非糖尿病肥胖者經減重後體適能的變化及其相關因子

Changes of Physical Fitness after Weight Loss and the Associated Factors in Obese Non-Diabetics

陳怡如(Yi-Ju Chen) ； 張尹凡(Yin-Fan Chang) ； 張秦松(Chin-Song Chang) ； 盧豐華(Feng-Hwa Lu) ； 吳至行(Chih-Hsing Wu) ； 張智仁(Chih-Jen Chang)

《臺灣家庭醫學研究》 4卷1期 (2006/01) Pp. 40-51

https://doi.org/10.29475/TFMR.200601.0004

摘要

身體脂肪過多及有氧體適能不足都是肥胖相關疾病發生的獨立危險因子之一。體重減輕可以改善有氧體適能，但是相關影響因素仍未被充分了解。爲了探討非糖尿病肥胖者減重後體適能的變化及其相關因子，本研究收集某醫學中心體重管理特別門診自2001年12月至2004年7月間完整追蹤至16週之非糖尿病肥胖個案共110位，其中非藥物輔助治療組21位；藥物輔助治療組89位，包括服用orlistat有65位，服用sibutramine有24位。全部個案減重前平均身體質量指數爲31.3±4.6（公斤／公尺^2），於16週時平均減重7.7±4.4公斤(9.1±4.2%)。同時在脂肪質量、腰圍、空腹血漿血糖值、血壓、總膽固醇值及三酸甘油酯值也都達統計學上顯著的下降。三項體適能方面，心肺耐力指數、一分鐘仰臥起坐及坐姿體前彎均有明顯的改善。比較有無藥物輔助治療兩組發現，減重後脂肪質量、腰圍變化及體適能方面兩組並無顯著差異，而生化代謝功能上只有總膽固醇值在藥物治療組有明顯的下降。以相關係數分析發現脂肪質量改變百分比和心肺耐力指數、一分鐘仰臥起坐測驗及坐姿體前彎測驗改變量呈現顯著負相關。而複迴歸線性模式也發現脂肪質量變化爲影響三項體適能指標變化量的獨立因子，而體重變化則只對心肺耐力指數變化量有影響。
整體而言，經16週之藥物或非藥物適度減重後之非糖尿病肥胖者，均可顯著改善有氧體適能，而體適能的改善則與脂肪質量與體重減輕有關。

並列摘要

Obesity and low aerobic fitness are both independent risk factors for obesity-related comorbidities. The aerobic fitness would be improved by adequate weight loss, but its associated factors were inadequately evaluated. To assess the changes of physical fitness after weight loss and the associated factor, a total of 110 obese non-diabetics (70 females, 40 males, body mass index: 31.3±4.6 kg/m^2), who had completed the 16-week of comprehensive weight-reduction program with either non-pharmacological intervention (21 cases), orlistat 120mg thrice daily (65 cases), or sibutramine 10/15 mg once daily (24 cases), were collected from the weight management clinic of a tertiary medical center during Dec. 2001 to July 2004. Over the 16-week follow-up, a moderate weight loss (7.7 kg, 9.1%) associated with significant improvements of body fat mass, waist circumference, blood pressure, fasting plasma glucose, total cholesterol, triglyceride, and three physical fitness tests of 3-min step test, curl-up test, and sit-and-reach test were found. Compared the changes between the subjects with non-pharmacological (21 cases) and pharmacological intervention (89 cases), only the decrement of total cholesterol was significantly found higher in the pharmacological intervention group. The change of body fat mass was negatively associated with the changes of the three physical fitness tests. Using the multiple linear regression models, the change of body fat mass was the independent factor for the all three physical fitness tests. The change of body weight was only independently associated with 3-min step test.
In conclusion, moderate weight loss, either by non-pharmacological or pharmacological interventions, could result in the improvement of physical fitness in the obese non-diabetics. The associated factors of the changes of physical fitness are the changes of body weight and, especially, the body fat mass.

並列關鍵字

weight loss ； obese ； physical fitness ； body fat mass