簡易檢索 / 詳目顯示

研究生: 黃幼龍
Huang You-Long
論文名稱: 不同減重成效對肥胖者荷爾蒙與免疫反應之影響
Different Effects of Weight Loss on Hormones and Immune Responses in Obese Humans
指導教授: 徐孟達
Hsu, Meng-Da
學位類別: 碩士
Master
系所名稱: 體育學系
Department of Physical Education
論文出版年: 2010
畢業學年度: 98
語文別: 中文
論文頁數: 57
中文關鍵詞: 減重成效瘦體素胰島素敏感度免疫反應
英文關鍵詞: effect of weight loss, leptin, insulin sensitivity, immune response
論文種類: 學術論文
相關次數: 點閱:78下載:5
分享至:
查詢本校圖書館目錄 查詢臺灣博碩士論文知識加值系統 勘誤回報
  • 長期規律的有氧運動能夠有效利用脂肪作為能量來源,協助肥胖者恢復健康體態,減少慢性疾病的罹患率。本研究主要在探討不同減重成效對肥胖者荷爾蒙與免疫反應之影響。本實驗招募54名肥胖者參與減重介入計畫,以完成全程的22人為本研究受試者(平均年齡─23.27 ± 3.95歲;平均體脂肪率─男37.09 ± 6.10 %、女36.73 ± 4.76 %),並依其平均減少體脂率,將受試者分派為減重成效差組 (L) 與減重成效佳組 (H) (-1.30 ± 0.84 % vs. -5.56 ± 2.48 %)。所有受試者進行為期12週的有氧運動作為減重方式,並於介入前 (T1) 、後 (T2) 、以及介入計畫結束後3週 (T3) ,分別進行採血,以分析荷爾蒙與免疫反應變化情形。所得資料以混合設計二因子變異數分析以及皮爾遜積差相關進行考驗。結果發現:1.瘦體素濃度只有在H組有顯著下降 (p < .05);胰島素敏感度皆未有顯著變化 (p > .05)。2.白血球總數和IL-6濃度在L組有顯著提升 (p < .05),H組雖有提升卻未達顯著水準 (p > .05);TNF-α濃度皆有顯著提升 (p < .05)。3.體脂肪量與瘦體素及胰島素敏感度呈現顯著正相關,兩組除了在每日平均步數與瘦體素濃度有顯著差異外,其餘變項皆無顯著差異。IL-6和TNF-α皆有幫助脂肪細胞分解及啟動免疫反應的作用。在本研究減重後上升趨勢不同,可能是有先後調節的作用,往後可配合其餘指標觀察,以釐清變化的機制。身體活動量亦是影響能量調節與生理反應變化的重要因素,將來可延長減重計畫時間及增加運動頻率,以期減重成效達到更大的差異。

    The lone-term regular aerobic exercise can use fat effectively as an energy source to help obese people back to healthy posture and reduce chronic disease morbidity. This study focused on investigating the different effects on hormones and immune responses caused by aerobic exercise as a weight loss intervention. This study recruited 54 obese people to participate in the weight loss intervention. Among all the participants, 22 of them completed the whole course of weight loss intervention and therefore were subjects for this study (the average age of the subjects was 23.27 ± 3.95 years; the average percentage of body fat for male was 37.09 ± 6.10%, and for female was 36.73 ± 4.76%). According to their fat-loss results, the subjects were categorized into poor weight-loss-effect group (group L) and good weight-loss-effect group (group H) (-1.30 ± 0.84% vs. -5.56 ± 2.48%). All the subjects participated in a 12-week aerobic exercise as a weight loss intervention, and their blood samples were carried out before (T1), after (T2), and 3 weeks after the end of weight loss intervention (T3) in order to analyze changes in hormones and the immune responses. The collected data were analyzed by mixed design two-way ANOVA and the Pearson product-moment correlation. The results showed that: 1. The concentration of leptin decreased significantly only in the group H (p < .05); insulin sensitivity made no significant change on both groups (p > .05). 2. The counts of white blood cell and the concentration of IL-6 increased significantly in the group L (p < .05), but no significant enhance in the group H (p > .05). Besides, the concentration of TNF-α increased significantly in both groups (p < .05). 3. Body fat mass was correlated positively with leptin and insulin sensitivity significantly. Under the different effects of weight loss, in addition to average daily number of steps and the concentration of leptin, the other variables were not significant different in two groups. IL-6 and TNF-α not only help lipolysis but also activate immune responses. In this study, the different upward trends after weight loss intervention might be caused by the role of regulation sequence. In order to clarify the mechanisms of the changes, further experiment can be tested with other indicators. Physical activity is also an important factor to influence the regulation of energy and physiological responses; therefore, the period of subsequent weight loss intervention can be extended and the frequency of exercise can be increased, with a view to achieving greater differences in weight loss effect.

