associated with syndrome X. Archives of internal medicine, 163(16), 1889-1895.

Winder, W. W. (2001). Energy-sensing and signaling by AMP-activated protein kinase in skeletal muscle. Journal of Applied Physiology, 91, 1017-1028.

Whaley, M. H., Kampert, J. B., Kohl 3rd, H. W., & Blair, S. N. (1999). Physical fitness and clustering of risk factors associated with the metabolic syndrome. Medicine and Science in Sports and Exercise, 31(2), 287-293.

2005 Dietary Guidelines for Americans. http://www.health.gov/DietaryGuidelines.

2008 Physical Activity Guidelines for Americans. http://www.health.gov/paguidelines.