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研究生: 黃君秦
Huang, Chun-Chin
論文名稱: 有氧運動前攝取咖啡因對糖尿病前期者運動後血糖調控之影響
Effect of Pre-Exercise Caffeine Ingestion on Post-Exercise Glycemia Regulation in Prediabetes
指導教授: 王鶴森
Wang, Ho-Seng
口試委員: 吳慧君
Wu, Huey-June
林信甫
Lin, Hsin-Fu
劉宏文
Liu, Hung-Wen
陳勇志
Chen, Yung-Chih
王鶴森
Wang, Ho-Seng
口試日期: 2021/06/11
學位類別: 博士
Doctor
系所名稱: 體育學系
Department of Physical Education
論文出版年: 2021
畢業學年度: 109
語文別: 中文
論文頁數: 71
中文關鍵詞: 胰島素阻抗葡萄糖耐受度空腹血糖
英文關鍵詞: insulin resistance, glucose tolerance, fasting plasma glucose
研究方法: 實驗設計法
DOI URL: http://doi.org/10.6345/NTNU202100495
論文種類: 學術論文
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  • 背景:糖尿病前期為第二類型糖尿病 (type 2 diabetes, T2D) 的高風險族群,透過運動時骨骼肌收縮刺激葡萄糖吸收與維持血糖恆定,是非藥物控制血糖、降低罹患糖尿病的有效方法。然而,咖啡因 (caffeine) 是一項廣泛使用的食品添加物,其不利於血糖控制的效果與運動相反,因此運動前攝取咖啡因對糖尿病前期者運動後血糖調控的影響仍需進一步釐清。目的:探討糖尿病前期者,攝取咖啡因對單次有氧運動後空腹血糖、胰島素、C-胜鍊胰島素 (C-peptide) 及葡萄糖耐受度的影響。方法:招募12名糖尿病前期男性,採雙盲、重複量數及平衡次序設計,所有參與者分別接受咖啡因+運動 (CE, 3mg/kg) 與安慰劑+運動 (PE) 兩種處理,運動形式為30分鐘60% VO2max (maximal oxygen uptake) 強度的跑步運動,並於攝取前、攝取後30分鐘/運動前、運動後立即及運動後120分鐘檢測血糖、胰島素及 C-peptide 濃度,另外,運動後立即進行口服葡萄糖耐受度測驗 (oral glucose tolerance test, OGTT)。結果:血糖在處理與時間因子的交互作用未達顯著 (p > .05),在處理因子主要效果中,CE 處理之平均血糖值顯著高於 PE 處理 (133.87 ± 41.22 vs 127.04 ± 34.17 mg/dl) (p < .05);而胰島素濃度在處理與時間因子的交互作用則達顯著 (p = .010),單純主要效果顯示,CE 處理在運動後30及120分鐘顯著高於PE 處理;另外,CE 處理於 OGTT 測驗中血糖與胰島素濃度變化總曲線下面積 (area under the curve, AUC) 亦顯著高於PE 處理 (p < .05)。而 CE 處理與 PE處理間之 C-peptide 濃度則無顯著差異 (p > .05)。結論:糖尿病前期者有氧運動前攝取咖啡因會引發體內血糖、胰島素濃度提升,產生短暫性胰島素敏感度下降反應,因此,從事有氧運動前攝取咖啡因可能不利於糖尿病前期者運動後的血糖調控。

