跳到主要內容

臺灣博碩士論文加值系統

(18.97.14.86) 您好!臺灣時間:2025/02/07 23:14
字體大小: 字級放大   字級縮小   預設字形  
回查詢結果 :::

詳目顯示

: 
twitterline
研究生:黃金環
研究生(外文):HUANG, CHIN-HUAN
論文名稱:肝炎和肝癌病患葉酸、維生素B12、同半胱胺酸營養狀況與肝病變指標之相關性探討
論文名稱(外文):Relationships between the plasma folate, vitamin B12 nutrient status and homocysteine levels and liver disease maker in hepatitis and hepatoma patients
指導教授:許瑞芬許瑞芬引用關係
指導教授(外文):Huang, Rwei-Fen Syu
學位類別:碩士
校院名稱:輔仁大學
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:2006
畢業學年度:94
語文別:中文
論文頁數:89
中文關鍵詞:肝炎肝癌同半胱胺酸葉酸維生素B12
外文關鍵詞:hepatitishepatomahomocysteinefolatevitamin B12
相關次數:
  • 被引用被引用:0
  • 點閱點閱:1648
  • 評分評分:
  • 下載下載:207
  • 收藏至我的研究室書目清單書目收藏:1
肝病變干擾葉酸和維生素B12代謝進而影響同半胱胺酸代謝,然而國內對
於肝病變患者血漿葉酸、維生素B12營養狀況和同半胱胺酸變化與肝病變指標之相關性不甚清楚。本研究以大林慈濟醫院肝病中心收集之個案為對象,B型肝炎58名、C型肝炎32名、肝癌36名為病例組,健康民眾85名為對照組,進行半定量飲食頻率問卷調查和血中葉酸、維生素B12、同半胱胺酸濃度和肝病變指標GPT、GOP、AFP和Child-Pugh肝硬化程度分級分析。各類別變項差異以卡方檢定分析,等距變項差異以ANOVA檢定。以皮爾森相關係數檢定各變項之相關性,以邏輯斯迴歸分析法(Logisticregression method)檢定肝炎和肝癌罹病風險。結果血漿葉酸在B型肝炎組、C型肝炎組和對照組無顯著差異,且B型肝炎和C型肝炎患者飲食葉酸攝取狀況符合DRIs(國人膳食營養素參考攝取量)的建議,血漿葉酸營養狀況良好無缺乏情況,但肝癌組則有顯著的葉酸攝取不足及血漿葉酸邊緣性缺乏情況。維生素B6和B12之攝取量,四組間無顯著差且達國人每日飲食建議攝取量。經年齡和性別調整後,血漿同半胱胺酸濃度四組之間皆無顯著性的差異,肝炎和肝癌病人沒有高同半胱胺酸血症的情況。血漿維生素B12肝癌組顯著高於B型肝炎、C型肝炎組和對照組,而B型肝炎和C型肝炎組也顯著高於對照組,且經調整年齡和性別後,GOP與肝炎組之血漿維生素B12呈顯著正相關,顯示血漿維生素B12濃度和肝病變進展可能具有相關性。飲食葉酸攝取與肝癌組與血漿葉酸有顯著正相關(r=0.395,P= 0.021)。在B型肝炎組和對照組其血漿葉酸和同半胱胺酸濃度呈顯著負相關。經調整年齡和性別後,Child-Pugh肝硬化程度分級與血漿同半胺胱酸、葉酸、維生素B12、GPT、GOT和AFP無顯著相關性,但和TBI呈顯著正相關和ALB呈顯著負相關。AFP與肝癌組之血漿同半胺胱酸、葉酸、維生素B12、GPT、GOT、TBI和ALB皆無顯著性差異。將葉酸攝取量、血漿葉酸濃度、血漿維生素B12及同半胱胺酸濃度以三分位法區分為三等份,經由邏輯斯迴歸分析,發現葉酸攝取量為319.57-572.08μg/day者罹患肝癌的危險率為葉酸攝取量為52.14-319.56μg/day者之0.3倍。血漿葉酸濃度為8.03-12.09ng/ml者罹患肝癌的危險率為血漿葉酸濃度為3.33-8.02 ng/ml者之0.4倍。血漿同半胱胺酸濃度預測罹患肝癌之勝算比無統計上顯著意義。血漿維生素B12濃度為788-16111 pg/ml者罹患肝癌之危險率為血漿維生素B12濃度95-486 pg/ml者之7.8倍。結論肝炎病患無葉酸缺乏情況,肝癌病人有顯著的葉酸攝取不足及血漿葉酸邊緣性缺乏情況,可作為日後營養衛教之參考。
The folate, vitamin B12 and homocysteine metabolism may be impaired in liver disease. However, the plasma folate, vitamin B12 nutrient status and homocysteine levels and liver disease maker in hepatitis and hepatoma patients were unclear. The study aimed to investigate the plasma folate, vitamin B12 nutrient status and homocysteine concentrations were analyzed in hepatitis and hepatoma patients. In Dalin Tzu Chi Medical Center, we recruited 90 patients with hepatitis, 36 patient with hepatoma and 85 healthy control subjects. We used a semi-quantitative food frequency questionnaire to estimate the long-term intake. The folate, vitamin B12, homocysteine concentrations and GPT, GOP, AFP and Child-Pugh score of liver disease maker were analyzed. Statistical methods used included Chi- square test, ANOVA test, Pearson correlation coefficient, Logistic regression method for odd ratios. Mean