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研究生:陳沛綺
研究生(外文):CHEN, PEI-CHI
論文名稱:蝦紅素及複方補充劑對第 2 型糖尿病患致血栓危險因子之探討
論文名稱(外文):Effect of astaxanthin and astaxanthin formula on thrombotic risk factors in type 2 DM patients
指導教授:詹恭巨詹恭巨引用關係
指導教授(外文):CHAN, KUNG-CHI
口試委員:殷梅津黃晉修
口試委員(外文):YIN, MEI-CHINHUANG, CHIN-SHIU
口試日期:2014-05-20
學位類別:碩士
校院名稱:靜宜大學
系所名稱:食品營養學系
學門:醫藥衛生學門
學類:營養學類
論文種類:學術論文
論文出版年:2014
畢業學年度:102
語文別:中文
論文頁數:124
中文關鍵詞:糖尿病蝦紅素C 反應蛋白凝血因子促發炎細胞激素致血栓性
外文關鍵詞:type 2 diabetic mellitusastaxanthinC-reactive proteinCoagulation factorpro-inflammatory cytokinesthrombogenic risk
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近年來糖尿病的死亡人數有逐漸攀升的趨勢,而高血糖所導致的大血管併發症是造成糖尿病患者死亡的主因。研究證實蝦紅素具有極佳抗氧化及抗發炎的作用。本研究目的為探討蝦紅素及複方補充劑對第2型糖尿病患者致血栓危險因子的影響。以台中市澄清醫院103名第2型糖尿病患者為收案對象,排除不適任者後,隨機分為安慰劑組 (Placebo, P) 及蝦紅素複方組 (Astaxanthin formula, AX) (蝦紅素6 mg + 維生素E 150 mg + 生育三烯醇 15mg/day) 和蝦紅素單方組(Astaxanthin, AX) (蝦紅素14 mg/day) ,每組18位,為期8週,在實驗第0週及第8週收集空腹血液樣本並分析血漿中蝦紅素濃度、禁食血糖 (FBG) 及HbA1c、血脂 (TG、TC及LDL)、肝腎功能指標 (GPT、Uric acid及Creatinine) 、氧化發炎指標 (MDA、IL-6、TNF-α及CRP) 、凝血因子 (FV、FVII及PAI-1) 濃度、抗凝血因子 (AT-III及PC) 濃度及血管內皮細胞損傷指標 (vWF) 。結果顯示,蝦紅素可被人體所吸收且呈現劑量效應,補充蝦紅素複方可顯著降低HbA1c、CRP及vWF之濃度。而蝦紅素單方之補充,可顯著降低HbA1c、TG、TC、GPT、發炎指標TNF-α與CRP及vWF之濃度,且可顯著降低促凝血因子FVII與PAI-1並提升抗凝血因子AT-III之表現。綜合上述結果可得知,14 mg/day蝦紅素的補充可以改善第2型糖尿病患者的血脂及肝功能,並且可透過抑制促發炎細胞激素的分泌而降低發炎反應及改善血管內皮細胞損傷。蝦紅素也有助於調節凝血及抗凝血因子之平衡,降低第2型糖尿病患致血栓之危險性。
Macrovascular complications are the major causes of death among diabetic patients, and hyperglycemia-induced oxidation and subsequent chronic inflammation play an important role in the etiology of diabetic macroangiopathy. Astaxanthin (AX) is one of the carotenoids with excellent anti-inflammatory and antioxidative capacity; therefore, the purpose of this study was to investigate the effect of astaxanthin and astaxanthin formula (AXF) on thrombogenic risk in type 2 diabetic patients. One hundred and three type 2 diabetic patients were recruited from Cheng Ching Hospital in Taichung city. After exclusion of unqualified patients, all subjects were randomly assigned into three treatment groups including placebo group (P), AXF (AX 6 mg + vitamin E 150 mg + Tocotrienol 45 mg/day) group and AX (AX: 14 mg/day) group, respectively. After two month’s supplementation, plasma concentration of AX, fasting blood glucose (FBG), HbA1c, lipid profiles, markers of hepatic and renal function, oxidative and inflammatory markers, coagulation and anti-coagulation factors were measured. The results showed that plasma levels of AX increased by supplementation in a dose-dependent manner. Plasma concentration of HbA1c, CRP and vWF was significantly decreased in AXF group. Plasma concentration of HbA1c, TG and TC, GPT, inflammatory cytokines of TNF-α, CRP and vWF was significantly decreased in AX group. In addition, plasma concentration of coagulation factor VII and PAI-1 was significantly decreased, and AT-III level was significantly increased in AX group. In conclusion, AX supplementation for two months may have beneficial effects on type 2 DM patients in ameliorating hyperglycemia, hyperlipidemia and liver malfunction. AX supplementation also decreases oxidation stress and inhibits chronic inflammation, hence ameliorates endothelial damage and thrombogenic risk in type 2 DM patients.
