臺灣博碩士論文加值系統

第2型糖尿病患者 (type 2 diabetes mellitus) 血漿中Adiponectin含量較低，且血漿Resistin及C-reactive protein (CRP) 濃度較高。因此，本研究欲探討第2型糖尿病患者每天攝取38公克米麩榖粉 (富含膳食纖維) 為期12週，對血糖、糖化血色素、Adiponectin、Resistin及CRP含量及胰島素敏感性的影響。本研究是採取隨機、雙盲、交叉試驗設計。受試者為羅東博愛醫院30-80歲第2型糖尿病患者共24名，其中男性5名，女性19名參與本研究。受試者隨機分成兩組，所有的受試者每天攝取38公克米麩穀粉 (RB組) 或白米穀粉 (安慰劑組) 5週後，經過2週的排空期後，再攝取38公克白米穀粉或米麩穀粉5週，為期12週。在研究期間，要求受試者在12週內不改變其平日飲食習慣、運動習慣及用藥種類及份量。收集受試者第0、5、7、12週進行口服葡萄糖耐受試驗。結果顯示: RB組在攝取米麩穀粉5週後，顯著的降低10.8%空腹血糖值 (P < 0.05) 及2.5%糖化血色素 (glycated hemoglobin, HbA1C) (P < 0.05)。在血漿Adiponectin含量方面，RB組在攝取米麩穀粉5週後可顯著的增加Adiponectin的含量。在評估胰島素敏感性HOMAIR指標方面，RB組呈現降低的趨勢 (-5.8%) (P = 0.09)。總結，第2型糖尿病患每天攝取38公克米麩穀粉5週後，可顯著降低2.5%糖化血色素、10.8%空腹血糖值以及增加9.6% 血漿Adiponectin的含量。

Plasma adiponectin concentration is lower and plasma resistin and c-reative protein concentration is higher in type 2 diabetes mellitus than euglycemic human. Therefore, the aim of this study was to observe the effect of rice bran flour supplementation for 12 weeks on the concentrations of plasma glucose, glycated hemoglobin (HbA1C), adiponectin, resistin, and c-reactive protein concentration, and insulin sensitivity in type 2 diabetes mellitus. This study was designed as randomized, double-blind and crossover trials. Twenty-four type 2 diabetes subjects in Lo-Tung Pohai hospital in Yilan, 5 men and 19 women aged 30 to 80 years volunteered to participate. The subjects were randomized to two sequences that included 5 weeks of treatment with 38 g of rice bran flour and rice flour. Treatment was preceded by a 14-day washout period. During intervention periods, subjects did not change their dietary habit, the physical condition, and the kinds of medicine and amounts of medicine. On the beginning, 5, 7 and 12 weeks, oral glucose tolerance test were conducted. The results showed rice bran flour supplementation, plasma fasting glucose concentration and HbA1C level was significantly decreased 10.8% and 2.5%, respectively. Plasma adiponectin concentration in RB group was significantly increased compared with baseline (P < 0.05). Insulin sensitivity index (HOMAIR) was tended to decrease (-5.8%, P = 0.09) in RB group. In conclusion, type 2 diabetic patients supplementation 38 g of rice bran flour every day for 5 weeks were significantly decreased 2.5% HbA1C and 10.8% plasma fasting glucose, and significantly increased 9.6% plasma adiponectin concentration.

中文摘要 I
Abstract III
誌謝 V
目錄 VII
表目錄 IX
圖目錄 X
第一章 緒論 1
第二章 文獻回顧 4
第一節 糖尿病流行病學 4
第二節 糖尿病的分類及病理學 5
一、糖尿病分類 5
二、糖尿病病理學 5
三、糖尿病診斷標準 7
四、糖尿病併發症 8
第三節 糖尿病的治療 9
一、飲食 9
二、運動 10
三、藥物 11
第四節 膳食纖維的生理功能 13
第五節 膳食纖維與第2型糖尿病患者體內脂肪細胞衍生物的關係 15
一、胰島素抗性 15
二、脂肪組織分泌Adiponectin及Resistin與胰島素之相關性 16
三、C-reactive protein 18
第三章 材料與方法 20
第一節 受試者 20
第二節、實驗方法 21
一、實驗設計 21
二、受試者的飲食紀錄 22
三、腸道生理狀況紀錄表 22
四、榖粉的製備 23
五、分析項目 24
六、分析方法 25
七、統計分析 40
第四章 結果 41
第一節 米麩穀粉及白米穀粉一般分析 41
第二節 受試者 41
第三節 受試者的飲食狀況 42
第四節 腸道生理狀況紀錄表 43
第五節 一般血液生化值 43
第六節 血糖、胰島素、糖化血色素及胰島素敏感性指標 44
第七節 葡萄糖耐受試驗 45
第八節 血液脂質分析 45
第九節 脂質組織分泌物質-Adiponectin及Resistin 46
第十節 發炎指標 46
第五章 討論 47
第一節 米麩穀粉 47
第二節 受試者的飲食狀況 49
第三節 血糖控制 52
第四節 胰島素敏感性 54
第五節 C-反應蛋白 (C-reactive protein) 57
第六章 結論 58
第七章 參考文獻 59
附錄 84
腸道生理狀況紀錄表 84

Ajani UA, Ford ES & Mokdad AH (2004) Dietary fiber and C-reactive protein: findings from national health and nutrition examination survey data. J Nutr 134:1181-1185.
