2014-08-012024-05-13https://scholars.lib.ntu.edu.tw/handle/123456789/646092摘要：背景：代謝症候群防治是現代醫學重要課題，過去探討無心臟疾病、代謝症候群患者運動成效的研究有限，多無長期追蹤，且發現中強度連續性有氧訓練（中運動）對降低代謝異常危險因子的成效較非代謝症候群患者為差，而高強度搭配主動恢復之間歇運動（高運動）對提升運動能力的效果，在肥胖等特定族群較連續中強度運動好。目的：（1）比較16 週同樣能量消耗之中運動和高運動在訓練後、第10 和16 個月追蹤時，相對於控制組在降低代謝症候群代謝異常及盛行率的效果；（2）比較二種運動訓練計畫對運動能力、血管功能和代謝體學上與控制組的差異；（3）訓練後能改善成為非代謝症候群者與仍為代謝症候群兩個次族群在上述參數的比較。方法：本研究將跨國與多中心合作，預計徵召45-60 位、45-70 歲無心臟病之代謝症候群患者，接受初試後隨機分配至2 運動組和一般照護之控制組。中運動組每週運動5 次，2 次至院接受監測下至少30 分鐘、50-70%最大心率之中強度跑步機運動﹔高運動組每週運動3 次，2 次至院、1 次在家，含10 分鐘70%最大心率的暖身，4 個4 分鐘的高強度運動（90%最大心率）、間以3 分鐘的主動恢復，以及5 分鐘的緩和。受試者將在16週後、第10 個月和第16 個月後接受包括各代謝異常因子和代謝體學的檢查、身體組成、質量指數、腰圍、血管擴張、脈波傳導速度的量測，以及最大運動測試。本研究將以SPSS 做統計分析，以平均值±標準差或人數（百分比）方式呈現，採取意向分析，p 值＜0.05 為顯著差異。卡方檢定或單因數變異數分析比較三組在基礎值之差異﹔二因數重複測量變異分析和Bonferroni 後測比較組別、時間之差異和2 個次族群的比較；皮爾森相關分析和廣義線性模式分析各參數改變量間的關係。<br> Abstract: Background. The prevalence of metabolic syndrome (MetS) has been increasing, and how totreat metabolic syndrome and decrease the complications is an important health issueworldwide. Relatively few randomized controlled studies on the effects of exercise training inpatients with MetS with long-term follow-up were found. Not mentioned the optimal exerciseprogram has been investigated for these patients. The training effect on metabolicabnormalities or risk appeared to be less significant than those who did not meet the criteria ofMetS after the traditional training using continuous moderate-intensity exercise (CME).Recently, high-intensity interval training or aerobic interval training (AIT) consisting of highintensity separated by active recovery has been proposed to be more effective than isocaloricCME in raising exercise capacity (VO2max) in some specific patient population, such asobesity and heart diseases.Purpose. The purposes are (1) to compare the effects of 16-week isocaloric CME and AIT onreducing the metabolic risk factors in patients with MetS and the prevalence with the controlgroup; (2) to compare the differences in exercise capacity, cardiovascular function, andmetabolomics among CME, AIT, and control group after the 16-wk training and follow-ups10 months and 16 months after the enrollment. A subgroup analysis will be performedbetween those who met or did not meet the criteria of MetS after training, especially thedifferences in metabolomics.Method. This study will be part of an international multiple-center trial. Forty-five to 60asymptomatic subjects, aged 45-70 years, with a diagnosis of MetS will be recruited in eachcenter and randomizedly assigned to control, CME, or AIT group after baseline assessments.Participants in control group will receive usual care, while those in CME group will exerciseat least 30-minute at 50-70% maximal heart rate (HRmax) 5 times a week, twice on treadmillunder supervision and home exercise 3 times a week. Participants in AIT groups will receiveexercise training 3 times a week including twice under supervision and home exercise once aweek following the protocol of 10-minute warm-up and 5-minute cool-down at 70% HRmax,4-minute high-intensity (90% HRmax) training 4 times separated by 3-minute active recovery.All subjects will receive follow-ups at 16-week, 10-month and 16-month including blood test,measurements of body composition, body mass index, waist circumference, flowmediated-dilatation, and pulse wave velocity, as well as maximal exercise testing. Statisticalanalysis will be conducted using SPSS 11.5, p < 0.05 indicating statistical significance. Datawill be presented in mean±standard deviation or number (percentile) with intention-to-treatanalysis. Chi-square test or one-way Analysis of Variance (ANOVA) will be used to comparewhether the group differences at baseline. Two-way repeated measure ANOVA and post-hocBonferroni test will be performed to examine time and group effects and the subgroupanalysis between MetS and n-MetS after training. Correlation analysis and general linearmodel will be used to test the interrelationships among the changes of the parameters ofinterest.代謝症候群代謝危險因子高強度間歇運動連續中強度運動Metabolic syndromeMetabolic risk factorsHigh intensity interval trainingContinuous moderate-intensity exercise