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1 Asia Pacific Journal of Clinical Nutrition
       Volume 23, 1

         (March 2014)


Abstracts

Contents

Abstract PDF

Asia Pacific Clinical Nutrition Society Award for 2014: Maitree Suttajit

Duo Li

Asia Pac J Clin Nutr. 2014;23(1):i.

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Reviews

Ecosystem Health Disorders - changing perspectives in
clinical medicine and nutrition

MARK L WAHLQVIST
Asia Pac J Clin Nutr. 2014;23(1):1-15.

doi: 10.6133/apjcn.2014.23.1.20

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Dietetics in China at the crossroads

LINGXIA SUN AND JOHANNA DWYER
Asia Pac J Clin Nutr. 2014;23(1):16-26.

doi: 10.6133/apjcn.2014.23.1.19

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Nutritional standards for energy-dense low-nutrient density foods for children in Korea
SOON-KYU LEE, HYE-KYUNG PARK AND YOUN-JU CHOI
Asia Pac J Clin Nutr. 2014;23(1):27-33
.

doi: 10.6133/apjcn.2014.23.1.03

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Original Research Communications

Clinical Nutrition or Feeding Studies

The effects of intravenous, enteral and combined administration of glutamine on malnutrition in sepsis: a randomized clinical trial
GUNIZ MEYANCI KOKSAL, EMRE ERBABACAN, YUSUF TUNALI, GULSAH KARAOREN, SUPHI VEHID AND HUSEYIN OZ
Asia Pac J Clin Nutr. 2014;23(1):34-40.

doi: 10.6133/apjcn.2014.23.1.11

 

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Fast-track improves post-operative nutrition and outcomes of colorectal surgery: a single-center prospective trial in China
KA LI, JI-PING LI, NAN-HAI PENG, LI-LI JIANG, YAN-JIE HU AND MING-JUN HUANG
Asia Pac J Clin Nutr. 2014;23(1):41-47.

doi: 10.6133/apjcn.2014.23.1.09

 

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Nutritional Status, Dietary Intake, and Body Composition

A school-based comprehensive lifestyle intervention among Chinese kids against Obesity (CLICK-Obesity) in Nanjing City, China: the baseline data
FEI XU, XIAORONG WANG, ROBERT S WARE, LAP AH TSE, ZHIYONG WANG, XIN HONG, EMILY YING YANG CHAN,
JIEQUAN LI AND YOUFA WANG
Asia Pac J Clin Nutr. 2014;23(1):48-54.

doi: 10.6133/apjcn.2014.23.1.04

 

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Association of dietary fatty acids intake with pro-coagulation and inflammation in Saudi Adults
OMAR S AL-ATTAS, NASSER M AL-DAGHRI, MAJED S ALOKAIL, KHALID M ALKHARFY, NASIRUDDIN KHAN, HANAN A ALFAWAZ, IBRAHIM A AISWAIDAN, ABDULRAHMAN S AL-AJLAN AND GEORGE P CHROUSOS
Asia Pac J Clin Nutr. 2014;23(1):55-64.

doi: 10.6133/apjcn.2014.23.1.12

 

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Association between body fat and vitamin D status in Korean adults
SEUNG SEOK HAN, MYOUNGHEE KIM, SU MI LEE, JUNG PYO LEE, SEJOONG KIM, KWON WOOK JOO, CHUN SOO LIM, YON SU KIM AND DONG KI KIM

Asia Pac J Clin Nutr. 2014;23(1):65-75.

doi: 10.6133/apjcn.2014.23.1.10

 

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Eating behaviors and weight over time in a prospective study: the Healthy Twin Study
YUN-MI SONG, KAYOUNG LEE AND JOOHON SUNG
Asia Pac J Clin Nutr. 2014;23(1):76-83
.

doi: 10.6133/apjcn.2014.23.1.15

 

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Sleep deprivation is related to obesity and low intake of energy and carbohydrates among working Iranian adults: a cross sectional study
KOLSOOM PARVANEH, BEE KOON POH, MAJID HAJIFARAJI AND MOHD NOOR ISMAIL
Asia Pac J Clin Nutr. 2014;23(1):84-90.

doi: 10.6133/apjcn.2014.23.1.02

 

 

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Maternal and Clild Nutrition

Socio-economic factors and use of maternal health services are associated with delayed initiation and non-exclusive breastfeeding in Indonesia: secondary analysis of Indonesia Demographic and Health Surveys 2002/2003 and 2007
CHRISTIANA R TITALEY, PHILIPS C LOH, SABARINAH PRASETYO, IWAN ARIAWAN AND ANURAJ H SHANKAR
Asia Pac J Clin Nutr. 2014;23(1):91-104.
doi: 10.6133/apjcn.2014.23.1.18

 

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The impact on child wasting of a capacity building project implemented by community and district health staff in rural Lao PDR
BENJAMIN COGHLAN, MICHAEL J TOOLE, NIRAMONH CHANLIVONG, SENGCHANH KOUNNAVONG, KONGCHAY VONGSAIYA AND ANDRE RENZAHO
Asia Pac J Clin Nutr. 2014;23(1):105-111.
doi: 10.6133/apjcn.2014.23.1.16

 

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Disturbed eating tendency and related factors in grade four to six elementary school students in Taiwan
YUECHING WONG, YU-JHEN CHANG AND SHU-WEI TSAO
Asia Pac J Clin Nutr. 2014;23(1):112-120.

doi: 10.6133/apjcn.2014.23.1.07

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Influence of obesogenic behaviors on health-related quality of life in adolescents
BAMINI GOPINATH, JIMMY CY LOUIE, VICTORIA M FLOOD, GEORGE BURLUTSKY, LOUISE L HARDY, LOUISE A
BAUR AND PAUL MITCHELL

Asia Pac J Clin Nutr. 2014;23(1):121-127.

doi:10.6133/apjcn.2014.23.1.13

 

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Nutritional Epidemiology and Public Health

Breakfast eating patterns and the metabolic syndrome: the Korea National Health and Nutrition Examination Survey (KNHANES) 2007-2009
KI-BONG YOO, HEE-JAE SUH, MINJEE LEE, JAE-HYUN KIM, JEOUNG A KWON AND EUN-CHEOL PARK
Asia Pac J Clin Nutr. 2014;23(1):128-137.

doi: 10.6133/apjcn.2014.23.1.08

 

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Food insecurity and the metabolic syndrome among women from low income communities in Malaysia
ZALILAH MOHD SHARIFF, NORHASMAH SULAIMAN, ROHANA ABDUL JALIL, WONG CHEE YEN, YONG HENG YAW, MOHD NASIR MOHD TAIB, MIRNALINI KANDIAH AND KHOR GEOK LIN
Asia Pac J Clin Nutr. 2014;23(1):138-147.

doi: 10.6133/apjcn.2014.23.1.05

 

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Clustering and determinants of cardiometabolic risk factors among Filipino young adults
NIHA ZUBAIR, CHRIS W KUZAWA, NANETTE R LEE, THOMAS W MCDADE AND LINDA S ADAIR
Asia Pac J Clin Nutr. 2014;23(1):148-158.

doi: 10.6133/apjcn.2014.23.1.06

 

 

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What factors were important for dietary improvement in emergency shelters after the Great East Japan Earthquake?
NOBUYO TSUBOYAMA-KASAOKA, YUKO HOSHI, KAZUE ONODERA, SHOICHI MIZUNO AND KAZUKO SAKO

Asia Pac J Clin Nutr. 2014;23(1):159-166.

doi: 10.6133/apjcn.2014.23.1.17

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Nutrigenomics

Association of adiponectin gene -11377C>G polymorphism with adiponectin levels and the metabolic syndrome in Thais
KANJANA SURIYAPROM, BENJALUCK PHONRAT AND RUNGSUNN TUNGTRONGCHITR
Asia Pac J Clin Nutr. 2014;23(1):167-173.

doi: 10.6133/apjcn.2014.23.1.01

 

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The effect of HIF-1α on glucose metabolism, growth and apoptosis of pancreatic cancerous cells
GUODONG HE, YI JIANG, BO ZHANG AND GUOHAO WU
Asia Pac J Clin Nutr. 2014;23(1):174-180.

doi: 10.6133/apjcn.2014.23.1.14

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Erratum
Asia Pac J Clin Nutr. 2014;23(1):181.

doi: 10.6133/apjcn.2014.23.1.21

 

 

 

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Future Events

 

Asia Pac J Clin Nutr. 2014;23(1):182.

