서 론
1. 연구의 필요성
연구방법
2. 자료수집
연구 결과
1. 논문의 일반적 특성
Table 1.
2. 비만 중재 프로그램의 방법
Table 2.
3. 종속변수의 특성
Table 3.
First Author (Year) [Reference] |
Age Gender | Study design | Study groups (n) | Intervention | Duration of program | Measurement/Variable | Results |
---|---|---|---|---|---|---|---|
|
|||||||
Sedgwick MJ (2013) [19] | 12.6-14.3 Boy | Exp | G1: Exp (n=13) | Day 1: G1: treadmill 60 min | 2d*2d | FMD | FMD↑ |
G2: Con (n=13) | G2: exercise X | ||||||
Day 2: G1,G2: fasting FMD→high fat breakfast→FMD→high fat | |||||||
lunch→FMD | |||||||
Yu CC (2013) [20] | 11-18 Boy | Exp | G1: diet alone (n=20) | G1: nutritional education, hypocaloric diet | 10w | FMD | FMD↑ |
G2: diet+orlistat (n=21) | G2, G3: diet+orlistat therapy: three times a day with meals. | NMD | NMD↑ | ||||
G3: diet+orlistat +exercise (n=23) | G3: Diet+Orlistat+exercise: resistance training, twice a week, each session lasting 70 min | Insulin | LDL-Chole↓TG↓, | ||||
Glucose levels | Insulie↓,HOMA-IR↓ | ||||||
Montero D (2014) [16] | 15.09±1.32 Boy+girl | Quasi-exp | G1: Exp (n=17) | G1: hypocaloric diet + physical activity program | 16w | FMD | FMD (-) |
G2: Con (n=19) | G2: usual care | NMD | NMD (-) | ||||
Bruyndonckx L (2015) [15] | 12-18 Boy+girl | Quasi-exp | G1: Diet+exercise (n=33) | G1: dietary restriction+physical activity(cycling or running) +resistance training.)+ psychological support | 10m | RHI | RHI↑ |
G2: usual care (n=28) | G2: usual care | EPCs (endothelial progenitor cells) | EPCs↑ | ||||
EMPs (endothelial micro particles) | EMPs↓ | ||||||
Javed A (2016) [21] | 13-18 Boy+girl | RCT | G1: vitamin D3 100,000IU Tx (n=19) | G1: 100,000 IU vitamin D3 orally once a month for 3 months | 12w | FMD | FMD (-) |
PTH | PTH↓ | ||||||
Calcium | Calcium(-) | ||||||
Fasting lipids | Fasting lipids (-) | ||||||
Glucose | Glucose (-) | ||||||
Insulin | Insulin (-) | ||||||
CRP | CRP(-) | ||||||
Wesnigk J (2016) [22] | 15 Boy+girl | Exp | G1: Exp (n=8) | G1: dietary restriction (1500-1800 kcal/day)+physical activity: sports activitiespsychological support | 10m | HDL-mediated eNOS | HDL-mediated eNOS |
G2: Con (n=8) | G2: usual care | Phosphorylation | phosphorylation (+) | ||||
Reverese | Reverese cholesterol | ||||||
Cholesterolefflux | efflux (+) | ||||||
Zhang H (2017) [23] | 16-19 Boy | Quasi-exp | G1: Exp (n=45) | G1: priority to jogging, sports, including badminton, table tennis, aerobics and cycling1 | 12w | Adropin | Adropin↑ |
G2: Con (n=20) | G2: usual care | RHI | RHI↑ | ||||
Blood Lipid Levels | ALT↓, TC↓ LDL-C↓ | ||||||
HDL-C↑ | |||||||
Glucose↓, fasting | |||||||
insulin↓,HOMA-IR↓ | |||||||
Mueller UM (2017) [24] | 10-17 Boy+girl | Exp | G1: Exp (n=232) | G1: 60min Physical Exercise(treadmill test) -daily at school/ 5h per week | 5y | RHI | RHI↑ |
G2: Con (n=154) | G2: 45min Physical Exercise(treadmill test) -daily at school/ 2h per week | Blood cholesterol | Cholesterol, LDL↓, | ||||
G3: High level group (n=59) | G3: weekly up to 20 hours training | Questionnaire-quality of life | TG↓ | ||||
-physical activity | quality of life ↑ | ||||||
-family history | physical activity↑ |
↓=Decreased; ↑=Increased; +=And; (-)= No correlation; (+)=Correlation; ALT=Alanine Aminotransferase; B.W=Body weight; BUN=Blood urea nitrogen; Con=Control; Cr=Creatinine; CRP=C-reactive protein; d=Day; EMPs=Endothelial micro particles; EPCs=Endothelial progenitor cells; Exp=Experiment; FMD=Flow-mediated dilatation; G1=Group1; G2=Group2; G3=Group3; HDL-C=High density lipoprotein-cholesterol; HDL-mediated eNOS=High density lipoprotein cholesterol-mediated endothelial nitric oxide synthase; HOMA-IR=Homeostatic model assessment for insulin resistance; LDL-C=Low density lipoprotein-cholesterol; m=Month; NMD=Nitroglycerin mediated dilatation; PTH=Parathyroid hormone; PWV=Pulse wave velocity; Quasi-exp=Quasi-experiments; RHI=Reactive hyperemia index; TG=Triglycerides; Tx=Treatment; w=Week; y=Year
Table 4.