plasma concentrations of folate did not significantly differ between the hepatitic group and control subjects. Dietary intakes and plasma for folate concentrations of the hepatoma group were significantly lower than those of hepatitic group and control subjects. Dietary vitamin B6 and B12 intakes were similar among the groups. Plasma concentrations of homocysteine did not differ among the hepatitis, hepatoma and control subjects. Hyperhomocysteinemia was not observed in hepatitis and hepatoma patients. Plasma vitamin B12 levels in the hepatoma group were significantly higher than those of hepatitic group and control subjects. GOP was significantly correlated with plasma vitamin B12 in hepatitis patient. The folate intake between plasma folate was significantly correlated in hepatoma patient(r=0.395,P= 0.021). Plasma folate with homocysteine was significantly correlated in B hepatitis patient and control subjects. Child-Pugh score were correlated with plasma of homocysteine, folate, vitamin B12, GPT, GOT and AFP with no statistical significance, but were significantly correlated with TBI and ALB. AFP were correlated with plasma of homocysteine, folate, vitamin B12, GPT, GOT, TBI and ALB with no statistical significance in hepatoma patient. The odd ratios of hepatoma in the subjects with folate intake group(319.57-572.08μg/day), were 0.3 to the subjects with folate intake group(52.14-319.56μg/day), The odd ratios of hepatoma in the subjects with plasma folate group(8.03-12.09ng/ml)were 0.4 to the subjects with plasma folate group(3.33-8.02 ng/ml), The odd ratios of hepatoma in the subjects with plasma homocysteine group non-significantly. The odd ratios of hepatoma in the subjects with plasma vitamin B12 group(788-16111 pg/ml), were 7.8 to the subjects with plasma vitamin B12 group(95-486 pg/ml). In conclusion, The folate adequate status in hepatitis patient but dietary intake and plasma for folate were inadequate in hepatoma patient. Therefore, hepatitis patients are recommended to monitor their folate status. Increased folate intake or taking folate supplements could be of beneficial to improve their folate status.
目 錄
頁次
中文摘要………………………………………………………………… I
英文摘要………………………………………………………………… III
目錄……………………………………………………………………… V
表目錄…………………………………………………………………… IX
圖目錄…………………………………………………………………… XI
第一章 前言…………………………………………………………… 1
第二章 文獻回顧……………………………………………………… 3
一 肝炎………………………………………………………………… 3
(一)肝炎的盛行率………………………………………………… 3
(二)造成肝炎的主要原因………………………………………… 3
(三)病毒性肝炎的分類…………………………………………… 4
二 肝癌……………………………………………………………… 6
(一)肝癌的盛行率………………………………………………… 6
(二)造成肝癌的主要原因………………………………………… 7
(三)肝癌的分類….………………………………………………… 9
三 同半胱胺酸之代謝途徑及相關疾病之研究……………………… 10
四、同半胱胺酸代謝和葉酸、維生素B6、B12等營養素之相關性. 11