Al-Harithy RN ＆ Al-Ghamdi S (2005) Serum resistin, adiposity and insulin resistance in Saudi women with type 2 diabetes mellitus.Ann Saudi Med 25:283-7.
American Diabetes Association (2006): Standards of medical care in diabetes. Diabetes care 29:S4-42.
Amos AF, McCarty DJ ＆ Zimmet P (1997) The rising global burden of diabetes and its complications: estimates and projections to the year 2010. Diabet Med 5: 1-85.
Anderson JW, Hanna TJ, Peng X ＆ Kryscio RJ (2000) Whole grain foods and heart disease risk. J Am Coll Nutr 19:291S-299S
Arita Y, Kihara S, Ouchi N, Takahashi M, Maeda K, Miyagawa J, Hotta K, Shimomura I, Nakamura T, Miyaoka K, Kuriyama H, Nishida M, Yamashita S, Okubo K, Matsubara K, Muraguchi M, Ohmoto Y, Funahashi T & Matsuzawa Y (1999) Paradoxical decrease of an adipose-specific protein, adiponectin, in obesity. Biochem Biophys Res Commun 257:79-83.
Association of Official Analytical Chemists (1980) Offical methods of Analysis, 13th ed. AOAC, Washington DC.
Baan CA, Ruige JB, Stolk RP, Witteman JC, Dekker JM, Heine RJ & Feskens EJ (1999) Performance of a predictive model to identify undiagnosed diabetes in a health care setting. Diabetes Care 22:213-239.
Bajaj M, Suraamornkul S, Pratipanawatr T, Hardies LJ, Pratipanawatr W, Glass L, Cersosimo E, Miyazaki Y & DeFronzo RA (2003) Pioglitazone reduces hepatic fat content and augments splanchnic glucose uptake in patients with type 2 diabetes. Diabetes 52:1364-1370.
Bergman RN & Ader M (2000) Free fatty acids and pathogenesis of type 2 diabetes mellitus. Trends Endocrinol Metab 11:351-356.
Castaneda C, Layne JE, Munoz-Orians L, Gordon PL, Walsmith J, Foldvari M, Roubenoff R, Tucker KL & Nelson ME (2002) A randomized controlled trial of resistance exercise training to improve glycemic controlin older adults with Type 2 diabetes. Diabetes Care 25:2335-2341.
Combs TP, Berg AH, Obici S, Scherer PE ＆ Rossetti L (2001) Endogenous glucose production is inhibited by the adipose-derived protein Acrp30. J Clin Invest 108:1875–1881.
Daly ME, Vale CV, Walker M, Alberti KG & Mathers JC (1997) Dietary carbohydrates and insulin sensitivity: a review of the evidence and clinical implications. Am J Clin Nutr 66:1072-1085.
Davy BM, Davy KP, Ho RC, Beske SD, Davrath LR ＆ Melby CL (2002) High-fiber oat cereal compared with wheat cereal consumption favorably alters LDL-cholesterol subclass and particle numbers in middle-aged and older men. Am J Clin Nutr 76:351–358.
de Leeuw JA, Jongbloed AW ＆ Verstegen MW (2004) Dietary fiber stabilizes blood glucose and insulin levels and reduces physical activity in sows (Sus scrofa). J Nutr 134:1481-6.
Dunstan DW, Daly RM, Owen N, Jolley D, Vulikh E, Shaw J & Zimmet P (2005) Home-based resistance training is not sufficient to maintain improved glycemic control following supervised training in older individuals with type 2 diabetes. Diabetes Care 28:3-9.
