健康生活型態介入對於女性高膽固醇血症及其他代謝症候群風險因子之影響

The Effect of Lifestyle Modification on Hypercholesterolemia and Other Risk Factors for Metabolic Syndrome in Females

10.7023/TJFM.201012.0192

陳暉明(Hui-Ming Chen)；王聖棻(Sheng-Fen Wang)；黃志芳(Chih-Fang Huang)；周騰達(Tang-Tat Chau)；辜美安(Malcolm Koo)

lifestyle intervention ； metabolic syndrome ； waist circumference ； hypertension ； dyslipidemia

台灣家庭醫學雜誌

20卷4期（2010 / 12 / 01）

192 - 202

繁體中文

Background: Hypercholesterolemia and metabolic syndrome are increasingly threatening to the health of the Taiwanese people. Lifestyle modification remains the primary treatment strategy for these conditions. We investigated the effect of lifestyle modification on hypercholesterolemia and other risk factors for metabolic syndrome by utilizing a nine-month lifestyle modification program.Methods: The present study used a prospective design. Female subjects afflicted with hypercholesterolemia or risk factors for metabolic syndrome were selected from among the participants in the January 2005 adult health examination in Dalin township of Chiayi county in Taiwan. The intervention group consisted of 27 females who completed the 9-month lifestyle modification program. The control group consisted of 27 age-matched (at 5-year intervals) females who did not participate. Non-parametric tests were used to compare the differences in adult health examination data between the intervention and control groups. This data included body weight, body mass index, waist circumference, number of risk factors for metabolic syndrome, blood pressure, and levels of blood cholesterol, blood triglycerides, and blood glucose.Results: Significant differences were observed in the pre- and post-intervention values between the intervention and control groups. Change in the median value of waist circumference was -1cm in the intervention group and +1cm in the control group (p＜0.001). The median values of diastolic pressure decreased 7 mmHg in the intervention group but increased 2 mmHg in the control group (p=0.001). The median values of total cholesterol decreased 17 mg/dL in the intervention group but increased 6 mg/dL in the control group (p=0.004). The median values of triglycerides increased 2 mg/dL in the intervention group but increased 24 mg/dL in the control group (p=0.040). The median values of blood glucose decreased 9 mg/dL in the intervention group but increased 4 mg/dL in the control group (p=0.001).Conclusions: The lifestyle modification program significantly reduced the levels of cholesterol and other risk factors for metabolic syndrome in females.

Background: Hypercholesterolemia and metabolic syndrome are increasingly threatening to the health of the Taiwanese people. Lifestyle modification remains the primary treatment strategy for these conditions. We investigated the effect of lifestyle modification on hypercholesterolemia and other risk factors for metabolic syndrome by utilizing a nine-month lifestyle modification program.Methods: The present study used a prospective design. Female subjects afflicted with hypercholesterolemia or risk factors for metabolic syndrome were selected from among the participants in the January 2005 adult health examination in Dalin township of Chiayi county in Taiwan. The intervention group consisted of 27 females who completed the 9-month lifestyle modification program. The control group consisted of 27 age-matched (at 5-year intervals) females who did not participate. Non-parametric tests were used to compare the differences in adult health examination data between the intervention and control groups. This data included body weight, body mass index, waist circumference, number of risk factors for metabolic syndrome, blood pressure, and levels of blood cholesterol, blood triglycerides, and blood glucose.Results: Significant differences were observed in the pre- and post-intervention values between the intervention and control groups. Change in the median value of waist circumference was -1cm in the intervention group and +1cm in the control group (p＜0.001). The median values of diastolic pressure decreased 7 mmHg in the intervention group but increased 2 mmHg in the control group (p=0.001). The median values of total cholesterol decreased 17 mg/dL in the intervention group but increased 6 mg/dL in the control group (p=0.004). The median values of triglycerides increased 2 mg/dL in the intervention group but increased 24 mg/dL in the control group (p=0.040). The median values of blood glucose decreased 9 mg/dL in the intervention group but increased 4 mg/dL in the control group (p=0.001).Conclusions: The lifestyle modification program significantly reduced the levels of cholesterol and other risk factors for metabolic syndrome in females.

