目的：本研究探討12週登階有氧運動對肥胖成年男、女性腹部脂肪量之影響，並找出可準確推估腹部總內臟脂肪量的位置。方法：以成年肥胖患者20位，男性9位（40.00±12.80歲、95.30±17.50公斤、33.40±4.90kg/平方公尺）及女性11位（45.50±8.90歲、80.40±11.50公斤、33.00±7.30kg/平方公尺）為研究對象，持續12週漸進強度的登階有氧運動訓練；受試者先以電腻斷層掃描(computed tomography, CT scan)進行腹部腰椎2-5節影像掃描，再進一步分析訓練前、後腰椎2-5節腹部脂肪量之差異，以成對樣本t檢定考驗12週登階有氧運動對腹部脂肪量的影響，以二因子混合設計變異數分析考驗12週登階有氧運動訓練對男、女性腹部脂肪量之差異性，並以皮爾森相關係數考驗體重改變量與腹部脂肪量改變之相關性，顯著水準定為p<.05。結果：本研究發現男、女性在訓練後腹部脂肪量、內臟脂肪量、皮下脂肪量均達顯著下降效果(p<.05)；在男、女性與前、後測的交互作用中，腹部脂肪量、內臟脂肪量、皮下脂肪量均未達顯著差異(p>.05)，顯示12週登階運動對男、女性肥胖成年人腹部脂肪量的改變效果是一致的；在男、女性差異上，男性的腰椎2-5節腹部內臟脂肪量高於女性（前測1493.20±511.10vs.1055.40±228.70立方公分、後測1419.20±474.70 vs. 961.40±331.10立方公分，p<.05），顯示男性脂肪較多囤積在內臟中；在體重改變量與腰椎2-5節腹部脂肪改變量、內臟脂肪改變量及皮下脂肪改變量的相關性分別為r=.85，r=.52，r=.67，均達顯著水準(p<.05)，表示體重下降腹部脂肪也隨著下降。結論：不同的性別會造成脂肪囤積位置的不同，男性屬於內臟脂肪型肥胖，女性則多屬於皮下脂肪型肥胖；而12週有氧運動對肥胖成年人體重、腹部脂肪量、內臟脂肪量及皮下脂肪量皆有顯著的改善效果。另外，單一測量L3或L3-4可準確推估腹部總內臟脂肪量，作為往後評估腹部總內臟脂肪量的測量位置。

Purpose: The purpose of this study was to examine the effects of abdominal adipose tissue in obese adults after 12 weeks step aerobic exercise. Methods: Twenty obese adults, nine males (mean age 40.00±12.80 years, weight 95.30±17.50 kg) and eleven females (mean age 45.50±8.90 years, weight 80.40±11.50 kg) were recruited as subjects. Subjects were measured abdomen lumbar vertebra (L2-L5) images by computed tomography scan (CT scan) before and after exercise training. The data were analyzed by paired-t test to examine the change of abdomen fat after aerobic exercise. Two-way mixed analysis of variance was used to examine the difference between the different sex abdominal fat quantity with aerobic exercise training. Pearson correlation coefficients were used to examine the body weight increment and the change levels of abdominal fat. The statistical significance was determined at the .05 level. Results: The results showed that there were significant decreased in abdominal fat, visceral fat and subcutaneous fat quantity after exercise training (p<.05). In the different sex with measured before and after in the correlation, the abdominal fat, visceral fat, and subcutaneous fat didn't reach the remarkable difference (p>.05). We found that male's L2-L5 visceral fat was higher than the female's (before 1493.20±511.10 vs. 1419.20±474.70 cm^3, after 1055.40±228.70 vs. 961.40±331.10 cm^3, p<.05). The correlation in body weight, L2-L5 abdominal fat, visceral fat and subcutaneous fat change levels was r=.85, r=.52, r=.67, reaches the remarkable standard (p<.05). Conclusion: The different sex will affect the position which the fat stores up, the male belongs to visceral fat obesity, and the female belongs to subcutaneous. 12 weeks aerobic exercise can reduce weight and abdominal fat effectively. Moreover, surveys L3 or L3-4 solely may accurately estimates the abdominal total visceral fat quantity and make assessment to abdominal total visceral fat quantity of the survey position in the future.

登階有氧; 肥胖; 腹部脂肪量; 內臟脂肪量; 皮下脂肪量

Step aerobic exercise; Obese; Abdominal fat; Visceral fat; Subcutaneous fat