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研究生:陳瑋
研究生(外文):Wei Chen
論文名稱:木寡醣對第2型糖尿病患者體內氧化及生理狀況之影響
論文名稱(外文):Effects of Xylooligosaccharides on the oxidant and physiological status in patients with type 2 diabetes mellitus
指導教授:詹吟菁詹吟菁引用關係
指導教授(外文):Yin-Ching Chan
學位類別:碩士
校院名稱:靜宜大學
系所名稱:食品營養研究所
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:95
中文關鍵詞:氧化狀態第2型糖尿病血脂血糖木寡醣
外文關鍵詞:xylooligosaccharideblood sugaroxidative statustype 2 diabetesblood lipids
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木寡醣(xylooligosaccharide, XOS)在腸道中可被比菲德氏菌(Bifidobacteria)發酵利用產生短鏈脂肪酸(short chain fatty acid, ScFA)如:乙酸(acetate)、丙酸(propionate)及丁酸(butyrate),而這些脂肪酸可能會影響體內血糖及血脂之代謝。本研究旨在探討木寡醣對第2型糖尿病患者之影響。實驗篩選台中榮總新陳代謝科的門診患者,經醫師診斷為第2型糖尿病患者,且其糖化血色素需介於7%-10%之間,三酸甘油酯小於400mg/dL,經其同意後,隨機分成對照組(n=12)及木寡醣組(n=14)。木寡醣組每日服用4克木寡醣,對照組則服用安慰劑,實驗為期八週。在實驗前及後進行人體測量、飲食記錄、血液生化檢查及體內氧化狀態檢測。結果顯示實驗期間體位測量值及營養素攝取並無明顯變化。服用木寡醣後能顯著降低受試者的血糖、糖化血色素(HbA1c)、果糖胺(fructosamine)、血清總膽固醇、低密度脂蛋白膽固醇及apolipoprotein B,亦降低了受試者血清中氧化型低密度脂蛋白的含量及紅血球內抗氧化酵素catalase的活性,但在血清短鏈脂肪酸的含量上卻無顯著影響。綜合以上,每日補充4克的木寡醣,持續八週將有助於改善第2型糖尿病患者的血糖、血脂及氧化狀態。
Bifidobacteria can digest xylooligosaccharide (XOS) to produce short chain fatty acid (ScFA), such as acetate, propionate and butyrate, which may affect the metabolism of blood sugar and lipids. The purpose of this study was to evaluate the effects of XOS in patients with type 2 diabetes mellitus. Diabetes outpatient subjects of Taichung Veterans General Hospital, with the HbA1c level between 7.0%-10.0% and triglyceride < 400 mg/dL were enrolled in this study. Patients were randomly divided into control (n=12) or experimental group (n=14). The experimental group were supplemented with 4g XOS per day for eight weeks, while the control group was replaced with the placebo. Anthropometric values, dietary intakes, hematological and biochemical parameters, oxidative status were evaluated before and after the experiment. The results showed that the anthropometric values and nutrient intakes did not differ during the experimental period. Blood glucose, HbA1c, fructosamine, serum total cholesterol, LDL-C and apolipoprotein B concentrations were significantly reduced after XOS supplementation. The serum ox-LDL concentration and the catalase activity of RBC also reduced, while the serum ScFA did not differ after the experiment. In conclusion, the supplementation of 4 g XOS per day for eight weeks could improve the blood glucose, serum lipids and oxidative status in type 2 diabetic patients.
目錄
中文摘要………………………………………………………………. I
英文摘要………………………………………………………………. II
目錄……………………………………………………………………. III
表目錄…………………………………………………………………. VI
圖目錄…………………………………………………………………. VII

