本研究的主要目的在探討十二週耐力運動訓練對肥胖大學生心臟結構型態和泵血功能及心血管疾病危險因子的影響。31 位肥胖大學生 (男性之體脂肪百分比＞25 %，女性＞30 %) 自願參與本實驗，並隨機分配至耐力運動訓練組 (n＝16) 及控制組 (n＝15)。耐力運動訓練組接受每週 3 天，每次 30 分鐘漸增至 50 分鐘，運動強度為 70 % HRmax，為期 12 週的腳踏車訓練；控制組則維持正常的飲食及作息。受試者分別於實驗介入前後進行一次測驗，並利用生物電阻分析法 (BIA) 和心臟超音波 (echocardiogramphy) 進行身體組成與心臟結構型態和泵血功能各項指標之檢測。以混合設計二因子變異數分析 (two-way ANOVA) 考驗二組前後測是否有顯著的介入效果。結果發現 12 週耐力運動訓練介入顯著降低體重、BMI、體脂肪百分比、脂肪重、腰臀圍比和內臟脂肪量；降低安靜心跳率與收縮壓，並提高攝氧峰值 (VO2peak) 絕對值和相對值；心舒末期容積 (EDD)、心縮末期容積 (ESD)、心室中膈厚度 (IVST)、相對心室壁厚度 (RWT)、左心室質量 (LVM)、左心室質量指數 (LVMI) 和左心房大小 (LAD) 沒有顯著差異。每跳輸出量 (SV)、射血分率 (EF) 及 E/A 比例則顯著增加。由此可知，耐力運動訓練介入在肥胖治療上扮演重要的角色，規律的運動能有效改善身體組成，提升心肺適能及心臟泵血功能，降低心血管疾病的危險因子，對於心血管疾病的預防和治療具有成效。

引用文獻
一、中文部分
方進隆 (1992)。運動與健康：減肥健身與疾病的運動處方 (增訂版)。台北市：漢文書店。

方進隆 (1997)。運動與心血管疾病。健康世界，133。60-64。

何忠峰 (2002)。十二週健走運動與飲食控制計畫對停經婦女身體組成及血脂肪的影響。體育學報，32。11-24。

李正美、許秀桃、李寧遠 (1992)。水中有氧運動訓練對婦女體適能、身體組成及血液生化值之影響。國立體育學院論叢，3 (1)。139-150。

李淑貞 (2001)。身體活動與兒童青少年肥胖。台北市：國家衛生研究院。

林瑞興 (2003)。運動訓練及飲食教育計畫介入對體重過重大學生的效果探討。未出版博士論文，國立臺灣師範大學，台北市。

林瑞興、方進隆 (2000)。十二週不同形式快走訓練對血壓偏高青少年血壓值及血液分析值的效果探討。體育學報，29。115-125。

高丁美、曾明淑、葉文婷、張瑛韶、潘文涵 (1999)。台灣地區居民體位及肥胖現況。載於行政院衛生署 (主編)，國民營養現況：1993～1996國民營養健康狀況變遷調查結果 (頁145～164)。台北市：行政院衛生署。

陳元和、林正常 (2001)。八週減肥計畫對高中超重女生血清瘦身蛋白濃度之影響。體育學報，31。305-316。

陳思遠 (2001)。身體活動與身體組成。台北市：國家衛生研究院。

陳麗玉 (2001)。運動介入及飲食教育對肥胖兒童健康體能與血脂值影響之研究。體育學報，30。267-277。

麥秀英、卓俊辰 (1984)。有氧舞蹈訓練對成年婦女心肺適能與身體組成的影響。體育學報，6。135-141。

張尚宏 (譯) (2002)。當代心臟學：診斷與治療。台北市：合記圖書出版社。(Crawford, M. H., 1999)

郭家驊、陳美枝 (2002)。肥胖－與運動對脂肪儲存的效應。大專體育，58。89-94。

傅浩堅、楊錫讓 (2003)。運動健身的科學原理。香港：商務印書館有限公司。

楊明杰 (譯) (1997)。Ganong 醫學生理學。台北市：合記圖書出版社。(Ganong, W. F., 1995)