目錄 I
表目錄 VI
圖目錄 VII
中文摘要 VIII
英文摘要 IX
縮寫對照表 XI

第一章 前言 1
第二章 文獻回顧3
第一節 糖尿病之簡介3
一、 糖尿病之定義3
二、 糖尿病之診斷3
第二節 糖尿病之慢性併發症 4
一、 糖尿病性大血管併發症4
二、 糖尿病性小血管併發症5
第三節 氧化壓力與糖尿病6
一、 糖尿病患體內之抗氧化防禦系統 6
二、 糖尿病與氧化傷害 8
第四節 糖尿病與發炎反應 12
第五節 凝血機制與糖尿病 14
一、 凝血路徑簡介 14
二、 凝血相關因子 16
三、 糖尿病患體內異常凝血系統之現象 20
四、 糖尿病患血管內皮損傷之現象 23
第六節 蝦紅素之生理活性 25
一、 蝦紅素之簡介 25
二、 蝦紅素與抗氧化及抗發炎 26
三、 蝦紅素與糖尿病 27
第七節 維生素E之生理活性 29
一、 維生素E之簡介 29
二、 維生素E與糖尿病 30
第八節 研究目的 31
第三章 材料與方法 32
第一節 實驗材料與藥品 32
一、 實驗材料、藥劑與試劑組 32
二、 實驗用藥劑 32
三、 實驗用試劑組 33
第二節 人體試驗與研究設計33
一、 受試者招募與篩選33
二、 試驗設計及進行步驟 35
三、 血液樣本之前處理及注意事項 38
第三節 實驗分析方法 38
一、 血漿蝦紅素濃度之測定 38
二、 氧化及發炎指標之分析 40
(一) 丙二醛 (MDA) 濃度40
(二) 介白素-6 (IL-6) 濃度 41
(三) 腫瘤壞死因子-α (TNF-α) 濃度 42
(四) C反應蛋白 (hs-CRP) 濃度43
三、 凝血及內皮細胞功能之分析 44
(一) 凝血因子V ( FV) 濃度 44
(二) 凝血因子VII (FVII) 濃度 45
(三) (三)纖溶酶活化劑抑制因子-1 (PAI-1) 濃度 46
(四) Von Willbrand Factor (vWF) 濃度 47
四、 抗凝血因子之分析 48
(一) 第三抗凝血酶 (AT-III) 濃度 48
(二) 蛋白C (PC) 濃度 49
第四節 統計分析 50
第四章 結果 51
第一節 第2型糖尿病患之生活型態及飲食習慣 51
第二節 蝦紅素及複方補充劑對第2型糖尿病患血漿中蝦紅素濃度之影響51
第三節 蝦紅素及複方補充劑對第2型糖尿病患血糖、血壓、血脂及肝腎功能之影響52
一、 蝦紅素及複方補充劑對第2型糖尿病患空腹血糖濃度及糖化血色素之影響52
二、 蝦紅素及複方補充劑對第2型糖尿病患血壓之影響 52
三、 蝦紅素及複方補充劑對第2型糖尿病患血脂之影響 53
四、 蝦紅素及複方補充劑對第2型糖尿病患肝腎功能之影響53
第四節 蝦紅素及複方補充劑對第2型糖尿病患體內氧化及發炎指標之影響54
一、 蝦紅素及複方補充劑對第2型糖尿病患MDA濃度之影響 54
二、 蝦紅素及複方補充劑對第2型糖尿病患介白素-6 (IL-6) 濃度之影響54
三、 蝦紅素及複方補充劑對第2型糖尿病患腫瘤壞死因子-α (TNF-α) 濃度之影響55
四、 蝦紅素及複方補充劑對第2型糖尿病患高敏感C反應蛋 (hs-CRP) 濃度之影響55
第五節 蝦紅素及複方補充劑對第2型糖尿病患凝血與抗凝血因子濃度及內皮細胞功能之影響56
一、 蝦紅素及複方補充劑對第2型糖尿病患凝血因子V (FV) 濃度之影響56
二、 蝦紅素及複方補充劑對第2型糖尿病患凝血因子VII (FVII) 濃度之影響56
三、 蝦紅素及複方補充劑對第2型糖尿病患纖溶酶原活化劑抑制因子-1 (PAI-1) 濃度之影響57
四、 蝦紅素及複方補充劑對第2型糖尿病患第三抗凝血酶 (AT-III) 濃度之影響57
五、 蝦紅素及複方補充劑對第2型糖尿病患蛋白質C (PC) 濃度之影響58
六、 蝦紅素及複方補充劑對第2型糖尿病患Von Willebrand Factor (vWF) 濃度之影響58
第五章 討論 79
第一節 受試者基本資料之分析 79
第二節 蝦紅素及複方補充劑對第2型糖尿病患血糖、糖化血色素之影響80
第三節 蝦紅素及複方補充劑對第2型糖尿病患血脂之影響84
第四節 蝦紅素及複方補充劑對第2型糖尿病患MDA濃度之影響86
第五節 蝦紅素及複方補充劑對第2型糖尿病患體內發炎指標之影響87
第六節 蝦紅素及複方補充劑對第2型糖尿病患體內凝血、抗凝血因子濃度及內皮細胞功能之影響89
一、 蝦紅素及複方補充劑對第2型糖尿病患凝血功能之影響89
二、 蝦紅素及複方補充劑對第2型糖尿病患抗凝血功能之影響91
三、 蝦紅素及複方補充劑對第2型糖尿病患內皮細胞功能之影響 93
第六章 結論95
第七章 參考文獻 96

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