國立臺灣大學醫學院復健科陳思遠2006-07-262018-07-132006-07-262018-07-132001-10-31http://ntur.lib.ntu.edu.tw//handle/246246/28959疾病預防與健康促進為近年來醫學界努力的重點。運動有益健康，研究老人的日常活動量與健康的關係，更成為學者研究之重要問題。骨質疏鬆症及骨質疏鬆骨折是近年來非常熱門的話題，文獻上有許多探討其與骨代謝生化指標及骨骼定量式超音波檢查的研究，但罕有以老人為主要研究對象之研究報告。運動可使骨骼承受到身體重力及肌肉收縮等機械性外力，促進骨生成作用，進而增加骨量，雖然目前並不清楚老化是否會影響這些運動預防骨質疏鬆的效應，但此仍常被建議為預防骨質流失及骨質疏鬆骨折的方法之一。本研究之目的是想探討都會區老人的日常活動量、骨代謝生化指標及跟骨定量式超音波檢查間的相關性。研究對象是曾在民國85年參加「臺大醫院健檢」的516位台北市中正區老人。研究方法則是利用「貝基氏日常活動量量表（中文版）」、「鈣攝取量調查表」及「跟骨定量式超音波檢查」等測試工具對受試者進行評估，並測定其血清及尿液中的各種骨代謝生化指標。本研究結果顯示在年齡70歲以上的老人，婦女的骨吸收與骨生成生化指標皆高於男性，這代表著這些停經婦女的骨骼的代謝率上升；而「跟骨定量式超音波檢查」結果發現婦女跟骨的超音波傳導速度與骨樑面積率皆低於男性，表示其骨骼骨質疏鬆程度較為嚴重。此外，男性老人若其身體活動量愈多，則其尿液中的骨吸收代謝生化指標愈低，但其血液中的骨生成生化指標並不受到身體活動量多寡所影響，這代表者經常從事運動的男性老人其骨質流失的速率較慢，且骨生成速率不變，這並可進一步推論鼓勵男性老人經常從事運動將可能減緩其骨質流失。至於老年婦女則無上述相關性存在，為何研究結果在男女會有如此差異，原因並不清楚，仍待進一步研究。本研究結果支持規律運動可協助老年男性避免骨質流失，促進骨骼健康，並可作為日後進一步研究「老人運動訓練是否可減少骨質流失並降低骨質疏鬆骨折發生率？」之重要參考。Physical activity or exercise has been proved to be beneficial for health. The relationship between physical activities and health is becoming an important issue to be investigated among the elderly. Osteoporosis is a major health concern when the number of older people increases rapidly in Taiwan. Exercise has the osteogenic effect to maintain bone density or decrease the rate of bone loss. Regular exercise may prevent osteoporotic fractures by preventing both osteoporosis and falls. However, these benefits have not yet been proved in the elderly. The purpose of this study is to study the relationship among the amount of physical activities, biochemical markers of bone, and calcaneal quantitative ultrasound (QUS) in elderly people. Study subjects were 512 elder people with age 70 or over recruited from a cohort of 1002 elderly persons who lived in Chung-Cheng District of Taipei City and received comprehensive medical exam in National Taiwan University Hospital in 1996. All study subjects were evaluated with “Modified Baecke Questionnaire (Chinese Version)”, serum and urine biochemical markers of bone, and calcaneal QUS. Our results revealed female had higher bone turnover rate and lower bone area ratio then male. Physically active 1 male had lower level of biochemical markers of bone resorption than sedentary male. On the contrary, no association of the amount of physical activity and biochemical markers of bone was observed in the elder female. The results of this study provide vital evidence to recommend the elder male to increase the amount of daily physical activities or participate in exercise regularly, which may prevent osteoporosis. Further studies is required to clarify the role of exercise in prevention of osteoporosis in elder female.application/pdf165923 bytesapplication/pdfzh-TW國立臺灣大學醫學院復健科老人日常活動量骨代謝生化指標骨骼定量式超音波檢查agedphysical activitybone biological markerquantitative ultrasoundotherhttp://ntur.lib.ntu.edu.tw/bitstream/246246/28959/1/892314B002464.pdf