 

 

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Ecosystem Health Disorders - changing perspectives in clinical medicine and nutrition
MARK L WAHLQVIST
The inseparability of people from their ecosystem without biological change is increasingly clear. The discrete species concept is becoming more an approximation as the interconnectedness of all things, animate and inanimate, becomes more apparent. Yet this was evident even to our earliest Homo Sapiens sapiens ancestors as they hunted and gathered from one locality to another and migrated across the globe. During a rather short 150-200,000 years of ancestral history, we have changed the aeons-old planet and our ecology with dubious sustainability. As we have changed the ecosystems of which we are a part, with their opportunities for shelter, rest, ambulation, discourse, food, recreation and their sensory inputs, we have changed our shared biology and our health prospects. The rate of ecosystem change has increased quantitatively and qualitatively and so will that of our health patterns, depending on our resilience and how linear, non-linear or fractal-like the linkage. Our healthassociated ecosystem trajectories are uncertain. The interfaces between us and our environment are blurred, but comprise time, biorhythms, prokaryotic organisms, sensory (auditory, visual, tactile, taste and smell), movement, endocrine with various external hormonal inputs through food and contaminants, the reflection of soil and rock composition in the microbes, plants, insects and animals that we eat (our biogeology) and much more. We have sought ways to optimise our health through highly anthropocentric means, which have proven inadequate. Accumulated ecosystem change may now overwhelm our health. On these accounts, more integrative approaches and partnerships for health care practice are required.
Key Words: ecohealth and econutrition, geobiology, connectedness, species, food and health systems
 

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衛生生態系統失調–改變臨床醫學及營養的觀點
人類與其生態系統不可分性,在沒有生物學變化下,日益明顯。當所有事物、
有生命及無生命的,相互關聯性日趨明顯時,分立物種變成只是一個近似概
念。有證據指出,即使是人類早期的祖先,他們從一個地區狩獵及採集到另一
個地區,甚至在整個地球遷徙。在相對短暫的150-200,000 年間人類歷史,我
們毫不猶豫的改變了億萬年的星球和生態。當我們改變我們所屬的生態系統,
以取得居所、休息、活動、交談、食物、娛樂及感覺輸入機會的同時,我們也
改變了我們共享的生物學及我們的健康前景。生態系統改變的速率已呈現量性
及質性的增加,因此我們的健康型態,將取決於我們的應變能力,以及線性、
非線性或不規則的關連性。我們的衛生相關生態系統的軌跡是不確定的。我們
和我們的環境之間的介面是模糊的,但包括時間,生物節律,原核微生物,感
官(聽覺,視覺,觸覺,味覺和嗅覺),關聯運動,透過食物和污染物內分泌與
各種外部荷爾蒙,微生物,植物,昆蟲和我們吃的動物(我們的生物地質學)等
等,反映土壤和岩石成分。我們透過高度的人類中心主義的手段,尋求優化我
們的健康的途徑,但已被證明是不夠的。生態系統累積的變化現在可能壓倒我
們的健康。據此,健康照護實踐需要更加統合的方法和夥伴關係。
關鍵字:衛生生態與營養生態、地球生物學、聯絡性、物種、食物與衛生系統

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Dietetics in China at the crossroads
LINGXIA SUN AND JOHANNA DWYER
Background: A dietetics profession that conforms to the international standards for dietetics exists in many countries but not in the Peoples’ Republic of China (China). Might China benefit from the presence of the dietetics profession? Objective: The article reviews the current dietetic situation in China, summarizes the gaps between current realities in China with respect to meeting needs for nutritional care, and recommends improvements. Results: Gaps and barriers exist between current practice in dietetics and a more optimal system for meeting China’s nutritional care needs. Recommendations for actions over the near term that would lead to fuller development of the field of dietetics in China are summarized, following the model suggested by the International Confederation of Dietetic Associations. Alternative personnel deployment strategies over the next decade are also discussed. Conclusion: Whether there is a role for the profession of dietetics in China today or in the near future will depend on the attitudes and political will of Chinese government authorities, health professionals, educators, and consumers.
Key Words: dietetics, dietitian, China, gaps, nutrition

 

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处在十字路口的中国膳食营养学
背景:符合国际标准的膳食营养职业存在于许多国家,但在中国並没有。膳食
营养这一职业是否会对中国带来益处呢?目的:本文旨在回顾中国膳食营养领
域的现状,总结营养保健的需求与中国目前的现状之间的差距,并提出改善建
议。结果:中国膳食营养领域的现状与为了满足中国的营养保健需求更优化而
需要的系统之间存在着差距和阻碍。结合国际饮食营养联盟建议的模型,本文
总结了在短期内可采取的有助于膳食营养领域更全面发展的行动之相关建议,
并讨论了在未来十年内人员部署策略的替代方案。结论:膳食营养职业是否能
在当今中国或在不久的将来有所作为,取决于中国政府、卫生专业人员、教育
工作者和消费者的态度和政治意愿。
关键词:膳食营养学、营养师、中国、差距、营养

 

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Nutritional standards for energy-dense low-nutrient density foods for children in Korea
SOON-KYU LEE, HYE-KYUNG PARK AND YOUN-JU CHOI
The increasing rate of child obesity has developed into a serious concern in contemporary society. In Korea, additional concerns over unsanitary environments of food establishments near schools led to the enforcement in 2009 of the Special Act on the Safety Management of Children’s Dietary Life in order to improve food safety and nutrition. Some of the main policies of the Special Act are the prohibition of Energy-dense Low-Nutrient density Foods (hereinafter referred to as EDLNF) at school canteens and in the outstanding businesses, along with restrictions on television advertisement for EDLNF products. Confectioneries, candies, sweetened-ice products, breads, chocolates, processed milk, fermented milk, ice cream, fish-meat sausages, fruit/vegetable beverages, carbonated beverages, mixed beverages, and lactic acid bacteria beverages are classified as applicable food types of EDLNF. To establish the nutritional standards for EDLNF, the intake proportions and the pattern of nutrients in children’s preferred foods in Korea were analyzed, based on the 2005 National Health and Nutrition Survey of Korea. The foods containing more than 250 kcal, more than 17 g of sugar or more than 4 g of saturated fat and less than 2 g of protein per serving are considered EDLNF snacks. The Korean government is concentrating its efforts in promoting healthy environments for children in its research and in food policies. Further studies are necessary to investigate the current state of changes in the children's foods industry.
Key Words: energy-dense low-nutrient density foods, children's preferred foods, obesity, snacks, meal substitutes

 

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韩国儿童的高能量低营养食品之营养标准
儿童肥胖的比例不断增加,已经成为当代社会一个严重的问题。在韩国,学
校附近食品摊的卫生环境尤其令人堪忧,所以2009 年《儿童饮食生活健康管
理特殊法》出台实施,旨在增强食品安全,提高食品营养。特殊法的一些主
要措施包括禁止学校餐厅和优秀企业出售高能量低营养食品(以下简称
EDLNF),禁止电视台播放EDLNF 的广告。蜜饯、糖果、甜味冰制品、面
包、巧克力、加工牛奶、发酵乳、冰淇淋、鱼肉香肠、水果/蔬菜饮料、碳酸
饮料、复合饮料和乳酸菌饮料均属于EDLNF 类别。为了制定EDLNF 的营养
标准,以《2005 年韩国国家健康和营养调查》为基础,分析了韩国儿童偏爱
食物的摄入比例和营养类别。每份食物如包含超过250 千卡的热量,超过17
克的糖或超过4 克的饱和脂肪和少于2 克的蛋白质则被视为EDLNF 零食。韩
国政府正集中致力于通过调查研究和食品政策,以提高儿童的健康环境。需
要更多的研究著手调查目前儿童食品行业状态的改变。
关键词:高能量低营养食物、儿童偏爱食物、肥胖、零食、代餐


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The effects of intravenous, enteral and combined administration of glutamine on malnutrition in sepsis: a randomized clinical trial
GUNIZ MEYANCI KOKSAL, EMRE ERBABACAN, YUSUF TUNALI, GULSAH KARAOREN, SUPHI VEHID AND HUSEYIN OZ
Our aim was to compare the effects of intravenous, enteral, and enteral plus intravenous supplemented glutamine on plasma transferrin, nitrogen balance, and creatinine/height index in septic patients with malnutrition. Blood and urine samples were collected for transferrin, urea and creatinine measurements. Samples, SOFA score and protein-calorie intake values were repeated on days 7 and 15. Patients (n:120) were randomly divided into 4 groups. Group I received 30 g/day IV glutamine, group II received 30 g/day enteral glutamine, group III received 15 g/day IV and 15 g/day enteral glutamine. Group IV received only enteral feeding as a control group. Transferrin levels decreased in group IV (p<0.01 0-7 days, p<0.01 7-15 days, p<0.01 0-15 days). Nitrogen balance levels were highest in group IV when compared with group I (p<0.05, p<0.001), group II (p<0.001), and group III (p<0.05, p<0.001) on days 7-15. Creatinine/height indexes increased in group I (p<0.001), group II (p<0.001), group III (p<0.001), and group IV (p<0.05) on day 15. In group III the creatinine/height index was higher than in groups I and II (p<0.05). In group IV, creatinine/height index was lower than in group I (p<0.01) and group II (p<0.001). Protein-calorie intake in group IV was higher than others on day 7 (p<0.05). SOFA scores of group IV were higher than the other groups on day 15 (p<0.05). This study demonstrated, that combined route of gln supplementation resulted in the most positive outcome to transferrin, creatine/height index and nitrogen balance (on days 7 and 15) during the catabolic phase of septic patients with malnutrition.
Key Words: malnutrition, glutamine, sepsis, transferrin, nitrogen balance
 

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比較由靜脈輸入或腸道攝取或合併使用的方式補充麩醯胺酸對營養不良之敗血