滿庭芳、駱明潔 (2004)。循環系統。載於駱明潔 (總校閱)，新編生理學 (頁217～262)。台中市：華格那企業有限公司。

鄭景峰、林煉傑、黃憲鐘 (2002)。八週有氧或肌力訓練對身體組成的影響。大專體育學刊，4 (2)。187-195。

潘震澤 (譯) (2002)。人體生理學 (下)。台北市：合記圖書出版社。(Vander, A. J., Sherman, J. H., & Luciano, D. S., 1998)

劉建恆、周芬碧、李水碧、李祖遠、方進隆 (1997)。二週運動減肥對女性肥胖基因 (ob gene) 表現之影響。體育學報，23。227-238。

謝伸裕 (1997)。規律運動的生理適應。載於國立臺灣師範大學體育研究與發展中心 (主編)，教師體適能指導手冊 (頁60-73)。台北市：教育部。
謝錦城 (2000)。運動與心血管功能。台北市：國家衛生研究院。

二、英文部分
American College of Sports Medicine (1998). Position stand: The recommended quantity and quality of exercise for developing and maintaining cardiorespiratory and musclular fitness and flexibility in healthy adults. Medicine and Science in Sports and Exercise, 30, 957-971.

American Heart Association. (1994). Heart and Stroke Facts: 1994 Statistical Supplement. Dallas: Author.

Bjorntorp, P. (1997). Hormonal control of regional fat distribution. Human Reproduction, 12 (1), 21-25.

Calle, E. E., Thun, M. J., Peterlli, J. M., Rodriguez, C., & Heath, C. W. (1999). Body-mass index and mortality in a prospective cohort of U.S. adults. The New England Journal of Medicine, 341, 1097-1105.

Daniels, S. R., Kimball, T. R., Morrison, J. A., Khoury, P., Witt, S., & Meyer, R. A. (1995). Effect of lean body mass, fat mass, blood pressure, and sexual maturation on left ventricular mass in children and adolescents. Circulation, 92, 3249-3254.

Daniels, S. R., Loggie, J. M., Khoury, P., & Kimball, T. R. (1998). Left ventricular geometry and severe left ventricular hypertrophy in children and adolescents with essential hypertrophy. Circulation, 97, 1907-1911.

Daniels, S. R., Morrison, J. A., Sprecher, D. L., Khoury, P., & Kimball, T. R. (1999). Association of body fat distribution and cardiovascular risk factors in children and adolescents. Circulation, 99, 541-545.

Dart, A. M., Meredith, I. T., & Jennings, G. (1992). Effects of 4 week endurance training on cardiac left ventricular structure and function. Clinical and Experimental Pharmacology and Physiology, 19, 777-783.

DeStefano, R. A., Capiro, S., Fahey, J. T., Tamborlane, W. V., & Goldberg, B. (2000). Changes in body composition after a 12-wk aerobic exercise program in obese boys. Pediatric Diabetes, 1, 61-65.

Ehsani, A. A., Hagberg, J. M., & Hickson, R. C. (1978). Rapid changes in left ventricular dimensions and mass in response to physical conditioning and deconditioning. The American Journal of Cardiology, 42, 52-56.

Elrick, H. (1996). Exercise is medicine. The Physician and Sportsmedicine,24 (2), 72-78.

Gardin, J. M., Wagenkencht, L. E., Anton-Culver, H., Flack, J., Gidding, S., Kurosaki, T., Wong, N. D., Manolio, T. A. (1995). Relationship of cardiovascular risk factors to echocardiographic left ventricular mass in healthy young black and white adult men and women. The CARDOA Study. Circulation, 92, 380-387.

Gates, P. E., Gentile, C. L., Seals, D. R., & Christou, D. D. (2003). Adiposity contributes to differences in left ventricular structure and diastolic function with age in healthy men. The Journal of Clinical Endocrinology and Metabolism, 88, 4884-4890.

Hardman, A. E. (1996). Exercise in the prevention of atherosclerotic, metabolic and hypertensive disease: a review. Journal of Sports Science, 14, 201-218.
Harjai, K. J. (1999). Potential new cardiovascular risk factors: left ventricular hypertrophy, homocysteine, lipoprotein (a), triglycerides, oxidative stress, and fibrinogen. Annals of Internal Medicine, 131 (5), 376-386.