1. 陳怡如、吳至行、張秦松、張尹凡、吳坤陵(2005)。不同減重程度對非糖尿病肥胖者代謝症候群的影響。台灣家醫誌，15，220-31。
   連結：
2. Bandura, A(1986).Social Foundations of Thought and Action: A Social Cognitive Theory.Englewood Cliffs, N.J.:Prentice Hall.
3. Baxter, AJ,Coyne, T,McClintock, C(2006).Dietary patterns and metabolic syndrome-a review of epidemiologic evidence.Asia Pac J Clin Nutr,15,134-42.
4. Bo, S,Ciccone, G,Baldi, C(2007).Effectiveness of a lifestyle intervention on metabolic syndrome. A randomized controlled trial.J Gen Intern Med,22,1695-703.
5. Carr, DB,Utzschneider, KM,Hull, RL(2004).Intra-abdominal fat is a major determinant of the National Cholesterol Education Program Adult Treatment Panel III criteria for the metabolic syndrome.Diabetes,53,2087-94.
6. Donnelly, JE,Blair, SN,Jakicic, JM,Manore, MM,Rankin, JW,Smith, BK(2009).American College of Sports Medicine: American College of Sports Medicine Position Stand. Appropriate physical activity intervention strategies for weight loss and prevention of weight regain for adults.Med Sci Sports Exerc,41,459-71.
7. Grundy, SM(2008).Metabolic syndrome pandemic.Arterioscler Thromb Vasc Biol,28,629-36.
8. Grundy, SM,Hansen, B,Smith, SC, Jr.,Cleeman, JI,Kahn, RA,American Heart Association,National Heart, Lung, and Blood Institute,American Diabetes Association(2004).Clinical management of metabolic syndrome: report of the American Heart Association/National Heart, Lung, and Blood Institute/American Diabetes Association conference on scientific issues related to management.Circulation,109,551-6.
9. Holman, H,Lorig, K(2004).Patient self-management: a key to effectiveness and efficiency in care of chronic disease.Public Health Rep,119,239-43.
10. Ilanne-Parikka, P,Eriksson, JG,Lindström, J(2008).Effect of lifestyle intervention on the occurrence of metabolic syndrome and its components in the Finnish Diabetes Prevention Study.Diabetes Care,31,805-7.
11. Kamioka, H,Nakamura, Y,Yazaki, T(2006).Effectiveness of comprehensive health education combining hot spa bathing and lifestyle education in middle-aged and elderly women: one-year follow-up on randomized controlled trial of three- and six-month interventions.J Epidemiol,16,35-44.
12. Kim, CJ,Kim, BT,Chae, SM(2010).Application of the transtheoretical model: exercise behavior in Korean adults with metabolic syndrome.J Cardiovasc Nurs,25,323-31.
13. Kingsley, RG,Wilson, GT(1977).Behavior therapy for obesity: a comparative investigation of long-term efficacy.J Consult Clin Psychol,45,288-98.
14. Lichtenstein, AH,Ausman, LM,Jalbert, SM(2002).Efficacy of a Therapeutic Lifestyle Change/Step 2 diet in moderately hypercholesterolemic middle-aged and elderly female and male subjects.J Lipid Res,43,264-73.
15. Loucks, EB,Rehkopf, DH,Thurston, RC,Kawachi, I(2007).Socioeconomic disparities in metabolic syndrome differ by gender:evidence from NHANES III.Ann Epidemiol,17,19-26.
16. Magkos, F,Yannakoulia, M,Chan, JL,Mantzoros, CS(2009).Management of the metabolic syndrome and type 2 diabetes through lifestyle modification.Annu Rev Nutr,29,223-56.
17. Milani, RV,Lavie, CJ,Mehra, MR(2004).Reduction in C-reactive protein through cardiac rehabilitation and exercise training.J Am Coll Cardiol,43,1056-61.
18. Munakata, M,Honma, H,Akasi, M(2008).Japanese study to organize proper lifestyle modifications for metabolic syndrome (J-STOP-MetS): design and method.Vasc Health Risk Manag,4,415-20.
19. National Cholesterol Education Program (NCEP)(2002).Expert Panel on Detection,Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III): 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) final report.Circulation,106,3143-421.
20. Ohkawara, K,Tanaka, S,Miyachi, M,Ishikawa-Takata, K,Tabata, I(2007).A dose-response relation between aerobic exercise and visceral fat reduction:systematic review of clinical trials.Int J obes,31,1786-97.
21. Orchard, TJ,Temprosa, M,Goldberg, R(2005).The effect of metformin and intensive lifestyle intervention on the metabolic syndrome: the Diabetes Prevention Program randomized trial.Ann Intern Med,142,611-9.
22. Paul-Ebhohimhen, V,Avenell, A(2009).A systematic review of the effectiveness of group versus individual treatments for adult obesity.Obes Facts,2,17-24.
23. Prochaska, JO,DiClemente, CC(1982).Transtheoretical therapy: toward a more integrative model of change.Psychother Theory Res Pract Train,19,276-88.
24. Prochaska, JO,Velicer, WF(1997).The transtheoretical model of health behavior change.Am J Health Promot,12,38-48.
25. Slentz, CA,Aiken, LB,Houmard, JA(2005).Inactivity, exercise, and visceral fat.STRRIDE: a randomized, controlled study of exercise intensity and amount.J Appl Physiol,99,1613-8.
26. Tuomilehto, J,Lindström, J,Eriksson, JG(2001).Prevention of type 2 diabetes by changes in lifestyle among subjects with impaired glucose tolerance.N Engl J Med,344,1343-50.
27. Wamala, SP,Lynch, J,Horsten, M,Mittleman, MA,Schenck-Gustafsson, K,Orth-Gomér, K(1999).Education and the metabolic syndrome in women.Diabetes Care,22,1999-2003.
28. Xiang, GD,Wang, YL(2004).Regular aerobic exercise training improves endothelium-dependent arterial dilation in patients with impaired fasting glucose.Diabetes Care,27,801-2.
29. 陳建仁、游山林、白其卉(2003)。,行政院衛生署國民健康局。

1. 劉美蘭、陳俊瑜、徐儆暉(2013)。高科技職場員工健康促進介入性方案對代謝症候群員王之影響。健康促進與衛生教育學報，39，27-52。