    目 次 中文摘要--------------------------------------------------------------------------------- i 英文摘要--------------------------------------------------------------------------------- ii 謝誌---------------------------------------------------------------------------------------- iv 目次--------------------------------------------------------------------------------------- v 表次--------------------------------------------------------------------------------------- vii 圖次-------------------------------------------------------------------------------------- viii 第壹章 緒論---------------------------------------------------------------------------- 1 第一節 前言------------------------------------------------------------------------ 1 第二節 問題背景------------------------------------------------------------------ 2 第三節 研究目的------------------------------------------------------------------ 3 第四節 研究範圍------------------------------------------------------------------ 3 第五節 研究限制------------------------------------------------------------------ 3 第六節 研究的重要性------------------------------------------------------------ 4 第七節 名詞操作性定義--------------------------------------------------------- 4 第貳章 相關文獻探討---------------------------------------------------------------- 7 第一節 肥胖與人體荷爾蒙及免疫系統之關聯------------------------------ 7 第二節 運動對減重的功效------------------------------------------------------ 11 第三節 運動訓練對荷爾蒙及免疫反應之影響------------------------------ 12 第四節 減重對荷爾蒙及免疫反應之影響------------------------------------ 14 第五節 減重後保留效果之探討------------------------------------------------ 18 第六節 本章總結------------------------------------------------------------------ 20 第參章 研究方法與步驟------------------------------------------------------------- 21 第一節 受試者--------------------------------------------------------------------- 21 第二節 實驗設計------------------------------------------------------------------ 21 第三節 實驗日期------------------------------------------------------------------ 21 第四節 實驗地點------------------------------------------------------------------ 22 第五節 實驗流程------------------------------------------------------------------ 23 第六節 實驗儀器------------------------------------------------------------------ 24 第七節 實驗方法與步驟--------------------------------------------------------- 24 第八節 資料分析與處理--------------------------------------------------------- 27 第肆章 結果---------------------------------------------------------------------------- 28 第一節 受試者基本資料-------------------------------------------------------- 28 第二節 減重計畫強度與每日步數-------------------------------------------- 31 第三節 介入前後瘦體素濃度的變化情形----------------------------------- 32 第四節 介入前後胰島素敏感度的變化情形------------------------------- 33 第五節 介入前後白血球總數的變化情形---------------------------------- 33 第六節 介入前後IL-6濃度的變化情形------------------------------------- 34 第七節 介入前後TNF-α濃度的變化情形---------------------------------- 35 第八節 身體組成與各生化指標之相關情形-------------------------------- 36 第伍章 討論與結論------------------------------------------------------------------- 38 第一節 討論----------------------------------------------------------------------- 38 一、 不同減重效果對瘦體素濃度和胰島素敏感度的影響----------- 38 二、 不同減重效果對白血球總數和細胞激素濃度的影響----------- 40 三、 身體組成、荷爾蒙濃度及免疫反應之相關性-------------------- 41 第二節 結論----------------------------------------------------------------------- 43 引用文獻--------------------------------------------------------------------------------- 44 附錄一 受試者須知及同意書---------------------------------------------------- 55 附錄二 健康情況調查表---------------------------------------------------------- 56 個人小傳--------------------------------------------------------------------------------- 57 表 次 表1-7-1 簡易判定肥胖表------------------------------------------------------------ 4 表2-1-1 世界衛生組織與我國衛生署訂定肥胖之標準------------------------ 8 表4-1-1 受試者基本資料摘要表-------------------------------------------------- 28 表4-1-2 全體受試者體重、體脂率與體脂重之變化情形-------------------- 29 表4-1-3 兩組減重過程體重變化情形-------------------------------------------- 29 表4-1-4 兩組減重過程體脂率變化情形----------------------------------------- 30 表4-1-5 兩組減重過程體脂重變化情形----------------------------------------- 31 表4-2-1 兩組有氧運動後心跳數與每日步數記錄表-------------------------- 31 表4-3-1 受試者於不同時期的瘦體素濃度變化情形-------------------------- 32 表4-4-1 受試者於不同時期的胰島素敏感度變化情形----------------------- 33 表4-5-1 受試者於不同時期的白血球總數變化情形-------------------------- 34 表4-6-1 受試者於不同時期IL-6濃度的變化情形---------------------------- 35 表4-7-1 受試者於不同時期TNF-α濃度的變化情形------------------------- 36 表4-8-1 受試者身體組成與生化指標之相關性-------------------------------- 37 圖 次 圖2-1-1 瘦體素與胰島素交互作用的關係---------------------------------------- 9 圖2-4-1 瘦體素在不同飲食情況下的免疫反應調節-------------------------- 17 圖3-5-1 實驗流程-------------------------------------------------------------------- 23

    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.

    下載圖示
    QR CODE