五、同半胱胺酸和肝臟疾病之相關性……………………………… 12
六、葉酸和肝臟疾病的之相關性…………………………………… 14
七、維生素B12和肝臟疾病的相關研究…………………………… 15
第二章 材料與方法…………………………………………………… 17
一、研究設計…….………………………………………………… 17
二、研究對象…….………………………………………………… 17
三、研究方法………………………………………………………… 18
(一)調查方式……………………………………………………… 18
(二)問卷內容……………………………………………………… 19
(三)血樣生化檢驗………………………………………………… 20
四、統計分析………………………………………………………… 23
(一)描述性統計…………………………………………………… 23
(二)推論性統計…………………………………………………… 23
第四章 結果…………………………………………………………… 24
一、對象之基本資料分析………………………………………………24
二、研究對象之生活型態資料分析……………………………………25
三、肝炎和肝癌病患與健康對照組熱量、纖維、B群維生素攝取狀態和血漿同半胱胺酸、血漿維生素B12、血漿葉酸之血液檢測值… 27
四、肝炎和肝癌病患與健康對照組飲食葉酸、維生素B6、B12與血漿葉酸、維生素B12、同半胱胺酸濃度相關性分析……………… 28
五、肝炎和肝癌病患與健康對照組個別之血漿同半胺胱酸與血漿維生素B12和葉酸之相關性分析……………………………………… 28
六、肝炎和肝癌病患與健康對照組之葉酸攝取量比例分佈比較分析 29
七、對照組、肝炎組和肝癌組之GPT、GOT與血漿同半胺胱酸、葉酸和維生素B12之相關性分析………………………………………… 30
八、肝癌組之肝硬化不同程度患者之生化檢測值………………… 30
九、肝癌組之肝硬化不同程度患者飲食熱量、葉酸、維生素B6、B12和膳食纖維之攝取量分析………………………………………… 30
十、肝癌組之肝硬化程度分級與血漿同半胺胱酸、葉酸、維生素B12、GPT、GOT、TBI、ALB和AFP之相關性分析…………………… 30
十一、肝癌組之AFP與血漿同半胺胱酸、葉酸、維生素B12、GPT、GOT、TBI和ALB之相關性分析……………………………………… 31
十二、研究對象之飲食葉酸攝取預測罹患肝炎危險性分析………… 31
十三、研究對象之血漿葉酸預測罹患肝炎危險性分析……………… 32
十四、研究對象之血漿同半胱胺酸預測罹患肝炎危險性分析……… 32
十五、研究對象之血漿維生素B12預測罹患肝炎危險性分析……… 32
十六、研究對象之飲食葉酸攝取預測罹患肝癌危險性分析……… 33
十七、研究對象之血漿葉酸預測罹患肝癌危險性分析…………… 34
十八、研究對象之血漿同半胱胺酸預測罹患肝癌危險性分析…… 35
十九、研究對象之血漿維生素B12預測罹患肝癌危險性分析……… 35
第五章 討論……………………………………………………………… 37
一、究對象之基本資料分析………………………………………… 37
二、研究對象生活型態分析………………………………………… 37
三、研究對象飲食頻率問卷營養素攝取狀態分析………………… 38
四、研究對象之血漿同半胺胱酸、血漿葉酸、血漿維生素B12分析 40
五、肝炎和肝癌病患與健康對照組飲食葉酸、維生素B6、B12與血漿葉酸、維生素B12、同半胱胺酸濃度相關性分析…………… 42
六、肝炎和肝癌病患與健康對照組個別之血漿同半胺胱酸與血漿維生素B12和葉酸之相關性分析…………………………………… 42
七、對照組、肝炎組和肝癌組之GPT、GOT與血漿同半胺胱酸、葉酸和維生素B12之相關性分析………………………………………… 43
八、肝癌組之AFP與血漿同半胺胱酸、葉酸、維生素B12、GPT、GOT、TBI和ALB之相關性分析………………………………………… 43
九、研究對象之血漿葉酸預測罹患肝炎危險性分析………………… 43
十、研究對象之血漿同半胱胺酸和血漿維生素B12預測罹患肝炎危險性分析……………………………………………………………… 43
十一、研究對象之飲食葉酸攝取和血漿葉酸預測罹患肝癌危險性分析 44
十二、研究對象之血漿同半胱胺酸和血漿維生素B12預測罹患肝癌危險性分析………………………………………………………… 44
第六章 結論…………………………………………………………46
參考文獻……………………………………………………………… 70
附錄一Child-Pugh分級………………………………………………… 80
附錄二 問卷內容…………………………………………………………… 81
表 目 錄
表一、 肝炎和肝癌病患與健康對照組之基本資料…………………… 51
表二、肝炎和肝癌病患與健康對照組生活型態資料…………………… 52
表三、肝炎和肝癌病患與健康對照組熱量、纖維、B群維生素攝取狀態和血漿同半胱胺酸、血漿維生素B12、血漿葉酸之血液檢測值… 53
表四、肝炎和肝癌病患與健康對照組飲食葉酸、維生素B6、B12與血漿葉酸、維生素B12、同半胱胺酸濃度相關性分析……………… 54
表五、肝炎和肝癌病患與健康對照組個別之血漿同半胺胱酸與血漿維生素B12和葉酸之相關性分析……………………………………… 55
表六、肝炎和肝癌病患與健康對照組之葉酸和維生素B12攝取量及血漿同半胱胺酸濃度比例分佈分析…………………………………… 56
表七、對照組、肝炎組和肝癌組之GPT、GOT與血漿同半胺胱酸、葉酸和維生素B12之相關性分析………………………………………… 57
表八、 肝癌組之肝硬化不同程度患者之生化檢測值………………… 58
表九、肝癌組之肝硬化不同程度患者飲食熱量、葉酸、維生素B6、B12和膳食纖維之攝取量和血漿同半胱胺酸、葉酸、維生素B12分析 59
表十、肝癌組之肝硬化程度分級與血漿同半胺胱酸、葉酸、維生素B12、GPT、GOT、TBI、ALB和AFP之相關性分析…………………… 60
表十一、肝癌組之AFP與血漿同半胺胱酸、葉酸、維生素B12、GPT、GOT、TBI和ALB之相關性分析……………………………………… 61
表十二、研究對象之飲食葉酸攝取和血漿葉酸預測罹患肝炎危險性分析 62