First Author (Year) [Reference] |
Age Gender | Study design | Study groups (n) | Intervention | Duration of program | Measurement/Variable | Results |
---|---|---|---|---|---|---|---|
|
|||||||
Chon SG (2009) [12] | 13.8-13.8 Boy | Quasi-exp | G1: Exp (n=10) | G1: (For First 1 Month) 1Km Running + walking + Foot-sal, Badminton, basket-ball, Stretching +breathing (For First 2-3Month) 3Km Running + walking + Foot-sal, Badminton, basket-ball, Stretching + breathing | 12w | IMT | IMT (-) |
G2: Con (n=10) | G2: Maintenance of a lifestyle | PWV | PWV(-) | ||||
FMD | FMD↑ | ||||||
Blood lipid | insulin resistance (-) | ||||||
Yoon ES (2010) [25] | 13-14 Boy | Quasi-exp | G1: Exp (n=10) | G1: 60~90min/once , 3 days a week, 3km running, walking, Foot-sal, Badminton, basketball, Stretching | 12w | IMT | IMT↓ |
G2: Con (n=10) | G2: Maintenance of a lifestyle | FMD | FMD↑ | ||||
Blood lipid | Blood lipid(-) | ||||||
Insulin resistance | Insulin resistance (-) | ||||||
Lee YJ (2011) [26] | 13 Boy | Quasi-exp | G1: Exp (n=11) | G1: 5times a week every day, on Saturday doing it once every two weeks, Exercise time | 12w | RHI | RHI↑ |
G2: Con (n=10) | G2: Maintenance of a lifestyle | AIx | AIx(+) | ||||
PWV | PWV(-) | ||||||
Blood lipid | HDL-C↑, TC, LDL-C,TG, Glucose(-) | ||||||
CRP | CRP (-) | ||||||
VO2max | VO2max↑ | ||||||
Park SH (2012) [27] | 13-14 Boy | Quasi-exp | G1: Exp (n=11) | G1: 5 days a week, 40minutes a day, round trip, football, basketball, nabacone running, stretching | 6w | RHI | RHI↑ |
G2: Con (n=10) | G2: Control Group:Maintenance of a lifestyle | PWV | PWV↑ | ||||
Blood lipid | HDL-C↑, TC,LDL-C, TG(-) | ||||||
Blood sugar | Glucose(-) | ||||||
VO2max | VO2max↑ | ||||||
Kim HK·(2012) [28] | 15.16-15.18 Boy | Quasi-exp | G1: Exp (n=10) | G1: 4times a week, 60 min for 1 time, Aerobic exercise: treadmill + Resistance exercise: | 16w | NOx | NOx, VC↑ |
G2: Con (n=10) | VC | Plasma ET-1↓ | |||||
Plasma ET-1 | TC,LDL-C, TG↓, | ||||||
Blood lipid | HDL-C↑ | ||||||
Insulin resistance | Insulin resistance↓ | ||||||
Son WM (2014) [29] | 13-14 Girl | Quasi-exp | G1: Eating sweet potatoes, a mixed exercise group (n=7) | G1: 5 times a week, exercise(60min)+Eating purple sweet potatoes(1 day for 1~2 weeks, 3 times before meals (morning, lunch, dinner), For each 2g, a total of 6g, eating a) | 12w | PWV | PWV↓ |
G2: exercise group (n=7) | G2: 5 times a week, exercise(60min) | NO | NO↑ | ||||
G3: Eating sweet potatoes group (n=7) | G3: Eating purple sweet potatoes (1 day for 1~2 weeks, 3 times before meals (morning, lunch, dinner), For each 2g, a total of 6g, eating) +(1day for 3-12 weeks, 3 times before meals (morning, lunch, dinner), for each 3 g, a total of 9g, eating them) | Blood lipid | TC,TG,HDLC,LDL-C(-) | ||||
G4: Control group (n=7) | G4: Maintenance of a lifestyle |
↓=Decreased; ↑=Increased; +=And; (-)=No correlation; (+)=Correlation; AIx=Aorticaugmentation index; CRP=C-reactive protein; Exp=Experiment; FMD=Flow-mediated dilatation; G1=Group1; G2=Group2; G3=Group3; G4=Group4; HDL-C=High density lipoprotein cholesterol ; IMT=Intima-media thickness; LDL-C=Low density lipoprotein cholesterol; NOx=Nitrogen oxides; Plasma ET-1=Plasma endothelin-1; PWV=Pulse wave velocity; RHI=Reactive hyperemia index; TC=Total cholesterol; TG=Triglycerides; VC=Vascular compliance; VO2max=Maximal oxygen uptake; w=Week
4. 연구결과 분석
논 의
결론 및 제언
청소년의 혈관내피 기능 향상을 위한 단기적 운동 중재 프로그램뿐만 아니라 운동의 효과가 지속 될 수 있도록 장기적 운동 중재 프로그램 개발이 이루어져야 할 것이다.
기존의 연구현황의 문제점들을 보완하여 식이요법을 포함한 국내 비만 청소년의 혈관내피 기능을 향상 할 수 있는 치료적 간호 중재 프로그램을 개발하고 그 효과를 검증하는 연구가 이루어져야 할 것이다.
마지막으로 연구 결과를 바탕으로 치료적 간호 중재 프로그램을 통해 혈관내피 기능이 향상된 비만 청소년들이 성인이 되어서 실제로 성인병 유병률이 감소되었는지에 대한 후향적 코호트 연구가 필요하다.