症病患的效果:隨機臨床試驗
本研究目的為比較以不同途徑補充麩醯胺酸,分別為靜脈輸入、腸道攝取、及
靜脈輸入合併腸道攝取三種方式,對於營養不良之敗血症病患,其血漿運鐵蛋
白、氮平衡與肌酸酐/身高指數之效果。收集血液和尿液樣本,用於測量運鐵蛋
白、尿素和肌酸酐。在試驗第7 及15 天重複收集生化樣本、執行器官衰竭評
分(SOFA score)與記錄蛋白質熱量攝取量。將120 位病患隨機分配到四組。第
一組每日以靜脈營養方式補充30 g 麩醯胺酸;第二組每日由腸道攝取30 g 麩
醯胺酸;第三組每日以靜脈輸入15 g 麩醯胺酸,再加上腸道攝取15 g 麩醯胺
酸;第四組為控制組,以腸道營養進食。運鐵蛋白數量在第四組顯著減少(0-7
天 p<0.01;7-15 天 p<0.01;0-15 天 p<0.01)。氮平衡在第7 及15 天,與第一組
(p<0.05, p<0.001)、第二組(p<0.001)、第三組(p<0.05, p<0.001)比較,第四組為
最高。肌酸酐/身高指數在第15 天各組均有顯著提升。第三組肌酸酐/身高指數
比第一組及第二組高;第四組則比第一組及第二組低。蛋白質熱量攝取量在第
7 天,第四組較其他組別高(p<0.05)。器官衰竭分數在第15 天,第四組較其他
組高(p<0.05)。本研究顯示,結合腸道與靜脈營養的途徑補充麩醯胺酸,對於
營養不良之敗血症病患,其運鐵蛋白、肌酸酐/身高指數與氮平衡有最正面的效
果(在第7 與15 天)。
關鍵字:營養不良、麩醯胺酸、敗血症、運鐵蛋白、氮平衡

 

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Fast-track improves post-operative nutrition and outcomes of colorectal surgery: a single-center prospective trial in China
KA LI, JI-PING LI, NAN-HAI PENG, LI-LI JIANG, YAN-JIE HU AND MING-JUN HUANG

Fast-track (FT) has been shown to enhance post-operative recovery. The aim of this study was to compare the effects of FT and traditional nutrition on post-operative rehabilitation, as well as evaluate the feasibility of applying FT in nutrition management of colorectal surgery. A prospective and randomized controlled trial was performed. This study included 464 patients who underwent colorectal surgery. The patients were randomly assigned into an FT group and a traditional group. The nutritional risk screening (NRS 2002) score, post-operative recovery index and surgical complications were compared between the FT and traditional groups. The NRS 2002 score in the FT group was better than the traditional group (p<0.05). Serum indicators for nutrition (HGB, ALB, A/G) and immune function (lymphocyte rate [LYMPH%], IgA, and CD4+) in the FT group were superior to those in the traditional group (p<0.05) on post-operative day 5. The first time to aerofluxus, defecation, oral intake and ambulation in the FT group was shorter when compared to the traditional group (p<0.05). The complication incidence was significantly lower in the FT group than in the traditional group (p<0.05). In particular, the occurrence rate of anastomotic leakage was higher in the traditional group than in the FT group (0.5% vs 2.8%, p<0.05). Taken together, these data suggest that FT management can improve the nutritional condition and outcomes of colorectal surgical patients.
Key Words: fast-track, nutrition, post-operative, colorectal, prospective
 

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加速康复外科改善结直肠癌患者术后营养状态及临床效果:中国的一项单中心、

前瞻性研究
研究证明加速康复外科能够促进手术患者康复。本研究的目的是比较加速康复
外科流程与传统流程下的营养支持对患者术后康复的影响,同时探究加速康复
外科流程在结直肠手术患者营养支持方案中的临床适用性。本研究前瞻性地纳
入464 例结直肠癌手术患者,随机分为加速康复外科流程组(FT 组)和传统流程
组。终点指标为NRS2002,术后康复指标,术后并发症。FT 组NRS2002 评分
低于传统流程组(p<0.05);FT 组血红蛋白,白蛋白,白球比及淋巴细胞比率、
IgA、CD4+等指标在术后第5 天均优于传统流程组(p<0.05);FT 组首次排气、排
便、经口进食及下床活动时间短于传统流程组(p<0.05);FT 组的并发症发生率低
于传统流程组(p<0.05);传统流程组的吻合口瘘发生率高于FT 组(2.8%比上
0.5%,p<0.05) 。综上所述,本研究表明加速康复外科能够改善结直肠癌术后患
者的营养状态及临床效果。
关键词:加速康复外科、营养、术后、结直肠癌、前瞻性

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A school-based comprehensive lifestyle intervention among Chinese kids against Obesity (CLICK-Obesity) in Nanjing City, China: the baseline data
FEI XU, XIAORONG WANG, ROBERT S WARE, LAP AH TSE, ZHIYONG WANG, XIN HONG, EMILY YING YANG CHAN, JIEQUAN LI AND YOUFA WANG
Background: urgent development of effective interventions to prevent rapidly rising childhood obesity in China is needed. Methods: Between May 2010 and December 2013, a cluster randomized controlled trial was conducted among 4th graders in eight urban primary schools randomly assigned to intervention or control groups in Nanjing, China. A multi-component intervention program was implemented within the treatment group, while students in the control group followed their usual health education curriculum without additional intervention. Results: At baseline, 638 and 544 students were enrolled in the intervention and control group, respectively. The prevalence of excess body weight was 26.8%, with 27.4% in the intervention group and 26.1% in the control group (p=0.61). The mean (SD) BMI and WC was 18.7 (3.0) and 63.0 (9.2) for participants in intervention schools, and 18.5 (2.9) and 63.6 (8.7) for students in control group, separately (p=0.24 and 0.41, respectively). Compared to those who were not aware of what lifestyle/behavior factors were unhealthy, students who were aware of the unhealthy lifestyle/ behavior factors consumed fewer fried snacks (0.46±0.76 serves/week vs 0.65±0.91 serves/week; p<0.01), soft drinks (160±194 ml/week vs 199±227 ml/week; p<0.01), but larger amount of meat (502±429 g/week vs 449±344 g/week; p=0.03), and reported less screen time (214±232 minutes/week vs 252±264 minutes/week; p<0.01). Moreover, there was no difference within physical activity time between these two groups (257±341 minutes/week vs 218±324 minutes/week; p=0.13). Conclusions: Main characteristics of participants were balanced at baseline within intervention and control schools, but a gap existed between healthy lifestyle knowledge and actual healthy behavior in students. Trial Registration number: ChiCTR-ERC-11001819
Key Words: children, intervention trial, lifestyle, obesity, physical activity

 

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中国南京学校为基础的儿童肥胖生活方式干预试验(CLICK-Obesity):

基线结果
背景:在中国需要研发可行且有效的干预策略,来应对快速增长的儿童肥
胖。方法:2010年5月- 2013年12月在中国南京市选择8所城区小学,将4年级
的小学生随机分为干预组和对照组。在干预组的学生中,除了学校通用的日
常健康教育课程之外,另行实施多元的针对性干预措施;而在对照组中,则
只进行通用的日常健康教育。结果:基线入组时,638名学生被分入干预组,
544名学生被分入对照组。总的体重过多者的比例为26.8%,并且在干预组
(27.4%)和对照组(26.1%)中没有显著差异(p=0.61)。学生的体质指数的均数(标
准差)在干预组和对照组中分别为18.7(3.0)和18.5(2.9),差异没有统计学意义
(p=0.24);而腰围的均数(标准差)则分别为63.0(9.2)和63.6(8.7),差异也没有统
计学意义(p=0.41)。与不知道生活方式/行为是不健康者相比,知道生活方式/
行为不健康的学生食用更少的油炸快餐(0.46±0.76次/周 比上 0.65±0.91次/周;
p<0.01)和软饮料(160±194毫升/周比上199±227毫升/周; p<0.01) ,但食用较多
的肉食(502±429克/周比上449±344克/周;p=0.03);且看电视或使用电脑的时
间较少(214±232分钟/周比上252±264分钟/周;p<0.01)。干预组与对照组的学
生中,体力活动时间没有统计学差异(257±341分钟/周比上 218±324分钟/周;
p=0.13)。结论:在试验开始时,干预组和对照组之中学生,其主要人口学特
征是均衡可比的,但是了解健康生活方式相关知识并不意味着就采用相应的
健康行为。临床试验注册号:ChiCTR-ERC-11001819
关键词:儿童、干预试验、生活方式、肥胖、体力活动


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Association of dietary fatty acids intake with pro-coagulation and inflammation in Saudi Adults
OMAR S AL-ATTAS, NASSER M AL-DAGHRI, MAJED S ALOKAIL, KHALID M ALKHARFY, NASIRUDDIN KHAN, HANAN A ALFAWAZ, IBRAHIM A AISWAIDAN, ABDULRAHMAN S AL-AJLAN AND GEORGE P CHROUSOS
The aim of the study was to understand whether dietary fatty acids such as saturated, polyunsaturated, and monounsaturated fatty acids act as inflammatory mediators or influence pro-coagulation in Saudi adults. The study sought to examine inflammatory factors such as C-reactive protein, tumor necrosis factor-alpha and activated plasminogen activator inhibitor 1. A total number of 232 consenting Saudi adults, aged 18–60 years were randomly selected in this cross-sectional study. Independent Student t-test was done to compare means of normally distributed data. Spearman correlation between the variables was determined. The values of different fatty acids and adipokines were transformed logarithmically/square root to normalize data before correlations were determined and statistical analyses performed. Statistical significance was set at p<0.05. The results show a significant positive correlation of dietary intake of poly and monounsaturated fatty acids, but not saturated fatty acids, with activated plasminogen activator inhibitor 1 (r=0.31, p=0.02, r=0.32 p=0.04). On the other hand, dietary intake of saturated fatty acids showed a negative correlation with serum C-reactive protein levels (p=0.001) in males. Dietary unsaturated fatty acids is possibly associated with the production of a pro-coagulation factor without enhancing the secretion of pro-inflammatory molecules, while saturated fatty acids have no effect on activated plasminogen activator inhibitor 1, but their level is negatively associated with the inflammatory factor C-reactive protein. We conclude that dietary intake may exert a gender-specific effect in inflammatory processes among adults. Further studies are warranted to confirm present findings.
Key Words: dietary fatty acid, adipokines, plasminogen activator inhibitor -1, proinflammatory molecules, CRP
 