Hildick-Smith, D. J. R., & Shapiro, L. M. (2001). Echocardiographic differentia- tion of pathological and physiological left ventricular hypertrophy. Heart, 85, 615-619.

Hinderliter, A., Sherwood, A., Gullette, E. C. D., Badyak, M., Waugh, R., Georgiades, A., & Blumenthal, J .A. (2002). Reduction of left ventricular hypertrophy after exercise and weight loss in overweight patients with mild hypertension. Archives of Internal Medicine, 162, 1333-1339.

Hubert, H. B., Feinleib, M., McNamara, P. M., & Castelli, W. P. (1983). Obesity as an independent risk factor for cardiovascular disease: a 26-year follow-up of participants in the Framingham Study. Circulation, 67, 968-983.

Humphries, M. C., Gutin, B., Barbeau, P., Vemulapalli, S., Allison, J., & Owens, S. (2002). Relations of adiposity and effects of training on the left ventricle in obese youths. Medicine and Science in Sports and Exercise, 34 (9), 1428-1435.

Iacobellis, G., Ribaudo, M. C., Leto, G., Zappaterreno, A., Vecci, E., Mario, U. D., & Leonetti, F. (2002). Influence of excess fat on cardiac morphology and function: study in uncomplicated obesity. Obesity Research, 10 (8), 767-773.
Karason, K., Wallentin, I., Larsson, B., & Sjöström, L. (1997). Effects of obesity and weight loss on left ventricular mass and relative wall thickness: survey and intervention study. British Medical Journal, 315, 912-916.

Karason, K., Wallentin, I., Larsson, B., & Sjöström, L. (1998). Effects of obesity and weight loss on cardiac function and valvular performance. Obesity Research, 6 , 422-429.

Kokkinos, P. F. (2001). Exercise as hypertension therapy. Hellenic Journal of Cardiology, 42, 182-192.

Kokkinos, P. F., Narayan, P., Colleran, J. A., Pittaras, A., Notargiacomo, A., Read, D., & Parademetriou, V. (1995). Effects of regular exercise on blood pressure and left ventricular hypertrophy in African-American men with severe hypertension. The New England Journal of Medicine, 333, 1462-1467.

Ku, C. S., Lin, S. L., Wang, D. J., Chang, S. K., & Lee, W. J. (1994). Left ventricular filling normotensive obese adults. The American Journal of Cardiology, 73, 613-615.

Kuch, B., Hense, H. W., Gneiting, B., Döring, A., Muscholl, M., Bröckel, U., Schunkert, H. (2000). Body composition and prevalence of left ventricular hypertrophy. Circulation, 102, 405-410.

Kuperstein, R., Hanly, P., Niroumand, M., & Sasson, Z. (2001). The importance of age and obesity on the relation between diabetes and left ventricular mass. Journal of the American College of Cardiology, 37 (7), 1957-1962.
Lauer, M. S., Anderson, K. M., Kannel, W. B., & Levy, D. L. (1991). The impact of obesity on left ventricular mass and geometry: the Framingham Heart Study. The Journal of American Medicine Association, 266 (2), 231-236.

Lee, I. M., & Paffenbarger, R. S. J. (1996). Is weight loss hazardous? Nutrtion Reviews, 54 (2), S117-S124.

Levy, D., Anderson, K. M., Savage, D. D., Kannel, W. B., Christainsen, J. C., & Castelli, W. P. (1988). Echocardiographically detected left ventricular hypertrophy: prevalence and risk factors. The Framingham Study. Annals of Internal Medicine, 108, 7-13.

Levy, D., Garrison, R. J., Savage, D. D., Kannel, W. B., & Castelli, W. P. (1990). Prognostic implications of echocardiographically determined left ventricular mass in the Framingham Heart Study. The New England Journal of Medicine, 322, 1561-1566.

MacMahon, S. W., Wilcken, D. E., & Macdonald, G. J. (1986). The effect of weight reduction on left ventricular mass. The New England Journal of Medicine, 314, 334-339.

Maron, B. J. (1986). Structural features of the athlete heart as defined by echocardiography. Journal of the American College of Cardiology, 7, 190-203.

