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Physical Activity and Metabolic Syndrome

身體活動量和代謝性症狀

摘要


代謝性症狀是指一個人同時具有多項的代謝性危險因子。代謝性症狀是現代化國家的主要導致死亡原因,包括台灣,和其相關的疾病有中風、心臟病、糖尿病和高血壓。世界衛生組織已經針對代謝性症狀下定義:高血液胰島素、血糖過高、糖尿病和至少出現下列兩項情形以上:肥胖腰臀圍比>0.9或身體質量指數≧30,血脂肪不正常(三酸甘油酯≧1.7mmol/L,高密度脂蛋白≦0.9mmol/L),或高血壓(血壓≧140/90mmHg或服用高血壓藥物治療)。研究證據顯示,代謝性症狀和胰島素阻抗有關。胰島素阻抗是細胞的不正常而影響多重器官,使得代謝缺陷更容易發生。胰島素阻抗和致動脈粥樣化的血脂肪不正常(atherogenic dyslipidemia)、高血壓(hypertension)、血栓形成前(prothrombotic state)、和葡糖糖耐受度(glucose tolerance)的關聯性,可能是透過多重的代謝途徑所引起。導致胰島素阻抗的主要因子包括肥胖,缺乏身體活動量和遺傳,而其他影響因素為飲食種類、老化、糖皮質激素(glucocoticoid)和雄激素(androgen)。從公共衛生的觀點而官,缺乏身體活動量和肥胖是主要導致代謝性症狀的因素。

並列摘要


The metabolic syndrome (MS) consists of a clustering of several metabolic risk factors in a single individual. MS has been the major cause of death in the industrialized countries including Taiwan. MS includes strokes, coronary artery disease, diabetes and hypertension. World Health Organization defined the MS as the presence of hyperinsulinemia, impaired fasting glucose, or diabetes and the presence of at least two of the following: obesity (waist-to-hip ratio>0.90 or body mass index ≧30kg/m^2), dyslipidemia (serum triglycerides ≧1.7 mmol/L or serum high density lipoprotein cholesterol (HDL)≦0.9 mmol/L), or hypertension (blood pressure ≧140/90 mm Hg or blood pressure medication). Strong evidences suggest that a state of insulin resistance plays an essential role in the development of the MS. Insulin resistance is a complex cellular abnormality that affects multiple organ systems and predisposes to several metabolic defects. The connections of insulin resistance with atherogenic dyslipidemia, hypertension, a prothrombotic state, and glucose tolerance are complex and may be mediated through multiple metabolic pathways. Several factors underlie the development of insulin resistance. The most important factors are obesity, physical inactivity, and genetics. Other factors that may affect the degree of insulin resistance are diet composition, aging, glucocoticoid and androgens hormones. From the public health point of view, obesity and inactivity are the primary driving factors for the development of the MS. The genetic factors, which are important as well, are under intense investigation. Physical activity recommendations for metabolic health are proposed in this paper.

參考文獻


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