表十三、研究對象之血漿同半胱胺酸和血漿維生素B12預測罹患肝炎危險性分析…………………………………………………………… 63
表十四、研究對象之飲食葉酸攝取和血漿葉酸預測罹患肝癌危險性分析 64
表十五、研究對象之血漿同半胱胺酸和血漿維生素B12預測罹患肝癌危險性分析…………………………………………………………… 65
圖 目 錄
圖 一、同半胱胺酸(homocysteine)結構……………………………… 66
圖 二、同半光氨酸代謝與葉酸、維生素B6和B12之相關性………… 67
圖 三、實驗設計流程圖………………………………………………… 68
圖 四、研究對象之居住區域分佈圖…………………………………… 69
參考文獻

Afdhal NH, Nunes D.(2004):Evaluation of liver fibrosis: a concise review. Am J Gastroenterol.99:1160-1174

Baker, H., Frank, O. and Deangelis, B. (1987) : Plasma vitamin B12 titres as indicators of disease severity and mortality of patients with alcoholic hepatitis. Alcohol. 22 :1-5.
Baker H, Leevy CB, DeAngelis B, Frank O, and Baker ER.(1998):Cobalamin (Vitamin B12) and Holotranscobalamin Changes in Plasma and Liver Tissue in Alcoholics with Liver Disease. Journal of the American College of Nutrition, 17(3): 235-238.
Beasley RP, Hwang LY.(1984.):Epidemiology of hepatocellular carcinoma.Viral Hepatitis and Liver Disease. Grune & Stratton, New York, 209-224
Beasley RP.(1988): Hepatitis B virus. The major etiology of hepatocellualr carcinoma. Cancer, 61:1942-56.2.
Bernard M-C, Jubker E, Hettinger A, Lauterberg BH.(1998): Time course of total cysteine, glutathione and homocysteine in plasma of patients with chronic hepatitis C treated with interferon- with and without supplementation with N-acetylcysteine. J Hepatol, 28:751–5.
Bianchi G, Bugianesi E, Ronchi M, Fabri A, Zoli M, Marchesini G.(1997):Glutathione kinetics in normal man and in patients with cirrhosis. J Hepatol, 26:606–613.
Blount BC et al.(1997): Folate deficiency causes uracil misincorporation into human DNA and chromosome breakage: implications for cancer and neuronal damage. Proc Natl Acad Sci USA. 94(7):3290-5.
Bosy-Westphal A, Petersen S, Hinrichsen H, Czech N, J Muller M.(2001):Increased plasma homocysteine in liver cirrhosis. Hepatol Res. 1; 20(1):28-38.
Brattstrom, L. & Wilcken, D.E.L. (2000):Homocysteine and cardiovascular disease:
cause or effect ?. Am. J. Clin. Nutr. 72:315-323.
Buccianti G, Baragetti I, Bamonti F, Furiani S, Dorighet V, Patrosso C.(2004): Plasma homocysteine levels and cardiovascular mortality in patients with end-stage renal disease. J Nephrol. 17(3):405-410.
Cakir E, Ates Y, Erbil MK, Karaeren N, Dagalp K.(2005):Elevated plasma homocysteine concentrations as a predictor of steato hepatitis in patients with non-alcoholic fatty liver disease. J Gastroenterol Hepatol. 20(9):1448-55.
Chen Ben.(2004):Viral Hepatitis. The Journal of China Clinical Traditional Medicine. 10(1):54-6
Chen Ben.(2005):Prevention and Treatment of Liver Cirrhosis. Formosan Journal of Medicine.11(1):49-57.
Chen CH, Chen DS. (1992)Hepatocellular carcinoma: 30 years' experience in Taiwan. J Formosan Med Assoc. 91: 187s-202s.
Chen DS(1991):The Establishment of Data Bank for Domestic Medicine and Its Application in Health Policy. Formosan Journal of Medicine.
Chen HW, Kuo CL, Wang PY, Liu CS.(2003):Correlation Analysis between Vitamin B-group and Plasma Homocysteine in Non-smoking and Smoking Subjects. The Changhua Journal of Medicine. 8(3):141-148
Chern CL, Huang RF, Chen YH, Cheng JT, Liu TZ(2001): Folate deficiency-induced oxidative stress and apoptosis are mediated via homocysteine-dependent overproduction of hydrogen peroxide and enhanced activation of NF-kappaB in human Hep G2 cells. Biomed Pharmacother.55(8):434-42.
Clifford, A.J., Heid, M.K., Muller, H.G. and Bill, N.D. (1990) : Tissue distribution andprediction of total body folate of rats. J. Nutr. 120: 1633-1639.