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在沙烏地阿拉伯人膳食中脂肪酸攝取與促凝血及發炎之相關
本研究目的是了解在沙烏地阿拉伯成人中,膳食脂肪酸的攝取,如:飽和、
多元不飽和以及單元不飽和脂肪酸,是否為發炎反應的調節物質或影響促凝
血。本研究檢測發炎因子像是C-反應蛋白、腫瘤壞死因子-α 和活化的Ⅰ型纖
溶酶原激活物抑制因子(aPAI-1)。在此橫斷面研究中,以隨機抽樣,總計232
位沙烏地阿拉伯成人參與,年齡介於18 到60 歲之間。以獨立Student t 檢定
比較常態分佈資料的平均值。使用斯皮爾曼係數來確定變項間的相關。進行
相關性測定之前,不同的脂肪酸和脂肪因子的數值先轉化成對數/平方根,將
數據常態化,便於統計分析。統計上的顯著設定為p 值小於0.05。研究結果
顯示,飲食攝取的多元和單元不飽和脂肪酸與aPAI-1 有顯著的正相關,但飽
和脂肪酸與其則無相關。另一方面,男性飲食攝取的飽和脂肪酸顯示與血清
中C-反應蛋白呈現負相關。膳食不飽和脂肪酸可能與產生促凝血因子而不增
加促發炎因子的分泌有關;雖然飽和脂肪酸對aPAI-1 沒有影響,但與發炎因
子C-反應蛋白呈現負相關。結論是,飲食攝取脂肪酸在成年男、女性中對發
炎過程的影響可能有別。需要未來進一步的研究確認目前的研究結果。
關鍵字:膳食脂肪酸、脂肪因子、Ⅰ型纖溶酶原激活物抑制因子、促發炎因
子、C反應蛋白儿


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Association between body fat and vitamin D status in Korean adults
SEUNG SEOK HAN, MYOUNGHEE KIM, SU MI LEE, JUNG PYO LEE, SEJOONG KIM, KWON WOOK JOO, CHUN SOO LIM, YON SU KIM AND DONG KI KIM
The relationship between body fat mass and vitamin D appears to vary by ethnicity, but our understanding of this predisposition in Asians is limited due to the scarcity of prior investigations. Data on 1,697 Korean adults were obtained from the second and third years (2008-2009) of the fourth Korean National Health and Nutritional Examination Survey. Body fat mass was measured using dual-energy X-ray absorptiometry. Both linear regression analysis for serum 25-hydroxyvitamin D [25(OH)D] and logistic analysis for vitamin D deficiency [25(OH)D <20 ng/mL] were performed to determine significant predictors among BMI, waist circumference (WC), and body fat percentage (BF), after adjustment of multiple covariates. To explore a possible non-linear relationship between them, the fractional polynomials method was used. All analyses were conducted following stratification by sex. In linear regression analysis, BMI and WC were not associated with 25(OH)D. However, BF was inversely related to 25(OH)D, irrespective of the fat location (both appendicular and truncal fat) in both sexes. In logistic regression analysis, the highest quartile group of BF had a greater OR for vitamin D deficiency than the lower quartile groups, irrespective of the fat location and sex. However, the quartiles of BMI and WC were not associated with vitamin D deficiency. The linear relationships between BF and 25(OH)D (or vitamin D deficiency) were confirmed despite use of the fractional polynomials method. Body fat mass is inversely associated with serum 25(OH)D in Korean adults. Monitoring of vitamin D deficiency in Korean adults with high fat mass is needed.
Key Words: adiposity, body composition, body fat distribution, Koreans, vitamin D
 

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韓國成人體脂肪與維生素D 之關聯性
體脂肪與維生素D 的相關性受到種族的影響,但由於先前研究的缺乏,這個
論點在亞洲人仍未確認。來自於第四次韓國國家健康與營養調查的第二及第三
年(2008-2009)的1697 名韓國成人資料納入本研究。體脂肪量是以雙能量X 光
吸收儀測量的。以直線迴歸分析血清25-羥維生素 D[25(OH)D],及以邏輯斯迴
歸分析維生素D 缺乏[25(OH)D<20 ng/mL],以評估校正多種共變項後,
BMI、腰圍或體脂肪是否為顯著預測因子。以分數多項式法探究它們之間可能
的非線性關係。所有的分析以性別分層。線性迴歸分析結果,BMI 及腰圍與
25(OH)D 沒有相關性。然而,男女性的體脂肪與25(OH)D 為負相關,並與脂
肪部位(四肢及軀幹脂肪)無關。由邏輯斯迴歸分析結果指出,最高四分位的體
脂肪組比起最低四分位組,有較高的維生素D 缺乏風險,與脂肪部位及性別
無關。然而,BMI 及腰圍的四分位與維生素D 缺乏沒有相關性。即使用分數
多項式法分析,體脂肪與25(OH)D(或是維生素D 缺乏)間的直線相關仍然存
在。韓國成人的體脂肪量與血清25(OH)D 呈現負相關。因此有必要監測高體
脂肪量的韓國成人之維生素D 缺乏。
關鍵字:肥胖、體組成、體脂肪分布、韓國、維生素D

 

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Eating behaviors and weight over time in a prospective study: the Healthy Twin Study
YUN-MI SONG, KAYOUNG LEE AND JOOHON SUNG

We examined the relationships of combined initial restrained and external/emotional eating with initial BMI and change in weight and these subscales over time. BMI and the Dutch Eating Behavior Questionnaire were twicemeasured in 1361 Korean twins and families (482 men, 879 women) over a period of 2.7±0.9 years. Subjects were classified by combination of initial sex-specific restrained and external (or emotional) eating tertiles. Linear mixed models were performed after adjusting for confounders at baseline (household, sibling relations, sex, age, education level, smoking, alcohol use, energy intake, physical activity, and medical history). In adjusted models, initial BMI increased with increasing tertiles of initial restrained eating across initial external/emotional eating tertiles. Weight was less likely to increase over time with increasing tertiles of initial restrained eating in the lowest external eating tertile and middle tertile of emotional eating at baseline. Subscale scores decreased over time with increasing tertiles of corresponding subscales at baseline. These findings suggest that high dietary restraint and external/emotional eating may indicate concurrent high BMI and attenuated weight gain and decreases in corresponding subscales over time.
Key Words: eating behavior, body mass index, body weight changes, weight gain, obesity

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前瞻性研究中飲食行為與體重變化:韓國健康孿生研究
本研究探討結合初始節制飲食與情緒性進食/外因性進食與初始身體質量指數
(BMI)、隨時間之體重變化及這些飲食行為變化之間的關係。參與者為1361
位韓國雙胞胎與家人(男性482 位,女性879 位)。在一段期間(2.7±0.9 年)內,
測量兩次BMI 和填寫荷蘭飲食行為問卷。受試者被分為結合性別差異初始節
制飲食與外因性(或情緒性)飲食三分位的不同組合。在校正基線干擾因子
(如:家戶、手足關係、性別、年齡、教育程度、吸菸、飲酒、能量攝取、體
能活動與疾病史)後,執行線性混合模式。在校正後的模式,初始BMI 隨初始
節制飲食之分量上升而增加,在初始外因性或情緒性飲食之三個分位組皆
然。在外因性飲食最低分位組與情緒性飲食的中分位組,體重的變化,不隨
初始節制飲食的分量提高而增加。隨著相對應的飲食行為基線分量上升,該
飲食行為之後續變化量降低。這些結果表示,高節制飲食和外因性/情緒性進
食可能伴隨較高的BMI、較少體重增加與降低相對應的飲食行為變化。
關鍵字:飲食行為、身體質量指數、體重變化、體重增加、肥胖