    Background: Individuals with prediabetes increase the risk of developing type 2 diabetes. Exercise is potent stimulator of skeletal muscle glucose uptake and thus good for maintaining glucose homeostasis. That could be a conducive method to improve blood glucose regulation and prevent diabetes without medication intake. In contrast to exercise, the ingestion of caffeine is adverse for blood glucose regulation. Therefore, it is still unknown whether such effects of pre-exercise caffeine ingestion on post-exercise glycemia regulation in prediabetes. Purpose: It aimed to investigate the effects of caffeine on fasting glucose, insulin, C-peptide and glucose tolerance responses after acute aerobic exercise in individuals with prediabetes. Method: The study was a double-blinded, randomized and crossover trials design and twelve men with prediabetes will be recruited. Participants randomly underwent two different trials which were caffeine + exercise (CE, 3 mg/kg) and placebo + exercise (PE) one week apart in a counterbalanced and double-blinded design. Participants performed a 30-min running at 60% VO2max (maximal oxygen uptake) 30 min after caffeine / placebo ingestion in both trials. Blood glucose, insulin, and C-peptide concentrations were measured at pre-ingestion, pre-exercise, immediately after and 120 min after exercise. In addition, participants received OGTT immediately after exercise, with blood glucose and insulin measured every 30 min during the tests. Results: The results showed that no significant trial × time interaction was observed in blood glucose (p > .05). Regarding the main values of trial factor, blood glucose, (133.87 ± 41.22 vs 127.04 ± 34.17 mg/dl) in the CE were higher than PE (p < .05). Then, there were statistically significant differences in insulin between trials and time points (p = .010). The simple main effect indicated that insulin of CE at post-exercise 30 and 120 (OGTT 30, 120) were significant higher than the PE. Moreover, there were statistically significant differences (p < .05) in blood glucose and insulin AUC between trials. That in CE was significant higher than the PE trial. In addition, there were no differences in C-peptide between CE and PE trials at all time points. Conclusion: Acute caffeine ingestion could increase blood glucose and insulin post aerobic exercise, it will have a transient negative impact on insulin sensitivity in prediabetes. Thus, caffeine ingestion, though combined with aerobic exercise, might have a negative impact on glycemic control among prediabetes.

    第壹章 緒論 1 第一節 研究背景 1 第二節 研究目的 3 第三節 研究假設 3 第四節 名詞操作性定義 3 第五節 研究限制 4 第六節 研究重要性 4 第貳章 文獻探討 5 第一節 糖尿病前期簡介 5 第二節 有氧運動對糖尿病前期血糖調控的效益 7 第三節 咖啡因對葡萄糖代謝之影響路徑 15 第四節 咖啡因攝取對血糖調控的影響 17 第五節 本章總結 19 第參章 研究方法與步驟 20 第一節 研究參與者 20 第二節 實驗時間與地點 21 第三節 實驗流程 21 第四節 實驗方法與步驟 23 第五節 資料處理 25 第肆章 結果 26 第一節 研究參與者基本資料 26 第二節 不同實驗處理及葡萄糖耐受度測驗對血液葡萄糖濃度的影響 27 第三節 不同實驗處理及葡萄糖耐受度測驗對血液胰島素濃度的影響 29 第四節 不同實驗處理及葡萄糖耐受度測驗對血液 C-peptide 濃度的影響 32 第五節 HOMA-IR 與 HOMA-β 指標之變化 33 第伍章 討論與建議 35 第一節 咖啡因與運動對血液葡萄糖濃度變化的影響 35 第二節 咖啡因與運動對血液胰島素濃度變化的影響 38 第三節 咖啡因與運動對血液 C-peptide 濃度變化的影響 40 第四節 HOMA-IR 與 HOMA-β 指標的變化 41 第五節 結論與建議 43 參考文獻 44 附錄 54 附錄一 研究參與者身體活動調查問卷 54 附錄二 研究參與者知情同意書 60 附錄三 最大攝氧量紀錄表 64 附錄四 飲食紀錄表 65 附錄五 研究倫理審查核可證明書 66 附錄六 不同處理與不同時間點之血糖變異數分析摘要表 68 附錄七 不同處理與不同時間點之胰島素變異數分析摘要表 68 附錄八 不同處理與不同時間點之 C-peptide 變異數分析摘要表 69 附錄九 不同處理與不同時間點在 OGTT 中對血糖影響之變異數分析摘要表 69 附錄十 不同處理與不同時間點在 OGTT 中對胰島素影響之變異數分析摘要表 70 附錄十一 不同處理與不同時間點之 HOMA-IR 變異數分析摘要表 70 附錄十二 不同處理與不同時間點之 HOMA-β 變異數分析摘要表 71

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