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研究生: 童亢
Tung, Kang
論文名稱: 運動後增補不同劑量葡萄糖對前期高血壓至高血壓男性之踝臂脈波傳導速率及血壓的效應
Effects of Difference in Glucose Intake on Brachial-Ankle PWV and Blood Pressure After Exercise in Men with Prehypertension and Hypertension
指導教授: 王鶴森
Wang, Ho-Seng
口試委員: 王鶴森
Wang, Ho-Seng
廖翊宏
Liao, Yi-Hung
林信甫
Lin, Hsin-Fu
陳忠慶
Chen, Chung-Ching
陳勇志
Chen, Yung-Chih
口試日期: 2023/02/08
學位類別: 博士
Doctor
系所名稱: 體育與運動科學系
Department of Physical Education and Sport Sciences
論文出版年: 2023
畢業學年度: 111
語文別: 中文
論文頁數: 106
中文關鍵詞: 運動後低血壓高血糖症心血管疾病
英文關鍵詞: post-exercise hypotension, hyperglycemia, cardiovascular disease
DOI URL: http://doi.org/10.6345/NTNU202300729
論文種類: 學術論文
相關次數: 點閱:151下載:9
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  • 背景:有氧運動能改善動脈硬化指標-脈波傳導速率 (pulse wave velocity, PWV) 及血壓,而增補葡萄糖會導致高血糖使PWV及血壓上升。研究指出,正常血壓者進行有氧運動能抵消75g葡萄糖增補造成血壓及PWV的負面影響,不過,目前對於非正常血壓者及不同劑量葡萄糖增補下是否有相同效應仍有待釐清。目的:探討前期高血壓者至高血壓男性在單次有氧運動後增補不同劑量葡萄糖對踝臂脈波傳導速率 (brachial-ankle PWV, baPWV) 及血壓之效應。方法:招募12位無規律運動之前期高血壓至高血壓的成年男性並檢測65% 儲備心跳率。接著,以雙盲及平衡次序之實驗設計,在65% HRR強度跑步機運動30分鐘後立即增補0g (安慰劑;PT)、25g (25T)、75g (75T) 葡萄糖三種實驗處理,每次實驗處理間隔至少7天。baPWV、血壓及血流調節舒張功能 (flow-mediated dilation, FMD) 於運動前、運動後30、60、90及120分鐘檢測。結果:不同劑量葡萄糖處理的baPWV在運動前皆無差異 (p > .05),75T之baPWV在運動後120分鐘顯著高於PT (p < .05),但25T之baPWV與PT無差異。PT之baPWV在運動後60及90分鐘顯著低於運動前 (p < .05);不同劑量葡萄糖處理的平均動脈壓 (mean arterial pressure, MAP) 在各時間點皆無差異,75T的MAP在運動前與後無差異,而25T的MAP在運動後60至120分鐘顯著低於運動前 (p < .05),PT的MAP在運動後60及90分鐘顯著低於運動前 (p < .05);不同劑量葡萄糖處理的FMD在運動前皆無差異 (p > .05),但75T之FMD在運動後各時間點皆顯著低於PT及25T (p < .05),而25T之FMD在運動後30至90分鐘顯著低於PT (p < .05)。PT之FMD在運動後各時間點皆顯著高於運動前 (p < .05)。結論:有氧運動後立即增補75g葡萄糖會造成baPWV和FMD短暫負面影響,以及抵消有氧運動後降低MAP的效益。當有氧運動後增補葡萄糖劑量降至25g能減少葡萄糖對FMD及baPWV造成的負面影響,並達到運動後降低MAP的效益。