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Sleep deprivation is related to obesity and low intake of energy and carbohydrates among working Iranian adults: a cross sectional study
KOLSOOM PARVANEH, BEE KOON POH, MAJID HAJIFARAJI AND MOHD NOOR ISMAIL
Sleep deficiency is becoming widespread in both adults and adolescents and is accompanied by certain behaviors that can lead to obesity. This study aims to investigate differences in sleep duration of overweight/obese and normal weight groups, and the association between sleep deprivation and obesity, dietary intake and physical activity. A cross-sectional study was conducted among 226 Iranian working adults (109 men and 117 women) aged 20 to 55 years old who live in Tehran. Body weight, height, waist and hip circumferences were measured, and BMI was calculated. Questionnaires, including the Sleep Habit Heart Questionnaire (SHHQ), International Physical Activity Questionnaire (IPAQ) and 24-hour dietary recall, were interview-administered. Subjects were categorized as normal weight (36.3%) or overweight/obese (63.7%) based on WHO standards (2000). Overweight/obese subjects slept significantly (p<0.001) later (00:32±00:62 AM) and had shorter sleep duration (5.37±1.1 hours) than normal weight subjects (23:30±00:47 PM and 6.54±1.06 hours, respectively). Sleep duration showed significant (p<0.05) direct correlations to energy (r = 0.174), carbohydrate (r = 0.154) and fat intake (r = 0.141). This study revealed that each hour later in bedtime (going to bed later) increased the odds of being overweight or obese by 2.59-fold (95% CI: 1.61-4.16). The findings in this study confirm that people with shorter sleep duration are more likely to be overweight or obese; hence, strategies for the management of obesity should incorporate a consideration of sleep patterns.
Key Words: body weight, dietary intake, obesity, physical activity, sleep deprivation
 

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在職的伊朗成人其睡眠不足與肥胖、低熱量及碳水化合物攝取量相關:

橫斷性研究
睡眠不足在成年人及青少年已成為普遍的現象,這伴隨著某些行為可能導致肥
胖。此研究目的為研究體重過重/肥胖及正常體位者的睡眠時間差異,以及睡
眠不足與肥胖、飲食攝取及體能活動的相關性。本橫斷性研究的研究對象來自
於居住在德黑蘭的226 名伊朗在職成人(109 名男性及117 名女性),年齡介於
20 至55 歲。測量受訪者的體重、身高、腰臀圍,並計算其BMI。在面訪時使
用包含睡眠習慣心臟問卷(SHHQ)、國際體能活動問卷(IPAQ)及24 小時飲食回
憶問卷。研究對象依據WHO 標準(2000)被分類為正常體重(36.3%)或是體重過
重/肥胖(63.7%)。體重過重/肥胖者(凌晨00:32±00:62 就寢)比起正常體重者(夜
晚23:30±00:47 就寢及6.54±1.06 小時睡眠)顯著較晚睡覺,且有較短的睡眠時
間(5.37±1.1 小時)。睡眠時間則與熱量(r=0.174)、碳水化合物(r=0.154)及脂肪
(r=0.141)攝取量有顯著的直接相關性。這個研究亦發現,就寢時間每延後一小
時,體重過重或肥胖的機率則增加2.59 倍(95% CI=1.61-4.16)。此研究結果證
實,睡眠時間較短者較可能為體重過重或是肥胖;因此,肥胖的管理策略應同
時考量睡眠模式。
關鍵字:體重、飲食攝取、肥胖、體能活動、睡眠不足

 

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Socio-economic factors and use of maternal health services are associated with delayed initiation and non-exclusive breastfeeding in Indonesia: secondary analysis of Indonesia Demographic and Health Surveys 2002/2003 and 2007
CHRISTIANA R TITALEY, PHILIPS C LOH, SABARINAH PRASETYO, IWAN ARIAWAN AND ANURAJ H SHANKAR
This analysis aims to examine factors associated with delayed initiation and non-exclusive breastfeeding in Indonesia. Data were derived from the 2002/2003 and 2007 Indonesia Demographic and Health Survey. Information from 12,191 singleton live-born infants aged 0-23 months was used to examine factors associated with delayed initiation of breastfeeding. Furthermore, information from 3,187 singleton live-born infants aged 0-5 months was used to identify factors associated with non-exclusive breastfeeding. Associations between potential predictors and study outcomes were examined using logistic regression. Our study found that infants from high household wealth-index had significantly increased odds of both delayed initiation and non-exclusive breastfeeding. Other factors associated with an increased odds of delayed initiation of breastfeeding included infants from Sumatera region (OR=1.64, 95% CI: 1.38-1.95), Caesarean-section deliveries (OR=1.84, 95% CI: 1.39-2.44) and deliveries in government-owned (OR=1.38, 95% CI: 1.08-1.76) and non-health facility (OR=1.20, 95% CI: 1.00-1.43). Other factors associated with an increased odds for non-exclusive breastfeeding included parents who were in the workforce (OR=1.37, 95% CI: 1.06-1.78) and mothers with obstetric complication at childbirth (OR=1.35, 95% CI: 1.05-1.74). However, the odds reduced for infants from Eastern Indonesia (OR=0.64, 95% CI: 0.49-0.85). Poor breastfeeding practices are associated with environmental, socio-economic, pregnancy-birthing characteristics and maternal health services factors. Efforts to promote breastfeeding practices should be conducted comprehensively to target population at risk for poor breastfeeding practices.
Key Words: delayed initiation of breastfeeding, exclusive breastfeeding, Indonesia Demographic and Health Survey, Indonesia

 

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印尼婦女社經因子及孕產婦健康服務利用與延後開始及非純母乳哺餵有關:

印尼2002/2003 及2007 人口與健康調查次級資料分析
本分析目的為評估印尼婦女延後開始哺餵母乳,以及非純母乳哺餵的相關因
子。資料源自於2002/2003 及2007 年印尼人口與健康調查。評估共12,191 名,
年齡介於0-23 個月的活產獨生子女,延後開始母乳哺餵的相關因子。此外,也
評估3,187 名,年齡介於0-5 個月的活產獨生子女,其非純母乳哺餵的相關因
子。使用羅吉斯迴歸,評估潛在預測因子與結果的相關性。我們的研究發現 來
自高家戶財富指標的嬰兒,其延後開始哺餵母乳,及非純母乳哺餵的機會均顯
著增加。延後開始母乳哺餵的相關因子, 包括: 嬰兒來自Sumatera 區
(OR=1.64,95% CI=1.38-1.95)、剖腹產(OR=1.84,95% CI=1.39-2.44)及出生於
公立醫院(OR=1.38 , 95% CI=1.08-1.76) 或是非醫療機構(OR=1.20 , 95%
CI=1.00-1.43) 。與非純母乳哺餵相關的其他因子, 包括: 父母有工作
(OR=1.37,95% CI=1.06-1.78)及媽媽在小孩生產時有併發症(OR=1.35,95%
CI=1.05-1.74) 。然而, 來自印尼東部的嬰兒, 非純母乳哺餵的機率較低
(OR=0.64,95% CI=0.49-0.85)。母乳哺育落實不佳與環境、社經狀況、懷孕生
產的特性及母親健康服務因子有關。要促進母乳哺育,應全面針對那些母乳哺
育落實不佳的危險族群。
關鍵字:延後開始母乳哺餵、全母奶、印尼人口及健康調查、印尼

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The impact on child wasting of a capacity building project implemented by community and district health staff in rural Lao PDR
BENJAMIN COGHLAN, MICHAEL J TOOLE, NIRAMONH CHANLIVONG, SENGCHANH KOUNNAVONG, KONGCHAY VONGSAIYA AND ANDRE RENZAHO
The consumption of dates with coffee is common among Arabs and mLaos is a low-income food-deficit country with pockets of high levels of wasting in the highland areas. We implemented a 3-year health/nutrition project in 12 villages in the highlands of Savannakhet province to reduce acute malnutrition in children. Volunteer nutrition teams in each village monitored child growth and promoted healthy feeding practices; a multisectoral district committee conducted monthly outreach to assess child growth, manage acute malnutrition and deliver primary health care services. We conducted a cross-sectional assessment before project activities began and at the end of the project. The baseline survey randomly sampled 60% of all households; the endline assessment aimed to survey all eligible registered participants. Anthropometric measures were taken from children aged 6-59 months; mothers with children aged <12 months were asked about infant feeding practices, antenatal and post-partum care; and child immunizations were recorded for children aged between 0-23 months. At baseline, 721 households were sampled, while the endline assessment surveyed between 82% and 100% of eligible participants in each age group. Acute malnutrition reduced from 12.4% (95% CI: 10.4-14.3) to 6.1% (4.9-7.3). Unhealthy feeding practices declined: in 2008, 40.0% (34.7-45.3) of mothers breastfed their newborn within 2 hours of birth and 30.8% (25.7-35.8) threw the colostrum away; in 2011, these figures were 72% and 8% respectively. Maternal care and child immunisation coverage also improved. Improving the health environment and child feeding practices appears to have markedly reduced the level of wasting. Unsafe feeding practices were common but readily changed by the community-based nutrition teams.
Key Words: wasting, acute malnutrition, Laos, capacity-building, feeding behaviours

 

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由社區和地區保健人員在寮國鄉村實施健康能力建構計畫對兒童發育不良的影響
寮國是一個低收入且糧食缺乏的國家,特別在高原地區營養不足情況嚴重。在
沙灣拿吉省高地的12 個村莊,實施一項為期三年的健康營養計畫,目的是減少
此地區的兒童急性營養不良。各村莊的營養志工團隊監測兒童成長及推動健康
哺餵。多部門地區委員會每月巡迴各村莊,評量兒童生長情形、處置急性營養
不良與提供初級健康照護保健服務。在計畫執行前後分別進行一項橫斷型評
估。基線評估是隨機抽取60%家戶;而終線評估目標是調查所有合格登記的參
與者。6-59 月的兒童進行體位測量;詢問有12 個月以下兒童的母親,其哺餵嬰
兒的方式、產前與產後之照護;記錄0-23 月兒童的疫苗接種情況。基線取樣
721 個家戶;而終線評估在不同年齡組有82%-100%參與者被調查。急性營養不
良由12.4% (95% CI: 10.4-14.3)減少至6.1% (95% CI:4.9-7.3)。不健康的哺餵行為
降低:在2008 年,新生兒出生2 小時內進行餵母乳的母親佔40.4% (34.7-
45.3),而摒棄初乳的母親佔30.8% (25.7-35.8);在2011 年,二者比例分別為
72%和8%。孕產婦保健和兒童疫苗接種的覆蓋率也提高。改善醫療衛生環境與
幼兒哺餵方法,明顯降低兒童發育不良。不安全的哺餵方式雖然常見,但社區
為基礎的營養團隊,能即時促以改善。
關鍵字:發育不良、急性營養不足、寮國、健康能力建構、哺餵行為