Cravo ML, Gloria LM, Selhub J, Nadeau MR, Camilo ME, Resende MP, Cardoso JN, Leitao CN, Mira FC.(1996):Hyperhomocysteinemia in chronic alcoholism: correlation with folate, vitamin B-12, and vitamin B-6 status. Am. J. Clin. Nutr. 63(2):220-224.
Cravo ML, Camilo ME.(2000) Hyperhomocysteinemia in chronic alcoholism: relations to folic acid and vitamins B6 and B12 status. Nutrition, 16:296–302.
Duce AM, Ortiz P, Cabrero C, Mato JM.(1988) S-adenosyl-L-methionine synthase and phospholipid methyltransferase are inhibited in human cirrhosis. Hepatology.8:65–68
Egerton W, Silberberg JS, Cooks R, Ray C, Xie L, Dudman NPB.(1996): Plasma levels of homocyst(e)ine during the acute phase response. Am J Cardiol. 77:759–61.
Eguinoa E, Mato JM, Avila MA.(1999):Induction of TIMP-1 expression in rat hepatic stellate cells and hepatocytes: a new role for homocysteine in liver fibrosis. Biochim Biophys Acta. 20; 1455(1):12-22.

Fattovich G.(2003):Natural history and prognosis of hepatitis B. Semin Liver Dis. 23: 47-58.

Fenech, M. F., Aitken, C. and Rinaldi, J. (1998) : Folate, vitamin B12, homocysteine
status and DNA damage in young Australian adults. Carcinogenesis. 19(7) : 1163-1171.

Ferre, N., Gomez, F., Camps, J., Simo, J.M., Murphy, M.M., Fernandez-Ballart, J. and Joven, J. (2002) : Plasma homocysteine concentrations in patients with liver cirrhosis. Clin Chem. 48 (1) : 183-5.

Finkelstein, J. D.(1990):Methionine metabolism in mammals. Journal of Nutrition Biochemistry. 1:228-237.

Finkelstein, J. D. (1998) : The metabolism of homocysteine: pathways and regulation.Eur. J. Pediatr. 157(suppl. 2):S40-S44.

Garcia-Tevijano, E.R., Berasain, C., Rodriguez, J.A., Corrales, F.J., Arias, R.,
Martin-Duce, A., Caballeria, J., Mato, J.M., and Avila, M.A. (2001) :
Hyperhomocysteinemia in liver cirrhosis : mechanisms and role in vascular and hepatic fibrosis. Hypertension. 38 (5) : 1217-1221.
Gulsen M, Yesilova Z, Bagci S, Uygun A, Ozcan A, Ercin CN, Erdil A, Sanisoglu SY, Cakir E, Ates Y, Erbil MK, Karaeren N, Dagalp K.(2005):Elevated plasma homocysteine concentrations as a predictor of steato hepatitis in patients with non-alcoholic fatty liver disease. J Gastroenterol Hepatol.20(9):1448-55.
Halsted CH, Villanueva J, Chandler CJ, et al.(1996): Ethanol feeding of micropigs alters methionine metabolism and increases hepatocellular apoptosis and proliferation. Hepatology. 23:497–505.
Hayden MR, Tyagi SC.(2004) Homocysteine and reactive oxygen species in metabolic syndrome, type 2 diabetes mellitus, and atheroscleropathy: The pleiotropic effects of folate supplementation. Nutr J, 3(1):4
Hoofnagle JH.(2002):Course and outcome of hepatitis C. Hepatology.36: S21-S29

Hultberg B, Berglund M, Andersson A, Frank A.(1993): Elevated plasma homocysteine in alcoholics. Alcohol Clin Exp Res. 17:687–9.

Ji C, Kaplowitz N.(2004):Hyperhomocysteinemia, endoplasmic reticulum stress, and alcoholic liver injury. World J Gastroenterol. 15;10(12):1699-708.

Kang S-S, Wang PWK, Bock H-GO, Horwiz A, Grix A.(1991):Intermediate hyperhomocysteinemia resulting from compound heterozygosity of methylenetetrahydroflate reductase mutation. American Journal of Human Genetics. 48:P546-551.

Kim, Y. & Mason, J. B. (1995) : Folate, epithelial dysplasia and colon cancer. Proc.
Assoc. Am. Physicians. 107:218-227.

Kim, Y. I. (1999) Folate and cancer prevention: a new medical application of folate
beyond hyperhomocysteinemia and neural tube defects. Nutr. Rev. 57:314-321.

Koehler KM, Baumgartner RN, Garry PJ, Allen RH, Stabler SP and Rimm EB.(2001):Association of folate intake and serum homocysteine in elderly persons according to vitamin supplementation and alcohol use. Am. J. Clin. Nutr. 73(3): 628-637.