Doi Y, Kiyohara Y ＆ Kubo M (2005) Elevated C-reactive protein is a predictor of the development of diabetes in a general Japanese population: the Hisayama Study. Diabetes Care 28:2497–500.
Erbagci AB, Tarakcioglu M, Coskun Y, Sivasli E & Namiduru ES (2001) Mediator of inflammation in children with type 1 diabetes mellitus: cytokines in type 1 diabetes children. Clin Biochem 34:645-650.
Eriksson J, Franssila-Kallunki A, Ekstrand A, Saloranta C, Widen E, Schalin C & Groop L (1989) Early metabloic defects in persons at increased risk for noninsulin-dependent diabetes mellitus. N Engl J Med 321:337-343.
Esposito K, Marfella R, Ciotola M, Di Palo C, Giugliano F, Giugliano G, D'Armiento M, D'Andrea F ＆ Giugliano D (2004) Effect of a mediterranean-style diet on endothelial dysfunction and markers of vascular inflammation in the metabolic syndrome: a randomized trial. JAMA 292:1440-6.
Festa A, D’Agostino R Jr, Howard G, Mykkanen L, Tracy RP ＆ Haffner SM (2000) Chronic subclinical inflammation as part of the insulin resistance syndrome: the Insulin Resistance Atherosclerosis Study (IRAS). Circulation 102:42–47.
Ferrannini E (1998) Insulin resistance versus insulin deficiency in non-insulin- dependent diabetes mellitus: problems and prospects. Endocr Rev 19: 477-490.
Feskens EJ, Loeber JG ＆ Kromhout D (1994) Diet and physical activity as determinants of hyperinsulinemia: the Zutphen Elderly Study. Am J Epidemiol 140:350-60
Fruhbeck G, Gomez-Ambrosi J, Muruzabal FJ ＆ Burrell MA (2001) The adipocyte: a model for integration of endocrine and metabolic signaling in energy metabolism regulation. Am J Physiol Endocrinol Metab 280:E827-47. Review.
Fung TT, Hu FB,Pereira MA,Liu S, Stampfer MJ, Colditz GA ＆ Willett WC (2002) Whole-grain intake and the risk of type 2 diabetes: a prospective study in men. Am J Clin Nutr 76:535-40
Funnell MM ＆ Meritt JH (1993) The challenges of diabetes and older adult. Nurs Clin of North Am 28:45-53.
Funnell MM, Donnelly MB & Andreson DD (1992) Perceived effectiveness, cost and availability of patient education methods and materials. Diabetes Educ. 18:139 - 145
Gregg EW, Gerzoff RB, Caspersen CJ, Williamson DF & Narayan KM (2003) Relationship of walking to mortality among US adults with diabetes. Arch Intern Med 163:1440-1447.
Guerre-Milo M (2002) Adipose tissue hormone. J Endocrinol Invest 25: 855-861.
Haffner SM, Lehto S, Ronnemaa T, Pyorala K ＆ Laakso M (1998) Mortality from coronary heart disease in subjects with type 2 diabetes and in nondiabetic subjects with and without prior myocardial infarction. N Engl J Med 339:229-34.
Hartman HB, Hu X, Tyler KX, Dalal CK & Lazar MA (2002) Mechanisms regulating adipocyte expression of resistin. J Biol Chem 277:19754-19761.
Haugen F, Jorgensen A, Drevon CA & Trayhurn P (2001) Inhibition by insulin of resistin gene expression in 3T3-L1 adipocytes. FEBS Lett 507:105-108.
Hosker JP, Kumar S, Gordon C, Bhatnagar D, France M & Boulton AJ (1993) Diet treatment of newly presenting type 2 diabetes improves insulin secretory capacity, but has no effect on insulin sensitivity. Diabet Med 10:509-513.
Hotta K, Funahashi T, Arita Y, Takahashi M, Matsuda M, Okamoto Y, Iwahashi H, Kuriyama H, Ouchi N, Maeda K, Nishida M, Kihara S, Sakai N, Nakajima T, Hasegawa K, Muraguchi M, Ohmoto Y, Nakamura T, Yamashita S, Hanafusa T & Matsuzawa Y (2000) Plasma concentrations of a novel, adipose-specific protein, adiponectin, in type 2 diabetic patients. Arterioscler Thromb Vasc Biol 20:1595-1599.
Hotta K, Funahashi T, Bodkin NL, Ortmeyer HK, Arita Y, Hansen BC & Matsuzawa Y (2001) Circulating concentrations of the adipocyte protein adiponectin are decreased in parallel with reduced insulin sensitivity during the progression to type 2 diabetes in rhesus monkeys. Diabetes 50:1126-1133.