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Disturbed eating tendency and related factors in grade four to six elementary school students in Taiwan
YUECHING WONG, YU-JHEN CHANG AND SHU-WEI TSAO
OBJECTIVE: This study investigated Taiwanese elementary school students’ status in terms of body size, body satisfaction and disturbed eating tendencies. METHODS: In a cross-sectional survey, 1,261 elementary school children from grades four to six participated in this study. We used an anonymous selfreported questionnaire, which included: demographics and body satisfaction; Children’s Eating Attitude Test -26 (ChEAT-26); Nowicki-Strickland Locus of Control Scale; and Influence of Significant Others Scale and Media Impact Scale. RESULTS: We found that 58.4% of the children were of normal weight, and 32.7% of the boys and 22.2% of the girls were over-weight or obese. Moreover, 39% of the children wanted to be thinner. The mean ChEAT-26 score was 8.71±8.35, and 10.5% of the children were at high risk for disturbed eating tendencies (ChEAT-26≥20), including 8.4% of the boys and 12.6% of the girls. Scores on the ChEAT-26, Nowicki-Strickland Locus of Control Scale, Influence of Significant Others Scale and Media Impact Scale were positively correlated. The level of external control and the influence of significant others and the media were significantly higher in children with disturbed eating attitudes than in those without them. Multivariable logistic regressions showed that disturbed eating attitudes were associated with body satisfaction, locus of control, and the level of influence of significant others and the media. Conclusions: Disturbed eating behaviors exist among elementary school students in Taiwan. This survey highlights the need for education in acquiring healthy mental attitudes and eating behaviors by elementary school students.
Key Words: Children’s Eating Attitude Test -26, locus of control, significant others, media, elementary school students

 

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台灣國小四到六年級學童病態飲食行為傾向及相關影響因子探討
本研究主要目的在瞭解台灣國小四到六年級的學童的體型狀態、體型滿意度
及病態飲食行為傾向。本研究為橫斷式調查,共有1261 位四到六年級的國小
學童參與本研究。以匿名自填式問卷為研究工具,內容包括: 基本資料、體型
滿意度、兒童版飲食態度測驗(ChEAT-26) 、內外控信念量表( Nowicki-
Strickland Locus of Control Scale)、重要他人影響量表及媒體影響量表。結果
發現:58.4%的學童體型正常,分別有32.7%的男童及22.2%女童體型為過重
或肥胖,然而卻有39.0%的學童希望自己能再瘦一點。學童之ChEAT-26 平均
分數為8.71±8.35 分,10.5%的學童為病態飲食行為傾向高危險群(ChEAT-26≧
20),男童及女童分別為8.4%及12.6%。學童之ChEAT-26 得分與內外控信念
量表、重要他人影響量表及媒體影響量表得分皆呈現顯著正相關。具病態飲
食行為傾向的高危險群學童其外控信念、受重要他人及媒體影響程度皆顯著
高於低危險群。多元邏輯迴歸顯示,「體型滿意度」、「內外控信念」、
「重要他人影響程度」及「媒體影響程度」與學童病態飲食行為傾向有顯著
相關性。病態飲食行為相關問題確實存在於台灣國小學童,本研究結果突顯
出國小學童需要有健康心理與飲食行為的教育。
關鍵詞:兒童飲食態度測驗、內外控信念、重要他人、媒體、國小學童
 

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Influence of obesogenic behaviors on health-related quality of life in adolescents
BAMINI GOPINATH, JIMMY CY LOUIE, VICTORIA M FLOOD, GEORGE BURLUTSKY, LOUISE L HARDY, LOUISE A BAUR AND PAUL MITCHELL
We aimed to prospectively examine the association between the combined effects of obesogenic behaviors on quality of life (QOL) in adolescents. Of 2353 Sydney schoolchildren surveyed (median age 12.7 years), 1,213 were re-examined 5 years later at age 17-18. Children completed activity and food-frequency questionnaires. An unhealthy behavior score was calculated, allocating 1 point for the following: <60 minutes of total physical activity/day; ≥2 hours of screen time/ day; consumed salty snack foods and/or confectionery ≥5 times per week; ≥1 serves of soft drinks and/or cordial/ day; and not consuming both ≥2 serves of fruit and ≥3 serves of vegetables/day. Health-related QOL was assessed by the Pediatric Quality of Life Inventory (PedsQL). The prevalence of 0, 1, 2, 3, 4, and 5 lifestyle risk factors was 4.2%, 17.1%, 30.7%, 30.5%, 13.9% and 3.6%, respectively. After multivariable-adjustment, children engaging in 5 versus 0 unhealthy behaviors had 9.2-units lower PedsQL physical summary score (ptrend=0.001), five years later. Boys reporting 4 or 5 lifestyle risk factors compared to their peers reporting none or one at baseline, had lower total and physical summary scores at follow-up, ptrend=0.02 and 0.01, respectively. Girls engaging in 4 or 5 versus 0 or 1 unhealthy behaviors, had 4.6-units lower physical summary score (ptrend=0.04), five years later. The number of obesogenic lifestyle risk factors was independently associated with subsequent poorer QOL, particularly physical health, during adolescence. These findings underscore the importance of targeting lifestyle behaviors to promote general well-being and physical functioning in adolescents.
Key Words: adolescents, quality of life, lifestyle, diet, Sydney Childhood Eye Study
 

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易造成肥胖的行為對於青少年健康相關生活品質之影響
本研究是前瞻性研究,目的是探討容易造成肥胖的行為對青少年生活品質
(QOL)的綜合效應之間的關聯性。研究對象來自雪梨學童調查,共2,353 位學童
(年齡中位數為12.7 歲),5 年後有1213 位,於17-18 歲被再次調查。學童完成
活動及飲食頻率問卷。不健康的行為計算其得分,指定分數1 點如下:每天小
於60 分鐘的體能活動;每天超過2 小時看螢幕;每週攝取5 次以上鹹味零食和
/或糖果;每天攝取1 份以上碳酸飲料和/或甜香酒;每天沒有攝取2 份以上的水
果和3 份以上的蔬菜。健康有關的生活品質是由兒童生活品質問卷(PedsQL)所
評估。生活型態危險因子有0、1、2、3、4 及5 項的盛行率分別為4.2%、
17.1%、30.7%、30.5%、13.9%及3.6%。在多變項調整後,追蹤5 年結果發
現,兒童有5 項不健康行為比起0 項者,在PedsQL 中,體能總分低9.2 個單位
(ptrend=0.001)。男孩有4 項或5 項生活型態危險因子,相較於同年齡在基準點沒
有或有1 項危險因子者,在追蹤後,有較低整體及體能總分,趨勢的p 值分別
為0.002 及0.01。女孩在5 年後的追蹤,有4 項或5 項生活型態危險因子比起
沒有或有1 項者,在體能總分低4-6 個單位(ptrend=0.004)。學童容易造成肥胖的
生活型態危險因子的項目多寡與後續的生活品質較差是獨立相關,尤其是青春
期的體能健康。這些研究結果,強調針對青少年生活型態的行為,對於促進一
般健康和體適能的重要性。
關鍵字:青少年、生活品質、生活型態、飲食、雪梨兒童眼科研究


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Breakfast eating patterns and the metabolic syndrome: the Korea National Health and Nutrition Examination Survey (KNHANES) 2007-2009
KI-BONG YOO, HEE-JAE SUH, MINJEE LEE, JAE-HYUN KIM, JEOUNG A KWON AND EUN-CHEOL PARK
Objective: The purpose of this study is to find out the association between eating breakfast, breakfast patterns, and the metabolic syndrome. Methods: We used the fourth Korean National Health and Nutrition Examination Survey from 2007 to 2009. A total of 16,734 subjects were included. Breakfast dietary patterns were extracted by factor analysis. Multiple logistic regression was used to assess the relationship between breakfast consumption, breakfast dietary patterns, and the metabolic syndrome. Results: We found that breakfast consumption itself reduced the risk of the metabolic syndrome (odds ratio=0.82, 95% confidence interval=0.69-0.98). We identified two breakfast dietary patterns: the traditional Korean pattern and the dairy-cereal pattern. The dairy-cereal pattern was associated with a reduction in the risk of the metabolic syndrome among breakfast consumers. Compared to no breakfast consumption, the strongest traditional Korean pattern and the highest quartiles for the dairy-cereal pattern were associated with a reduced risk of the metabolic syndrome. Conclusions: Breakfast consumption is associated with the metabolic syndrome. Not all breakfast consumption patterns are associated with a reduced risk of having the metabolic syndrome. In particular, eating either a dairy-cereal breakfast or high energy and fiber breakfast are associated with a reduced risk of the metabolic syndrome.
Key Words: breakfast, eating patterns, the metabolic syndrome, Korea, dairy-cereal
 