Kono Y, Mattrey RF.(2005):Ultrasound of the liver. Radiol Clin North Am. 43: 815-826
Koutoubi S, Huffman FG.(2004):Serum total homocysteine levels, folate, and B-vitamins intake and coronary heart disease risk factors among tri-ethnic college students. Ethn Dis. 14(1):64-72.
Lambert D, Benhayoun S, Adjalla C, et al.(1997):Alcoholic cirrhosis and cobalamin metabolism. Digestion, 58:64–71.
Lin, J.M., Lin, C.C., Chiu, H.F., Yang, J.J. and Lee, S.G..(1993): Evaluation of the anti-inflammatory and liver-protective effects of Anoectochilus formosanus, Ganoderma lucidum and Gynostemma pentaphyllum in rats. Am. J. Chin. Med. 21: 59-69.
Lin JS, Lin CY, Yu YY, Shen MC, Hong MH, Wang YW, Lin BB(2002):The Prognostic Value of Plasma Folate Versus Plasma Vitamin B12 in Determining Plasma Total Homocysteine in Healthy Middle-Aged and Older Taiwanese. The Changhua Journal of Medicine.7(4):220-225
Linder, M.C., (1985) : Nutrition and metabolism of vitamins in: Nutritional
biochemistry and metabolism with clinical applications. pp.91-94.
Lindgren A, Brattstrom LE, Norrvig B, Hultberg B, Andersson A, Johansson BB. (1995):Plasma homocysteine in the acute and convalescent phase after stroke. Stroke, 26:795–800.
Look, M.P., Riezler, R., Reichel, C., Brensing, K.A., Rockstroh, J.K., Stabler, S.P., Spengler, U.,Berthold, H.K., and Sauerbruch, T. (2000) : Is the increase in serum cystathionine levels in patients with liver cirrhosis a consequence of impaired homocysteine transsulfuration at the level of γ-cystathionase ? Scand J Gastroenterol.
Loscalzo J.(1996): The oxidant stress of hyperhomocyst(e)inemia. J Clin Invest, 98:5–7.
Majumdar SK, Shaw GK, O'Gorman P, Aps EJ, Offerman EL, Thomson AD.(1982):Blood vitamin status (B1, B2, B6, folic acid and B12) in patients with alcoholic liver disease. Int J Vitam Nutr Res. 52(3):266-71.
Malaguarnera M, Ferri R, Bella R, Alagona G, Carnemolla A, Pennisi G.(2004) Homocysteine, vitamin B12 and folate in vascular dementia and in Alzheimer disease. Clin Chem Lab Med, 42(9):1032-1035
Maruyama S, Hirayama C, Yamamoto S, Koda M, Udagawa A, Kadowaki Y, Inoue M, Sagayama A, Umeki K(2001):Red blood cell status in alcoholic and non-alcoholic liver disease. Journal of Laboratory and Clinical Medicine.138(5):332-337

Mason, J. B. & Choi, S. W. (2000) : Folate and carcinogenesis: developing a unifying hypothesis. Adv. Enzyme Regul. 40:127-141.