第一章 緒論
第一節 研究動機………………………………………………... 01
一、 國內糖尿病現況…..………………………………... 01
二、 糖尿病患者體內血糖與氧化壓力之關係…..……... 01
三、 糖尿病患者體內血脂狀態…………………….…… 02
四、 木寡醣之簡介…………………..…………………... 03
第二節 研究目的……………………..…………………………. 04
第二章 文獻回顧
第一節 糖尿病之簡介.………………..………………………… 05
第二節 糖尿病患者血糖與氧化壓力狀態…………………...… 06
一、 自由基………………………………………………. 06
二、 氧化傷害……………………………………………. 07
三、 糖尿病患血糖與氧化壓力之關係…………………. 08
第三節 糖尿病患者血脂狀態…………………………………... 09
第四節 木寡醣之簡介及其生理機能…………………………... 11
一、 木寡醣之化學結構…………………………………. 11
二、 木寡醣之成份分析…………………………………. 11
三、 木寡醣之特性………………………………………. 11
四、 木寡醣之生理機能…………………………………. 12
第五節 木寡醣對血糖及血脂之影響機轉……………………... 16
一、 木寡醣影響血糖之可能機轉………………………. 16
二、 木寡醣影響血脂之可能機轉…………………..…… 17
第六節 實驗目的…………………………………..…………..…. 19
第三章 材料與方法
第一節 研究架構………………………………………………... 20
第二節 實驗設計流程圖………………………………………... 20
第三節 研究對象與方法………………………………………... 23
一、 研究對象……………………………………………. 23
二、 實驗分組……………………………………………. 23
三、 研究時間……………………………………………. 24
四、 食用材料……………………………………………. 24
第四節 問卷調查………………………………………………... 25
一、 個案基本資料………………………………………. 25
二、 飲食狀況評估………………………………………. 25
三、 生活型態……………………………………………. 25
第五節 人體測量………………………………………………... 25
一、 體位測量……………………………………………. 25
二、 血壓測量……………………………………………. 28
第六節 血液及尿液生化值分析………………………………... 28
一、 一般生化值分析……………………………………. 28
二、 血糖狀態分析………………………………………. 30
三、 血脂質分析……………….………………………… 32
四、 血清短鏈脂肪酸測定………………………............. 34
五、 血液常規檢查………………………………………. 34
六、 尿液檢測……………………………………………. 36
第七節 體內氧化壓力檢測……………………………………... 36
一、 血漿脂質過氧化物-丙二醛濃度測定……………… 36
二、 紅血球中Glutathione peroxidase活性之測定…….. 37
三、 紅血球中Catalase活性之測定……………………. 38
四、 紅血球中SOD活性之測定………………………... 39
第八節 統計分析方法…………………………………………... 41
一、 描述性統計分析……………………………………. 41
二、 推論性統計分析……………………………………. 41
第四章 結果
第一節 受試者之基本資料分析………………………………... 42
一、 基本資料……………………………………………. 42
二、 受試者疾病分佈……………………………………. 42
三、 腸道生理功能………………………………………. 43
第二節 受試者飲食攝取型態之分析…………………………... 44
一、 飲食特徵……………………………………………. 44
二、 影響腸道功能的食物攝取頻率……………………. 44
三、 飲食記錄……………………………………………. 44
第三節 受試者體位測量及血液生化值分析…………………... 45
一、 體位測量及血壓……………………………………. 45
二、 一般血清生化值及血液常規檢查之結果…………. 45
三、 血糖數值結果………………………………………. 45
四、 血脂質數值結果……………………………………. 46
五、 血清短鏈脂肪酸之測定結果………………………. 47
六、 尿液檢驗值…………………………………………. 47
第四節 受試者體內氧化物質及抗氧化酵素分析……………... 47
第五章 討論
第一節 受試者之基本資料分析………………………………... 50
第二節 受試者之飲食攝取及型態……………………………... 50
第三節 受試者體位測量、血壓及血液、尿液值……………... 51
一、 木寡醣對受試者體位之影響………………………. 51
二、 受試者體位與其他糖尿病研究比較……………….. 51
三、 受試者體位和國民營養現況調查比較……………. 51
四、 木寡醣對血壓之影響………………………………. 52
五、 木寡醣對一般血清生化值及血液檢查值之影響…. 52
六、 木寡醣對血糖數值的影響與其他試驗之比較……. 52
七、 木寡醣對血脂數值之影響…………………………. 54
八、 木寡醣對受試者血清短鏈脂肪酸之影響……..…... 55
九、 木寡醣對受試者尿中檢驗值之影響………………. 56
第四節 受試者體內過氧化物質及抗氧化酸素分析…………... 56
第五節 相關性分析…………………………………………….... 58
第六章 總結…………………………………………………………... 59
第七章 參考文獻……………………………………………………... 60

表目錄
表一 Suntory公司木寡醣(Xylooligo-95p)之組成份………………... 15
表二 受試者人口學特性……………………………………………... 68
表三 受試者的運動狀態……………………………………………... 69
表四 受試者疾病分佈及服藥情形…………………………………... 70
表五 實驗前受試者胃腸道功能之情形……………………………... 71
表六 實驗八週後受試者胃腸道功能之情形………………………... 72
表七 實驗前後受試者糞便性質之變化………………………........... 73
表八 受試者的飲食特性……………………………………………... 74
表九 影響腸道功能的食物攝取頻率表……………………………... 75
表十 受試者飲食攝取之情形………………………………………... 76
表十一 受試者飲食攝取情形之情形………………………………... 77
表十二 受試者之體位測量值之情形………………………………... 78
表十三 受試者血液學及生化學檢值………………………………... 79
表十四 受試者胰島素及血糖狀況之情形…………………………... 80
表十五 受試者血脂值之情形………………………………………... 81
表十六 受試者血清短鏈脂肪酸之情形……………………………... 82
表十七 受試者尿液檢驗值…………………………………………... 83
表十八 受試者尿液檢驗值…………………………………………... 83
表十九 受試者體內氧化狀態………………………………………... 84
表二十 受試者之飲食攝取與DRIs………………………………….. 85
表二十一 實驗前男女受試者之體位測量值及血壓………………... 86
表二十二 血糖相關性分析…………………………………………... 87
表二十三 血脂之相關性分析………………………………………. 87
表二十四 腎功能指數與其他數值的相關性分析…………………... 88
表二十五 體位測量與其他數值的相關性分析……………………... 89

圖目錄
圖一 木寡醣之化學結構…………………………………………...… 15
圖二 研究架構………………………………………………………... 21
圖三 實驗流程圖…………………………………………………...… 22
圖四 受試者實驗前後血糖變化情形………………………………... 90
圖五 受試者實驗前後糖化血色素變化情形………………………... 91
圖六 受試者實驗前後果糖胺變化情形……………………………... 92
圖七 受試者實驗前後總膽固醇變化情形…………………………... 93
圖八 受試者實驗前後低密度脂蛋白膽固醇變化情形……………... 94
圖九 受試者實驗前後apolipoprotein B變化情形………………….. 95

附錄
附錄一 人體試驗研究計畫許可書
附錄二 受試者同意書
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