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早餐模式與代謝症候群:2007-2009 韓國全國健康與營養評估調查(KNHANES)
目的:本篇研究目的為探究吃早餐、早餐模式及代謝症候群間之相關性。方
法:使用2007 至2009 年的第四次韓國全國健康與營養評估調查資料。共有
16,734 名受訪者納入。以因素分析去歸納早餐飲食模式。以多元羅吉斯回歸評
估早餐攝取、早餐飲食模式及代謝症候群之相關性。結果:攝取早餐降低代謝
症候群之風險(勝算比=0.82,95%信賴區間=0.69-0.98)。分析歸納出兩種早餐飲
食模式:傳統韓式及乳製品-穀類模式。在有食用早餐者間,乳製品-穀類模式
與降低代謝症候群風險有關。與沒有食用早餐者相比,攝取最高的傳統韓式與
最高四分位的乳製品-穀類早餐與降低代謝症候群的風險有關。結論:早餐攝取
與代謝症候群有關。但並非所有的早餐模式與降低代謝症候群罹患風險有關。
值得關注的是,無論攝取乳製品-穀類早餐或是高熱量及纖維早餐與降低代謝症
候群風險有關。
關鍵字:早餐、飲食模式、代謝症候群、韓國、乳製品-穀類

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Food insecurity and the metabolic syndrome among women from low income communities in Malaysia
ZALILAH MOHD SHARIFF, NORHASMAH SULAIMAN, ROHANA ABDUL JALIL, WONG CHEE YEN, YONG HENG YAW, MOHD NASIR MOHD TAIB, MIRNALINI KANDIAH AND KHOR GEOK LIN
This cross-sectional study examined the relationship between household food insecurity and the metabolic syndrome (MetS) among reproductive-aged women (n=625) in low income communities. The Radimer/Cornell Hunger and Food Insecurity instrument was utilized to assess food insecurity. Anthropometry, diet diversity, blood pressure and fasting venous blood for lipid and glucose profile were also obtained. MetS was defined as having at least 3 risk factors and is in accordance with the Harmonized criteria. The prevalence of food insecurity and MetS was 78.4% (household food insecure, 26.7%; individual food insecure, 25.3%; child hunger, 26.4%) and 25.6%, respectively. While more food secure than food insecure women had elevated glucose (food secure, 54.8% vs food insecure, 37.3-46.1%), total cholesterol (food secure, 54.1% vs food insecure, 32.1-40.7%) and LDL-cholesterol (food secure, 63.7% vs food insecure, 40.6-48.7%), the percentage of women with overweight/obesity, abdominal obesity, hypertension, high triglyceride, low HDL-cholesterol and MetS did not vary significantly by food insecurity status. However, after controlling for demographic and socioeconomic covariates, women in food insecure households were less likely to have MetS (individual food insecure and child hunger) (p<0.05), abdominal obesity (individual food insecure and child hunger) (p<0.01), elevated glucose (household food insecure), total cholesterol (child hunger) (p<0.05) and LDL-cholesterol (household food insecure and child hunger) (p<0.05) compared to food secure women. Efforts to improve food insecurity of low income households undergoing nutrition transition should address availability and accessibility to healthy food choices and nutrition education that could reduce the risk of diet-related chronic diseases.
Key Words: metabolic syndrome, food insecurity, harmonized criteria, low income communities, reproductive age women
 

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馬來西亞低收入社區的婦女之糧食不安全與代謝症候群
這個橫斷性研究評估在低收入地區的育齡婦女(625 位),其家戶糧食不安全性
與代謝症候群的相關性。利用Radimer/Cornell 飢餓及糧食不安全指南以評估糧
食不安全性。並取得體位測量值、飲食多樣性、血壓及禁食靜脈血脂及血糖
值。依據國際統一分類標準(Harmonized criteria),代謝症候群的定義為至少有
3 項危險因子。糧食不安全(家戶糧食不安全26.7%;個人糧食不安全25.3%;
孩童飢餓26.4%)及代謝症候群的盛行率分別是78.4%及25.6%。雖然糧食安全
比起有糧食不安全的婦女有較高的血糖(糧食安全54.8%比上糧食不安全37.3-
46.1%)、總膽固醇(54.1%比上32.1-40.7%)及低密度脂蛋白膽固醇(63.7%比上
40.6-48.7%),但是依糧食不安全程度來看,婦女體重過重/肥胖、腹部肥胖、
高血壓、高三酸甘油酯、低的高密度脂蛋白-膽固醇及代謝症候群的百分比,
都沒有顯著的差異。然而,在控制人口學及社經地位變項後,家戶糧食不安全
的婦女比起糧食安全的婦女有較少比率的代謝症候群(個人糧食不安全及孩童
飢餓)(p<0.05)、腹部肥胖(個人糧食不安全及孩童飢餓)(p<0.01)、高血糖(家戶
糧食不安全)、高總膽固醇(孩童飢餓)(p<0.05)及高的低密度脂蛋白膽固醇(家戶
糧食不安全及孩童飢餓)。低收入家戶處於營養轉型之際,致力於改善他們的
糧食不安全,應該著重健康食物選擇的可用性及可獲性與營養教育,以降低飲
食相關慢性疾病的風險。
關鍵字:代謝症候群、糧食不安全、國際統一標準、低收入社區、育齡婦女
 

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Clustering and determinants of cardiometabolic risk factors among Filipino young adults

NIHA ZUBAIR, CHRIS W KUZAWA, NANETTE R LEE, THOMAS W MCDADE AND LINDA S ADAIR
BACKGROUND: With modernization, cardiometabolic disease risk has increased in low and middle-income countries. To better understand cardiometabolic disease etiology, we evaluated the patterning risk factors in a susceptible young adult population. METHODS AND RESULTS: Participants included 1,621 individuals from the 2005 Cebu Longitudinal Health and Nutrition Survey. Using cluster analysis, we grouped individuals by the following biomarkers: triglycerides, HDL and LDL cholesterol, C-reactive protein, blood pressure, homeostasis model assessment of insulin resistance, and fasting glucose. Using multinomial logistic regression models we assessed how diet, adiposity, and environment predicted cardiometabolic clusters. We identified 5 distinct sexspecific clusters: 1) Healthy/High HDL cholesterol (with the addition of high LDL cholesterol in women); 2) Healthy/Low blood pressure; 3) High blood pressure; 4) Insulin resistant/High triglycerides; and 5) High Creactive protein. Low HDL cholesterol was the most prevalent risk factor (63%). In men and women, a higher intake of saturated fat increased the likelihood of being in the healthy clusters. In men, poorer environmental hygiene increased the likelihood of being in the High C-reactive protein cluster, compared to the healthy clusters (OR 0.74 [95% CI 0.60-0.90] and 0.83 [0.70-0.99]). Adiposity most strongly associated with membership to the Insulin resistant/high triglyceride cluster. CONCLUSIONS: Despite the population’s youth and leanness, cluster analysis found patterns of cardiometabolic risk. While adiposity measures predicted clustering, diet and environment also independently predicted clustering, emphasizing the importance of screening lean and overweight individuals for cardiometabolic risk. Finding predictors of risk in early adulthood could help inform prevention efforts for future disease.
Key Words: young adult, risk factors, cluster analysis, adiposity, cardiovascular diseases
 

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菲律賓年輕成人的心血管代謝疾病風險的集群及預測因子
背景:隨著現代化,在低及中收入國家的心血管代謝疾病風險已增加。為了探
究心血管代謝疾病的病原,評估在易感受性的年輕成人族群的危險因子模式。
方法及結果:納入1621 名來自2005 年宿霧長期健康與營養調查的參與者。使
用集群分析,以下列生化指標分組:三酸甘油酯、高密度脂蛋白及低密度脂蛋
白膽固醇、C 反應蛋白、血壓、恆定模式定量的胰島素阻抗及禁食血糖。使用
多項式邏輯斯回歸模式評估飲食、肥胖及環境如何預測心血管代謝集群。結果
區別出五種有性別差異的集群:1)健康/高HDL 膽固醇(女性並有高LDL 膽固
醇);2)健康/低血壓;3)高血壓;4)胰島素阻抗/高三酸甘油酯;5)高C 反應蛋
白。低HDL 膽固醇是盛行率最高的危險因子(63%)。在男女性,較高的飽和脂
肪攝取卻提昇進入健康集群的可能性。在男性,比起健康集群,較差的環境衛
生增高成為高C 反應蛋白集群的可能性(OR=0.74 及0.83)。肥胖與胰島素阻抗/
高三酸甘油酯集群有最強的相關性。結論:儘管這個族群是年輕且瘦的,集群
分析仍發現心血管代謝危險模式。儘管肥胖測量可預測集群,飲食及環境也是
獨立的集群預測因子,因此心血管代謝疾病風險的篩選不論在瘦或是體重過重
的人都很重要。發現年輕成人的預測因子可以協助未來疾病的預防。
關鍵字:年輕成人、危險因子、集群分析、肥胖、心血管疾病

 