McCully, K.S. (1993) : Chemical pathology of homocysteine thiolactone theory of
atherogenesis and carcinogenesis. Annals of Clinical and Laboratory Science. 24 : 27-59.
McCully KS.(2004)Homocysteine, vitamins, and prevention of vascular disease. Mil Med , 169(4):325-329.
Murthy SN, Matta AS, Mondal D, McNamara DB.(2003):Methods in assessing homocysteine metabolism. Metab Syndr Rel Disord, 1(2):129-140.
National Institute of Clinical Excellence (N.I.C.E.).(2000) Guidance on the use of ribavirin and interferon alpha for hepatitis C. October. Available from: URL: http//www.nice.org.uk/pdf/RIBAVIRIN-guidance14.pdf
New England Journal of Medicine(1999):Rising incidence of hepatocellular carcinoma in the United States.
Petri M, Roubenoff R, Dallal GE, Nadeau MR, Selhub J, Rosenberg IH. (1996):Plasma homocysteine as a risk factor for atherothrombotic events in systemic lupus erythematosus. Lancet, 348:1120–4.
Philippe D, Michel P, Nadine L, Suzanne LC, Denis B (2001) : Impaired homocysteine metabolism and atherothrombotic disease. Lab Invest. 81:645-672.
Pugh RNH, Murray-Lyon IM, Sawson JL, et al.(1973): Transection of the esophagus forbleeding esophageal varices. Br J Surg. 60: 646-9.
Rasmussen K,Moller J, Lyngbak M, Pedersen AM, Dybkjaer L(1996):Age and gender-specific reference intervals for total homocysteine and methylmalonic acid in plasma before and after vitamin supplementation. Clin Chem. 42: 630-636.
Refsum H, Wesenberg F, Ueland PM.(1991): Plasma homocysteine in children with acute lymphoblastic leukemia. Changes during a chemotherapeutic regimen including methotrexate. Cancer Res. 51:828–35.
Refsum H., Ueland, P.M., Nygard, O. and Vollset, S.E. (1998) :Homocysteine and
cardiovascular disease. Annu Rev Medicine. 49 : 31-62.
Refsum H, Smith AD, Ueland PM, Nexo E, Clarke R, McPartlin J, Johnston C, Engbaek F, Schneede J, McPartlin C, Scott JM.(2004): Facts and recommendations about total homocysteine determinations: an expert opinion. Clin Chem.50(1):3-32
Rwei-Fen S. Huang2, Yu-Chin Hsu, Hsiu-Ling Lin and Feili L. Yang. (2001) : Folate depletion and elevated Plasma homocysteine promote oxidative stress in rat livers. The American Society for Nutritional Sciences. 131 : 33-38
Roubenoff R, Dellaripa P, Nadeau MR, et al.(1997) :Abnormal homocysteine metabolism in rheumatoid arthritis. Arthr Rheum. 40:718–22.
Sachdev P.(2004):Homocysteine and neuro-psychiatric disorders. Rev Bras Psiquiatr, 26(1):50-56
Samonakis DN, Koutroubakis IE, Sfiridaki A, Malliaraki N, Antoniou P, Romanos J, Kouroumalis EA.(2004):Hypercoagulable states in patients with hepatocellular carcinoma. Dig Dis Sci. 49(5):854-858.
Selhub, J., Jacques, P. F., Wilson, P.W.F., Rush, D. & Rosenberg, I. H. (1993): Vitamin status and intake as primary determinants of homocysteinemia in the elderly. J. Am. Med. Assoc. 270:2693-2698.
Setola E, Monti LD, Galluccio E, Palloshi A, Fragasso G, Paroni R, Magni F, Sandoli EP, Lucotti P, Costa S, Fermo I, Galli-Kienle M, Origgi A, Margonato A, Piatti P.(2004): Insulin resistance and endothelial function are improved after folate and vitamin B12 therapy in patients with metabolic syndrome: relationship between homocysteine levels and hyperinsulinemia. Eur J Endocrinol. 151(4):483-489
Seshadri S, Beiser A, Selhub J, Jacques PF, Rosenberg IH, D'Agostino RB, Wilson PW, Wolf PA.(2002): Plasma homocysteine as a risk factor for dementia and Alzheimer's disease. N Engl J Med, 346(7):476-483
Seyedtaghi, S.T., Eric, J. G. and William, B.L. (2002) : Vitamin B12 stalls the 80 Sribosomal complex on the hepatitis C internal ribosome entry site. J. Mol. Biol. 319: 1-8.
Shrubsole M et al.(2001):Dietary folate intake and breast cancer risk: results from the shanghai Breast Cancer Study. Cancer Res. 61:7136-41.
Siri PW, Verhoef P, Kok FJ(1998): Vitamin b6, b12, and folate: association with plasma total homocysteine and risk of coronary atheroscler. J Am Coll Nutr. 17: 435-441.
Sun,C.A., Wu, D.M., Lin, C.C., Lu, S.N., You, S.L., Wang, L.Y., Suvit Areekul et al. (1977) : Vitamin B12 and vitamin B12 binding proteins in liver disease. Southeast Asian J. Trop. Med. Pub. Hlth. pp 322-327.

Sung JL.(1997): The control of liver cirrhosis and hepatocellular carcinoma in Taiwan: studies, policies and their efficacy. Formosan J Med. 1: 1-11

Susan J. Duthie3, Sabrina Narayanan, Gillian M. Brand, Lynn Pirie and George Grant. (2002) : Impact of folate deficiency on DNA stability. J. Nutr. 132 : 2444S-2449S.

Tkaczewski, W., Niedzielska, H., Malafiej, E., Dworniak, D. and Dramiski, M. (1971) : Studiesof serum folic acid level in patients with viral hepatitis. Polish Medical Journal. 10 (5) : 1081-4.

Torres L, Garcia-Trevijano ER, Rodriguez JA, Carretero MV, Bustos M, Fernandez E, Ueland, P.M., Refsum, H., Stabler. S.P., Manilow, M.R., Anderson, A. and Allen, R.H., (1993) : Total homocysteine in plasma or serum: methods and clinical applications. Clin Chem. 39 : 1764-79.
Torres L, Garcia-Trevijano ER, Rodriguez JA, Carretero MV, Bustos M, Fernandez E, Eguinoa E, Mato JM, Avila MA.(1999):Induction of TIMP-1 expression in rat hepatic stellate cells and hepatocytes: a new role for homocysteine in liver fibrosis. Biochim Biophys Acta. 20; 1455(1):12-22.
Ubbink JB.(1997):The role of vitamins in the pathogenesis and treatment of hyperho mocysteinemia. J Inher Metab Dis. 20:316-325.
Vega, M.J., Santolaria, F., Gonzalez-Reimers, E., Aleman, M.R., Milena, A.,
Martinez-Riera, A., and Gonzalez-Garcia, C. (2001) : High prevalence of hyperhomocysteinemia in chronic alcoholism: the importance of the thermolabile form of the enzyme methylenetetrahydrofolate reductase (MTHFR). Alcohol. 25 : 59-67.

