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頁籤選單縮合
題名 | Heart Rate Variability in Taiwanese Obese Children=臺灣肥胖兒童的心率變異性 |
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作者 | 傅振宗; 李燕鳴; 裴馰; 陳健麟; 駱惠銘; 吳篤安; 郭博昭; Fu, Chen-chung; Li, Yin-ming; Pei, Dee; Chen, Chien-lin; Lo, Huey-ming; Wu, Du-an; Kuo, Terry BJ; |
期刊 | 慈濟醫學 |
出版日期 | 20060600 |
卷期 | 18:3 民95.06 |
頁次 | 頁199-204+248 |
分類號 | 417.5912 |
語文 | eng |
關鍵詞 | 肥胖兒童; 心率變異性; 自律神經功能異常; Obese children; Heart rate variability; Autonomic nerve dysfunction; |
中文摘要 | 目的:探討肥胖兒童早期的心率變異性的變化。材料與方法:我們在91年針對花蓮市全部公立國中1,826名學生進行肥胖評估,初步調查總共有1,724名(94.4%)參加,然後依據衛生署91年發布青少年以身體質量指數所訂定的腫胖標準,分層抽樣選出225正常、過重與肥胖學童邀請參加心率變異性與生化抽血檢查三組。結果:共有170位(81位正常、33位過重與55位肥伴)學童參加,結果發現肥胖學童的身體質量指數、HOMA-IR、收縮壓與舒張壓明顯大於正常體位學童,此外,肥胖學童的心率變異性檢查結果,代表副交感神經控制的高頻(HF)在肥胖男、女學童都明顯降低而代表交感神經調控的低頻(LF%與LF/HF比值)在肥胖男學童有意義增加,而女學童的交感神經調控亦呈現增加,雖然沒有統計上意義。多變項分析顯示身體質量指數與心跳數和HF為負相關,和LF%與LF/HF比值為正省關,同時男童比女童有較高的LF%與LF/HF比值。結論:肥胖兒童有胰島素阻抗與心臟的自律神經異常,包括副交總神經的控制在男、女學童降低,且肥胖男童的交感神經調控增加。此外,男童比女童有較高的交感神經調控。 |
英文摘要 | Objective: The primary purpose of the present community-based study was to investigate early changes in cardiac autonomic function in obese children. Materials and Methods: A survey of juvenile obesity in Hualien in eastern Taiwan was performed in 2002. A total of 1,724 adolescents who were 12 or 13 years old were recruited. The overall prevalence of normal weight, over-weight and obese adolescents were 71.5% 13.1% and 15.4%, respectively. A stratified random sampling scheme was performed. We selected 100, 50 and 75 subjects from the above-mentioned three groups, and invited them to join this study. Totally, 170 students (normal-weight: overweight: obese= 81:34:55) participated in this study. They received blood checks and a heart rate variability (HRV) examination. The homeostasis model assessment of insulin resistance (HOMA-IR) was used to evaluate insulin sensitivity. Results: Compared with the normal-weight group, the obese children had significantly elevated body mass indexes (BMI), HOMA-IR, and systolic and diastolic blood pressure levels. In addition, compared to their normal weight counterparts, obese children had significantly reduced high-frequeny power (HF) but elevated low-frequency power in normalized units (LF%), and elevated ratios of low-freqeuncy power to high-frequency power (LF/HF ratio). Further analyses revealed that compared with the normal weight counterparts; obese boys had significantly reduced HF but elevated LF% and LF/HF ratios. Among obese girls, the HF was reduced significantly, LF% and the LF/HF ratio were increased, though not significantly. In stepwise multiple regression analysis, the BMI and heart rate were negatively associated with the HF component and positively associated with the LF/HF ration and LF%. For every 1 kg/□ increment in the BMI, the LF/HF ration and LF% components of HRV increased In (0.02) and 0.42% respectively, while HF decreased 0.03 ln(m□). Boys had a higher LF/HF ration and LF% than girls Conclusions: The obese boys and girls had increased insulin resistance and changes in autonomic nervous function that included reduced parasympathetic control and obese boys had elevated symathovagal modulation. Gender-related autonomic differences, such as girls having lower sympathetic modulations of HRV, were also noted. |
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