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What factors were important for dietary improvement in emergency shelters after the Great East Japan Earthquake?
NOBUYO TSUBOYAMA-KASAOKA, YUKO HOSHI, KAZUE ONODERA, SHOICHI MIZUNO AND KAZUKO SAKO
The Great East Japan Earthquake of 2011 left many evacuees with insufficient food and emergency shelter. However, there is no evidence concerning the factors affecting dietary circumstances in emergency shelters after disasters. To clarify the factors that influenced the provision of meals, we reanalyzed a data set from a dietary survey conducted in emergency shelters one month after the Great East Japan Earthquake (2011). Among the 69 shelters in “city A,” 53 (79.1%) had food shortages. The possibility of cooking in the emergency shelter improved the provision of meals to evacuees. When comparing emergency shelters with and without cooking equipment, the shelters with cooking equipment provided more meals, as well as more dishes containing grains and vegetables. When there was a gas supply, the twice per day provision of “balanced” meals (containing grains, vegetables, and meat/fish) was more frequent than when there was no gas supply. Interestingly, neither the water supply nor the electricity supply affected the provision of balanced meals. Further, emergency shelters with larger numbers of evacuees had a lower possibility of cooking and lower availability of gas supply. Our results demonstrate that early improvements to post-disaster meal provision may maintain the health of evacuees. Such improvements could be achieved by 1) the speedy restoration of the gas supply to enable cooking, and 2) limiting the number of evacuees per emergency shelter.
Key Words: disaster, emergency shelter, gas, cooking, meals
 

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東日本大地震後的緊急避難所飲食改善有哪些重要因子?
在2011 年的東日本大地震後,許多災民沒有足夠的食物和緊急避難所。然
而,關於災難後在緊急避難所中影響飲食情況的因素目前並無確證。為澄清
影響餐食供應的因素,重新分析在東日本大地震一個月後,於緊急避難所進
行的膳食調查資料。在A 城市中有69 間避難所,其中53 間(79.1%)有糧食短
缺的問題。在緊急避難所烹調的可能性,提升膳食供應給避難者。比較有或
無烹調設備之緊急避難所,有烹調設備者可以提供較多餐點,及較多包含穀
物和蔬菜的菜餚。有天然氣供應的避難所,每天提供兩次“均衡”餐點(包含穀
物、蔬菜和肉或魚)的頻率高於沒有天然氣者。特別的是,不論供水或電力供
應狀況都不影響提供均衡餐食。再者,多數緊急避難所的難民有較少的烹調
機會及較低的天然氣供應可獲性。本研究結果顯示,即早改善災難後餐食供
應可維持災民的健康。下列舉措可促成這種改善:(1)迅速恢復天然氣供應以
提供烹調;(2)限制每個緊急避難所的災民人數。
關鍵詞:災難、緊急避難所、天然氣、烹調、餐點
 

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Association of adiponectin gene -11377C>G polymorphism with adiponectin levels and the metabolic syndrome in Thais
KANJANA SURIYAPROM, BENJALUCK PHONRAT AND RUNGSUNN TUNGTRONGCHITR
The metabolic syndrome is related to increased risk of developing cardiovascular disease and type 2 diabetes. Adiponectin is an adipocyte-secreted protein with insulin-sensitizing and anti-atherogenic properties. The aims of this study were to evaluate adiponectin levels and biochemical parameters in metabolic-syndrome subjects and healthy controls. The study also sought to identify links between two polymorphisms, -11377C>G (rs266729) and +45T>G (rs2241766) of the adiponectin gene, in relation to adiponectin levels and the metabolic syndrome. Three hundres and thirty-two Thai volunteers: 164 metabolic-syndrome subjects and 168 healthy control subjects were investigated. The adiponectin and HDL-C levels of the metabolic-syndrome group were significantly lower than the control group (p<0.001). Decreased concentration of adiponectin was associated with -11377C>G polymorphism (p<0.001); this polymorphism was significantly more frequent in the metabolic syndrome group than in the control group (p<0.001). However, +45T>G polymorphism of the adiponectin gene was found not to be related to adiponectin level or metabolic syndrome. Therefore, -11377C>G polymorphism was related to the metabolic syndrome susceptibility, and this polymorphism impacted on circulating adiponectin concentrations among Thais.
Key Words: metabolic syndrome, visceral obesity, adiponectin, gene polymorphism, Thais
 

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泰國人的脂聯素基因-11377C>G 多型性與脂聯素濃度和代謝症候群之關聯性
代謝症候群與增加心血管疾病及第二型糖尿病罹患風險具有相關性。脂聯素
是一種由脂肪細胞分泌的蛋白質,具有促進胰島素敏感性及抗動脈粥狀硬化
的特性。本篇研究目的為評估代謝症候群患者與健康對照者的脂聯素濃度及
生化參數。另外也探討兩個脂聯素基因-11377C>G(rs266729) 與+45T>C
(rs2241766)的多型性與脂聯素濃度和代謝症候群間的關聯性。332 名
泰國志願者:164 名代謝症候群患者與168 名健康對照者為研究對象。代謝症
候群組的脂聯素與HDL-C 濃度顯著低於對照組(p<0.001)。較低的脂聯素濃度
與-11377C>G 基因多型性有關(p<0.001);此多型性在代謝症候群組比例顯著多
於對照組(p<0.001)。然而,脂聯素基因+45T>C 的多型性與脂聯素濃度或是代
謝症候群沒有相關性。因此,-11377C>G 多型性與代謝症候群的易感受性有
關,而這個多型性影響泰國人血液循環中的脂聯素濃度。
關鍵字:代謝症候群、內臟型肥胖、脂聯素、基因多型性、泰國人

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The effect of HIF-1α on glucose metabolism, growth and apoptosis of pancreatic cancerous cells
GUODONG HE, YI JIANG, BO ZHANG AND GUOHAO WU
Objectives: The aim of this study is to explore the possible role of HIF-1α in glucose metabolism, proliferation and apoptosis of pancreatic cancerous cells. Method: The pancreatic cancerous BxPC-3 cells were cultured in normoxia or hypoxia (3% O2), respectively. Cell proliferation was determined by MTT assay, apoptosis was determined by Annexin V/PI staining. Expression of Pyruvate dehydrogenase kinase (PDK1), Lactate dehydrogenase (LDHA), pyruvate kinase M2 (PKM2) and citrate synthase (CS) was determined by Western-blot and Realtime PCR. Results: Under hypoxia, the expression of HIF-1α and the lactate production were increased. The expression of glucose metabolic enzymes PDK1, LDHA, PKM2 was also increased compared with that under aerobic condition. Hypoxia treatment had little effect on expression of CS. Under hypoxia, knockdown of HIF-1α inhibited the production of lactate and the expression of PDK1, LDHA and PKM2. Knockdown of HIF-1α repressed the growth of pancreatic cancer BxPC-3 cells and induced apoptosis of the cells under hypoxia. Conclusion: Under hypoxia, the expression of HIF-1α is induced, leading to the increase of glycolysis in BxPC-3 cells possibly through upregulation of the enzymes related to glycolysis. HIF-1α knockdown can inhibit the prolife ratio and promote apoptosis of pancreatic cancerous BxPC-3 cells in vitro.
Key Words: HIF-1α, RNA interfering, glycolysis, pancreatic cancer, hypoxia
 

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探讨HIF-1α 基因对胰腺癌细胞之葡萄糖代谢、生长和凋亡的影响
目的:探讨HIF-1α 基因沉默对胰腺癌细胞生长和凋亡的影响;探讨HIF-1α
对胰腺癌细胞糖代谢的调控作用。方法:胰腺癌细胞分别在有氧及缺氧
(3%O2)条件下培养。利用MTT 实验绘制胰腺癌细胞生长曲线,流式细胞仪检
测细胞凋亡;利用乳酸试剂盒测定乳酸含量;利用定量PCR 和Western Blot
方法测定丙酮酸脱氢酶激酶1(PDK1)、乳酸脱氢酶A(LDHA)、丙酮酸激酶
M2(PKM2)和柠檬酸合成酶(CS)的表达,观察HIF-1α 沉默前后相关检测指标
的变化。结果:缺氧条件下,HIF-1α mRNA 和蛋白的表达均明显升高;乳酸
的生成、糖代谢酶PDK1、LDHA、PKM2 mRNA 和蛋白的表达均明显升高,
同有氧条件下比较,差别有统计学意义;CS mRNA 和蛋白的表达同有氧条件
下比较,差别无统计学意义。缺氧条件下,HIF-1α 基因沉默后,乳酸的生
成、糖代谢酶PDK1、LDHA、PKM2 mRNA 和蛋白的表达均受到明显抑制,
与空载体组比较,差别有统计学意义;CS mRNA 和蛋白的表达没有受到明显
影响,与空载体组比较,差别无统计学意义。缺氧条件下,HIF-1α 基因沉默
后,胰腺癌BxPC-3 细胞的生长受到抑制,凋亡率升高,同空载体组比较,差
别有统计学意义。结论:在缺氧条件下,HIF-1α 的表达明显增强,它可能通
过上调其下游糖酵解相关酶的表达,增强胰腺癌细胞的糖酵解代谢;HIF-1α
沉默在体外能抑制胰腺癌BxPC-3 细胞的生长,使其凋亡率升高。
關鍵字: HIF-1α、 RNA干擾、糖酵解、胰腺癌、缺氧

 

 

 

Last Updated: February 2014