Messerly, F. H., Ninez, B. D., Ventura, H. O., & Snyder, D. W. (1987). Overweight and sudden death. Archives of Internal Medicine, 147, 1725-1728.
Mitchell, B. M., Gutin, B., Kapuku, G., Barbeau, P., Humphries, M. C., Owens, S., Vemulapalli, S., & Allison, J. (2002). Left ventricular structure and function in obese adolescents: relations to cardiovascular fitness, percent body fat, and visceral adiposity, and effects of physical training. Pediatrics, 109 (5), e73.

Morricone, L., Malavazos, A. E., Coman, C., Donati, C., Hassan, T., & Caviezel, F. (2002). Echocardiographic abnormalities in normotensive obese patients: relationship with visceral fat. Obesity Research, 10, 489-498.

Mureddu, G. F., de Simone, G., Greco, R., Rosato, G. F., & Contaldo, F. (1996). Left ventricular filling pattern in uncomplicated obesity. The American Journal of Cardiology, 77, 509-514.

Must, A., Spadano, J., Coakley, E. H., Field, A. E., Colditz, G., & Dietz, W. (1999). The disease burden associated with overweight and obesity. The Journal of American Medicine Association, 288 (16), 1523-1529.

Myers, L., Goebbels, U., Dzeikan, G., Froelicher, V., Bremerich, J., Mueller, P., Buser, P., & Dubach, P. (2000). Exercise training and myocardial remodeling in patients with reduced ventricular function: one-year follow-up with magnetic resonance imaging. American Heart Journal, 139 (1), 252-261.

National High Blood Pressure Education Program Working Group (1993). National high blood pressure education program working group on prevention of hypertention. Archives of Internal Medicine, 153, 186-208.
Obert, P., Mandigout, S., Vinet, A., N’Guyen, L. D., Stecken, F., & Courteix, D. (2001). Effect of aerobic training and detraining on left ventricular dimensions and diastolic function in prepubertal boys and girls. International Journal of Sports Medicine, 22, 90-96.

Palmieri, V., de Simone, G., Arnett, D. K., Bella, J. N., Kitzman, D. W., Oberman, A., Hopkins, P. N., Province, M. A., & Devereux, R. B. (2001). Relation of various degrees of body mass index in patients with systemic hypertension to left ventricular mass, cardiac output, and peripheral resistance (The Hypertension Genetic Epidemiology Network Study). The Journal of Cardiology, 88, 1163-1168.

Park, S. K., Park, J. H., Kwon, Y. C., Yoon, M. S., & Kim, C. S. (2003). The effect of long-term aerobic exercise on maximal oxygen consumption, left ventricular function and serum lipids in elderly women. Journal of Physiological Anthropology and Applied Human Science, 22 (1), 11-17.

Pascual, M., Pascual, D. A., Soria, F., Vicente, T., Hernandez, A. M., Tebar, F. J., & Valdes, M. (2003). Effects of isolated obesity on systolic and diastolic left ventricular function. Heart, 89, 1152-1156.

Pasternak, R. C., Grundy, S. M., Levy, D., & Thompson, P. D. (1996). 27th Bethesda Conference: matching the intensity of risk factor management with the hazard for coronary disease events. Task Force 3. Spectrum of risk factors for coronary heart disease. Journal of the American College of Cardiology, 27, 978-990.

Peterson, L. R., Waggoner, A. D., Schechtman, K. D., Meyer, T., Gropler, R. J., Barzilai, B., & Davila-Roman, V. G. (2004). Alterations in left ventricular structure and function in young healthy obese women. Journal of American College of Cardiology, 43, 1399-1404.

Reid, C. M., Dart, A. M., Dewar, E. M., & Jennings, G. L. (1994). Interactions between the effects of exercise and weight loss on risk factors, cardiovascular haemodynamics and left ventricular structure in overweight subjects. Journal of Hypertension, 12 (3), 291-301.

Rosa, E. C., Moyses, V. A., Sesso, R. C., Plavnik, F. L., Ribeiro, F. F., Kohlmann, N. E. B., Ribeiro, A. B., Zanella, M. T., & Kohlmann, J. O. (2002). Left ventricular hypertrophy evaluation in obese hypertensive patients. Effect of left ventricular mass index criteria. Arquivos Brasileros de Cardiologia, 78 (4), 347-351.

