目的 : 探討不同的運動訓練模式對中老年人肌肉力量、心血管危險因子、脂肪激素和骨骼代謝指標之影響。方法 : 招募53位中老年人，隨機配對至高強度阻力運動組13位、中強度阻力運動組14位、整合式運動13位及控制組13位。運動組進行24週，每週兩次，由專人指導的運動介入。訓練前及24週訓練後所有參與者均以雙能X光分析儀檢測包括身體脂肪重、淨體重、骨質密度與最大肌力(one repetition-maximun, 1-RM)之量測及分析血清三酸甘油脂(TG)、總膽固醇(TC)、高密度脂蛋白膽固醇(HDL-C)、低密度脂蛋白膽固醇(LDL-C)、高敏感性C反應蛋白(hs-CRP)、瘦體素(leptin)和脂締素(adiponectin)等脂肪激素和骨鈣素(Octeocalcin)和羧基末端第一型前膠原蛋白(ICTP)等骨質代謝指標等血液生化指標。以單因子共變數分析檢定自變項對四組依變項的影響。結果 : 三運動訓練組的最大肌力(1-RM)相較於控制阻均有顯著增加 (p <0.001)，控制組則有下降的趨勢(-7.9~-8.2%)。整合式運動組的血液脂肪和空腹胰島素相較於其餘三阻顯著增加 (p <0.05)但均在正常範圍內。其他心血管因子如高敏感性C反應蛋白、空腹血糖、糖化血色素和脂肪激素均無顯著組間差異。在骨質密度部分:高阻力組(+0.9%)的進步顯著大於中阻力組(-0.2%)、整合式運動組(-0.1%)以及控制組(-0.2%) (p <0.05)。然而，各組脂肪激素和骨質代謝指標均無顯著改變 (p >0.05)。此外，運動後整合式運動組的體脂肪率(-5.9%)、腹部(-8.3%)和全身脂肪量(-6.6%)相較中阻力組(-2.1~0.1%)有顯著下降 (p <0.05)。三組運動組的手臂淨體重也顯著增加，控制組則減少 (p <0.05)。結論: 阻力訓練或結合有氧的整合式運動訓練會因其運動特質而有不同的效果，高強度阻力訓練可能藉由較高的負重來刺激骨質密度的提升，多元運動可能則有效地提升高密度脂蛋白膽固醇以及降低體脂率和腹部跟全身脂肪量，對於最大力量和手臂淨體重的增加效益則三組相似，日後在中高齡者的健康促進可視其需求而設定各自的健身運動策略。

Purpose: To investigate the effects of different exercise training on muscular strength, risk factors of cardiovascular diseases, adipocytokines, and bone turnover markers.
Method: Fifty-three middle-aged and elderly volunteers completed the study. They were randomly paired into four groups: the high-intensity resistance (HIR) (n=13, age 61.8±3.4 yrs; BMI 23.3±3.7 kg/m2), moderate-intensity resistance (MIR, n=14, age 61.4±5.2 yrs, BMI 23.7±1.8 kg/m2), multi-component exercise (MCE, n=13; age 61.7±4.5 yrs; BMI 24.5±3.4 kg/m2), and control groups (CON, n=13; age 61.5±4.4 yrs, BMI 24.9±5.4 kg/m2) by each subject’s mean of upper and lower maximal strength. Subjects in all the training groups engaged in exercise training twice per week under supervision for 24 weeks. Data collected at pre- and post-training included body fat mass, body lean mass, one repetition-maximum (1-RM), triglycerides, total cholesterol, high-density lipoprotein cholesterol, high-density lipoprotein cholesterol, adipocytokines (including adiponectin and leptin), bone mineral density (BMD), osteocalcin and cross-linked carboxy-terminal telopeptide of type I collagen of bone metabolic markers.
Results: All of the experimental groups showed significant improvements in 1-RM compared with the CON (p <0.001), while the CON showed decreased muscular strength. The MCE had a significant increase in all blood lipids profiles and fasting insulin compared to other three groups (p <0.05). The HIR had a greater increase in BMD (+0.9%) than the other three groups (p <0.05). Adipocytokines and bone metabolic markers had no significant changes between groups (p >0.05). Only the MCE showed a significant decrease in the percentage of fat mass and trunk and total fat mass compared with the MIR (p<0.05). All experimental groups had significantly augmented lean mass of the arm compared to the CON (p<0.05).
Conclusions: High- or medium intensity RT and multi-component exercise have positive and same effects on muscular strength and arm lean mass. Therefore, resistance training or multi-component exercise might decrease the bone turnover rate. High-intensity RT can further improve BMD due to higher stimulation. Multi-component exercise can elevate HDL-C and decrease fat present, trunk and total fat mass and perhaps decrease the risk of cardiovascular disease via aerobic training due to consecutive effects.

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