Ventura P, Rosa MC, Abbati G, Marchini S, Grandone E, Vergura P, Tremosini S, Zeneroli ML.(2005):Hyperhomocysteinaemia in chronic liver diseases: role of disease stage, vitamin status and methylenetetrahydrofolate reductase genetics. Liver International. 25(1):49-56.

Vermeulen EGJ et al.(2000):Effect of homocysteine lowering treatment with folic acid plus vitamin B6 on progression of subclinical atherosclerosis: a randomized trial. Lancet. 355:517-22.
Wald DS et al.(2001): Randomized trial of folic acid supplementation and serum homocysteine levels. Arch Intern Med. 161:695-700.
World Health Organisation. Hepatitis C factsheet no. 164, revised October 2000. Available from: URL:
Wu LL and Wu JT (2002): Hyperhomocysteinemia is a risk factor for cancer and a new potential tumor marker. Clinica Chimica Acta 322:21-28.
Wu J S(1996):Liver Diseases,Posted May.
Yang H-I, Lu S-N, Liaw Y-F, et al. (2002): Hepatitis B e antigen and the risk of hepatocellular carcinoma. N Engl J Med 347:168-174
Yang XY, Wen FY, Wu JL, Zhou HJ(2006):Relation of serological markers of hepatitis B virus and alanine transaminase to hepatic tissue pathology in patients with chronic hepatitis B. Nan fang yi ke da xue xue bao 26(6):892-3.

台灣地區食品營養成分資料庫(行政院衛生署,1997)

李貞慧(2002)膳食葉酸攝取狀況與缺血性腦中風之危險相關性研究 碩士論文 輔仁大學食品營養學系

胡志棠(2001)肝硬化-臨床篇。當代醫學,2001;28

郭常勝(2003)慢性肝炎患者的葉酸及維生素B12營養狀況與血漿同半胱胺酸相關性之研究 碩士論文 輔仁大學食品營養學系
黃伯超、游素玲(1991)營養學精要,P163
鍾麗如(2003)葉酸及維生素B-12較維生素B-6對於降低冠狀動脈心臟病病人血漿同半胱胺酸濃度有顯著的效果 碩士論文 中山醫學大學
QRCODE
 
 
 
 
 
                                                                                                                                                                                                                                                                                                                                                                                                               
第一頁 上一頁 下一頁 最後一頁 top
1. 以微乳劑系統製備含藥奈米膠囊與其體外釋離之研究
2. 慢性肝炎患者的葉酸及維生素B12營養狀況與血漿同半胱胺酸相關性之研究
3. 葉酸及維生素B-12較維生素B-6對於降低冠狀動脈心臟病病人血漿同半胱胺酸濃度有顯著的效果
4. 孕婦第三孕期營養狀況與新生兒營養及生理之研究-以台南地區婦產科診所為例
5. 葉酸缺乏促進年輕大鼠組織老化指標粒線體DNA大片段斷損累積及其相關機制
6. 年輕素食者與非素食者血漿同半胱胺酸、維生素B-6、B-12及葉酸的營養狀況及其相關性
7. 單碳代謝分子(葉酸、維生素B12與同半胱胺酸),亞甲基四氫葉酸還原酶第677位點基因多型性與淋巴球粒線體DNA損傷與肝腫瘤惡化進展及肝癌罹患危險率之相關性
8. 飲水砷濃度及血漿中同半胱胺酸濃度與頸動脈粥狀硬化的相關性研究
9. 葉酸缺乏對餵予高脂飲食之大白鼠其抗氧化防禦系統及脂質之影響
10. 素食對血中同半胱胺酸濃度與胺基酸分佈的影響
11. 葉酸消耗缺乏引發人類肝癌HepG2細胞株程式凋亡
12. 輕度智能受損與阿茲海默症老人的血清維生素B12、葉酸與造血相關指標
13. 台灣地區老年人葉酸營養狀況與慢性疾病之相關性探討
14. 血漿同半胱胺酸及其代謝相關營養素:維生素B-6、B-12、葉酸之攝食與營養生化狀況對缺血型中風發生之預測性
15. 群居老年人之維生素B1、維生素B2、葉酸及維生素B12營養狀況評估