Ross, R., Dagnone, D., Jones, P. J. H., Smith, H., Paddags, A., Hudson, R., & Janssen, I. (2000). Reduction in obesity and related comorbid conditions after diet-induced weight loss or exercise-induced weight loss in men. Annals of Internal Medicine, 133, 92-103.

Ross, R., & Janssen, I. (1999). Is abdominal fat preferentially reduced in response to exercise-induced weight loss? Medicine and Science in Sports and Exercise, 31 (11), S597-S601.

Sadaniantz, A., Yurgalevitch, S., Zmuda, J. M., & Thompson, P. D. (1996). One year of exercise training does not alter resting left ventricular systolic or diastolic. Medicine and Science in Sports and Medicine, 28 (11), 1345-1350.

Savage, D. D., Levy, D., Dannenberg, A. L., Garrison, R. J., & Castelli, W. P. (1990). Association of echocardiographic left ventricular mass with body size, blood pressure and physical activity (the Framingham Study). American Journal of Cardiology, 65 (5), 371-376.

Schirmer, H., Lunde, P., & Rasmussen, K. (1999). Prevalence of left ventricular hypertrophy in a general population. The Tromso Study. European Heart Journal, 20, 429-438.

Schulte, H., Cullen, P., & Assmann, G. (1999). Obesity, mortality and cardiovascular disease in the Munster Heart Study (PROCAM). Atherosclerosis, 144, 199-209.

Shapiro, L. M., & Smith, R. G. (1983). Effect of training on left ventricular structure and function. An echocardiographic study. British Heart Journal, 50 (6), 534-539.

Smith, H. L. (1933). Adiposity of the heart. Archives of Internal Medicine, 52, 929-931.

Spina, R. J., Ogawa, T., Miller, T. R., Kohrt, W. M., & Ehsani, A. A. (1993). Effect of exercise training on left ventricular performance in older women free of cardiopulmonary disease. American Journal of Cardiology, 71, 99-104.

Szmedra, L., Lemura, L. M., & Shearn, W. M. (1998). Exercise tolerance, body composition and blood lipids in obese African-American women following short-term training. The Journal of Sports Medicine and Physical Fitness, 38, 59-65.

Tasić, I. S., Lovic, B. K., Hic, S., Djordjević, D., & Tasić, N. M. (2002). Relationship between obesity decrease and regression of hypertensive left ventricular hypertrophy. Facta Universitaties Series: Medicine and Biology, 9 (2), 181-187.

Turner, M. J., Spina, R. J., Kohrt, W. M., & Ehsani, A. A. (2000). Effects of endurance exercise training on left ventricular size and remodeling in older adults with hypertension. Journal of Gerontology, 55A (4), M245-M251.

Utter, A. C., Nieman, D. C., Shannonhouse, E. M., Butterworth, D. E., & Nieman, C. N. (1998). Influence of diet and/or exercise on body composition and cardiorespiatory fitness in obese women. International Journal of Sport Nutrition, 8, 213-222.

Vague, J. (1956). The degree of masculine differentiation of obesities: a factor for determining predisposition to diabetes, atherosclerosis, gout, and uric calculous disease. American Journal of Clinical Nutrition, 4, 20-33.

Van Itallie, T. B. (1985). Health implications of overweight and obesity in the United States. Annals of Internal Medicine, 103, 983-988.

Whalley, G. A., Doughty, R. N., Gamble, G. D., Oxenham, H. C., Walsh, H. J., Reid, I. R., & Baldi, J. C. (2004). Association of fat-free mass and training status with left ventricular size and mass in endurance-trained athletes. Journal of the American College of Cardiology, 44, 892-896.

Wing, R. R. (1999). Physical activity in the treatment of adulthood overweight and obesity: current evidence and research issues. Medicine and Science in Sports and Exercise, 31 (11), S547-S552.

Wieling, W., Borghols, E. A. M., Hollander, A. P., Danner, B., & Dunning, A. J. (1991). Echocardiographic dimensions and maximal oxygen uptake in oarsmen during training. British Heart Journal, 46, 190-195.

Wirth, A., & Kröger, H. (1995). Improvement of left ventricular morphology and function in obese subjects following a diet and exercise program. International Journal of Obesity, 19, 61-66.