- 學位論文
探討國內孕婦瘦素濃度與飲食攝取及體位之改變
The relationship between leptin and dietary pattern、body weight gain in pregnant women
摘要
Leptin（瘦素）字根源自希臘字leptos（瘦），合成瘦素的ob基因乃於1994年由Zhang等人定序出來。瘦素（Leptin）又稱為瘦體蛋白，是由脂肪組織中的 ob 基因所產生的一種荷爾蒙（adipocyte- derived hormone）。瘦素除了調節能量平衡之外與性成熟和生殖功能有關，在整個懷孕期間，瘦素傳遞訊息促使脂肪儲存，尤其於懷孕後期瘦素大量產生是為了擴大脂肪的儲存，以便提供整個孕產期能量的需求。國外許多研究報告指出，懷孕期間體重增加與瘦素之間有相當明顯的正相關，但是針對孕產期間熱量攝取與瘦素之間的關係卻不清楚。本次研究的目的欲了解國內婦女懷孕期間，瘦素濃度之改變與飲食攝取（熱量、蛋白質、脂質、醣類）及體位變化間的相關性。本研究招募55名健康孕婦，首先請受試者填寫個人資料，包括身高、未懷孕前體重、胎次；並指導受試者填寫24小時飲食紀錄。受試孕婦配合產檢於懷孕7-13週、21-27週、28-34週、生產時、產後6週回診抹片檢查時同時抽血、測量體重、體脂肪，並請孕產婦於前述懷孕三期、月子期間、產後6週回診時紀錄3天24小時飲食紀錄（2天平日1天假日）。生產時除收集母親血液外也收集臍帶血液並稱量新生兒體重與胎盤重。血液收集離心後，取血漿且存於-70?C下，以RIA kit 分析瘦素濃度。結果顯示，於懷孕期間及產後6週的體重、身體質量指數 ( BMI )、體脂肪與瘦素量都有顯著的相關性，孕前體重、BMI與孕期的瘦素也有顯著相關性；新生兒體重與臍帶血中瘦素量有顯著的相關性而與母親的瘦素量無關。飲食攝取方面，產後6週飲食中的脂質與瘦素量有顯著相關性。根據結果，懷孕前體位較大者與瘦素濃度之間有明顯的相關性，懷孕總增加重量與新生兒體重具相關性，懷孕期熱量攝取與瘦素濃度則無相關性。
並列摘要
The word "leptin" is originally from “Leptos”, the Greek affix. Dr. Zhang and others scholars defined the ob gene of synthetic leptin in 1994. Leptin is also called the lean albumen that is the adipocyte-derived hormone produced by ob gene from the adipose tissue. Besides keeping the energy balance, leptin is also related to the sexual maturity and the reproductive function. During the pregnancy, leptin transmits messages to keep the fat inside the body. Leptin reproduces more on the later pregnancy in order to save more fat and provides the demands of energy for the whole pregnancy. Many foreign researches indicate that there is relation between gaining the weight during the pregnancy and the leptin. However, there is no evidence to clarify the relation between the intake of calories and the leptin during the pregnancy. The purpose of this research is to exam the relation among the variations of leptin’s consistency, the change of body weight, body fat and the dietary intake (including energy, protein, fat and carbohydrate) during the pregnancy of Taiwan women. This research is based on the case studies from 55 healthy pregnant women. The first step of this research was to collect the personal data including the height, weight before the pregnancy, birth numbers and the 24-hour dieting recordings. When interviewees went back to the hospital for examination during the pregnancy, birth and the 6-week postpartum, they also did the blood drawing, weight and body fat measuring, and the 3-day 24-hour (2 weekdays and 1 holiday) diet recording during pregnancy, the period of the mother’s rest and the 6-week of postpartum. Besides mothers’ blood, the blood of the umbilical cords and the neonates’ weight and the placental’ weight during interviewees’ childbearing. After centrifugation, plasma and kept under the -70℃ for the leptin measurement using RIA kit. The result shows that there was correlation (p<0.01) between the weight (r=0.507), BMI (r=0.495), body fat (r=0.503) and the leptin concentration during the pregnancy. Also, BMI before the pregnancy and the leptin existed notable relation. There was the correlation (p<0.05) between the neonatal’s weight and the leptin (r=0.472). From the aspect of dietary intake, there was no remarkable relationship among the calories, protein, carbohydrate, body fat and the leptin during the pregnancy. But, the fat (% of total calories )in the postpartum food and the leptin existed the notable relation (r=0.975) (p<0.01). In conclusion, heavy weight and higher BMI before the pregnancy and the leptin’s consistency existed the significant correlation. There was no relationship between the calories intake and the leptin during the pregnancy.