    Background: Aerobic exercise can improve pulse wave velocity (PWV) and blood pressure. On the other hand, glucose supplementation can lead to hyperglycemia, resulting in an increase in PWV and blood pressure. Studies have shown that aerobic exercise in individuals with normal blood pressure can counteract the negative effects of a 75g glucose supplementation on blood pressure and PWV. However, it remains unclear whether the same effects exist in men with prehypertension and hypertension or under different doses of glucose supplementation. Purpose: To examine the effects of difference dose in glucose intake on brachial-ankle PWV and blood pressure after exercise in men with prehypertension and hypertension. Methods: 12 sedentary adult males with prehypertension to hypertension was recruited, and test 65% heart rate reserve (HRR) before trails. All the Participants perform three treatments in a double-blind counterbalanced design that include 0 (placebo), 25 and 75 g of glucose ingestion immediately after perform 30 min of treadmill running at intensity of 65% HRR. Each treatment on separate 7 days at least. baPWV, blood pressure, and flow-mediated dilation would be measured at baseline and 30,60, 90 and 120 min post-exercise in all treatments. Results: baPWV did not differ significantly among different treatments at baseline (p > .05). baPWV after 75g glucose treatment was significantly higher than 0g glucose treatment at 120 min post-exercise (p < .05), but there was no significant difference in baPWV between 25g glucose treatment and 0g glucose treatment. baPWV of the 0g glucose treatment was significantly lower than baseline at 60 and 90 min post-exercise (p < .05). Mean arterial pressure (MAP) did not differ significantly among different treatments at any time point. MAP of the 75g glucose treatment showed no significant difference baseline and post-exercise, while the MAP of the 25g glucose treatment was significantly lower than baseline at 60 to 120 min post-exercise (p < .05). MAP of the 0g glucose treatment was significantly lower than baseline at 60 and 90 min post-exercise (p < .05). Flow-mediated dilation (FMD) did not differ significantly among different treatments baseline (p > .05). FMD of the 75g glucose treatment was significantly lower than the 0g and 25g glucose treatments at all post-exercise time points (p < .05), and FMD of the 25g glucose treatment was significantly lower than the 0g glucose treatment at 30 to 90 min post-exercise (p < .05). FMD of the 0g glucose treatment was significantly higher than baseline at all post-exercise time points (p < .05). Conclusion: 75g of glucose supplement immediately after aerobic exercise can cause short-term negative effects on baPWV and FMD, and it would offset aerobic exercise decrease MAP. The negative effects of glucose on FMD and baPWV could be reduced when the supplemental glucose dose was reduced to 25g after aerobic exercise, and lower MAP after aerobic exercise.

    第壹章 緒論1 第一節 問題背景1 第二節 研究目的6 第三節 研究假設6 第四節 名詞操作性定義7 第五節 研究範圍與限制7 第六節 研究之重要性7 第貳章 文獻探討9 第一節 動脈硬化及血壓與心血管疾病9 第二節 有氧運動降低血壓及PWV與其相關機制13 第三節 有氧運動改善血糖及其相關機制18 第四節 葡萄糖增補對血壓及PWV之影響21 第五節 有氧運動與葡萄糖增補對PWV及血壓之相關研究24 第六節 本章總結26 第參章 研究方法與步驟28 第一節 受試對象28 第二節 實驗時間與地點29 第三節 實驗方法與步驟29 第四節 資料處理34 第肆章 結果35 第一節 研究對象基本資料35 第二節 有氧運動與不同葡萄糖劑量對baPWV的影響36 第三節 有氧運動與不同葡萄糖劑量對血壓的影響37 第四節 有氧運動與不同葡萄糖劑量對FMD的影響39 第五節 有氧運動與不同葡萄糖劑量對血糖濃度的影響40 第六節 有氧運動與不同葡萄糖劑量對血液胰島素濃度的影響41 第七節 有氧運動與不同葡萄糖劑量對血液三酸甘油脂濃度的影響43 第八節 有氧運動與不同葡萄糖劑量對HOMA-IR的影響43 第九節 有氧運動與不同葡萄糖劑量對McAuley index的影響45 第十節 有氧運動與不同葡萄糖劑量對心律變異性的影響46 第十一節 有氧運動與不同葡萄糖劑量增補後變項之間相關性50 第伍章 討論與建議52 第一節 葡萄糖與有氧運動對baPWV變化的影響52 第二節 葡萄糖與有氧運動對血壓變化的影響54 第三節 葡萄糖與有氧運動對FMD變化的影響56 第四節 葡萄糖與有氧運動對血液葡萄糖濃度變化的影響58 第五節 葡萄糖與有氧運動對血液胰島素濃度與HOMA-IR指標變化的影響60 第六節 葡萄糖與有氧運動對三酸甘油脂與McAuley index指標的變化62 第七節 葡萄糖與有氧運動對Mean HR與心律變異性的影響63 第八節 葡萄糖與有氧運動影響動脈硬化及內皮功能之可能機制67 第九節 綜合討論73 第十節 結論與建議77 參考文獻78

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