Hunter SJ & Garvey WT (1998) Insulin action and insulin resistance: diseases involving defects in insulin receptors, signal transduction, and the glucose transport effector system. Am J Med 105:331-345.
Isaksson G, Lundquist I ＆ Ihse I (1982) In vitro inhibition of pancreatic enzyme activities by dietary fiber. Digestion 24:54-9.
Jacobs DR Jr, Meyer KA, Kushi LH & Folsom AR (1998) Whole-grain intake may reduce the risk of ischemic heart disease death in postmenopausal women: the Iowa Women's Health Study. AmJ Clin Nutr 68:248-257.
Jenkins DJ, Kendall CW, Axelsen M, Augustin LS & Vuksan V (2000) Viscous and nonviscous fibres, nonabsorbable and low glycaemic index carbohydrates, blood lipids and coronary heart disease. Curr Opin Lipidol 11:49–56.
Jenkins DJ, Wolever TM, Jenkins AL, Giordano C, Giudici S , Thompson LU, Kalmusky J, Josse RG ＆ Wong GS (1986) Low glycemic response to traditionally processed wheat and rye products: bulgur and pumpernickel bread. Am J Clin Nutr 43:516-20
Jensen MK, Koh-Banerjee P, Franz M, Sampson L, Gronbæk M & Rimm EB (2006) Whole grains, bran, and germ in relation to homocysteine and markers of glycemic control, lipids, and inflammation. Am J Clin Nutr 83:275-283.
Jensen MK, Koh-Banerjee P, Hu FB, Franz M, Sampson L, Gronbaek M ＆ Rimm EB (2004) Intakes of whole grains, bran, and germ and the risk of coronary heart disease in men. Am J Clin Nutr 80:1492-9.
Jeppesen J, Schaaf P, Jones C, Zhou MY, Chen YD, Reaven GM (1997) Effects of low-fat, high-carbohydrate diets on risk factors for ischemic heart disease in postmenopausal women. Am J Clin Nutr 65:1027-33
Juntunen KS, Laaksonen DE, Poutanen KS, Niskanen LK ＆ Mykkanen HM (2003) High-fiber rye bread and insulin secretion and sensitivity in healthy postmenopausal women. Am J Clin Nutr 77:385–391.
Kannel WB, Wolf P ＆ Dawber TR (1978) Hypertension and cardiac impairments increase stroke risk. Geriatrics 33:71-7.
Kay RM ＆ Strasberg SM (1978) Origin, chemistry, physiological effects and clinical importance of dietary fibre. Clin Invest Med 1:9-24. Review.
Kernan WN, Inzucchi SE, Viscoli CM, Brass LM, Bravata DM & Horwitz RI (2002) Insulin resistance and risk for stroke. Neurology 59:809-815.
King DE, Egan BM & Geesey ME (2003) Relation of dietary fat and fiber to elevation of C-reactive protein. Am J Cardiol 92:1335-1339.
Koh-Banerjee P ＆ Rimm EB (2003) Whole grain consumption and weight gain: a review of the epidemiological evidence, potential mechanisms and opportunities for future research. Proc Nutr Soc 62:25-9. Review.
Laakso M (1993) How good a marker is insulin level for insulin resistance? Am J Epidemiol 137:959–65.
Lebovitz HE (2001) Insulin resistance: definition and consequence. Exp Clin Endocrinol Diabetes 109:S135-S148.
Liese AD, Roach AK, Sparks KC, Marquart L, D'Agostino RB Jr ＆ Mayer-Davis EJ (2003) Whole-grain intake and insulin sensitivity: the Insulin Resistance Atherosclerosis Study. Am J Clin Nutr 78:965-71.
Lin T, Chou P, Lai MS, Tsai ST ＆ Tai TY (2001) Direct costs-of-illness of patients with diabetes mellitus in Taiwan. Diabetes Res Clin Pract 1:S43-6.
Liu S, Manson JE, Stampfer MJ, Hu FB, Giovannucci E, Colditz GA, Hennekens CH ＆ Willett WC (2000) A prospective study of whole-grain intake and risk of type 2 diabetes mellitus in US women. Am J Public Health 90:1409-15.
Liu S, Stampfer MJ, Hu FB, Giovannucci E, Rimm E, Manson JE, Hennekens CH ＆ Willett WC (1999) Whole-grain consumption and risk of coronary heart disease: results from the Nurses' Health Study. Am J Clin Nutr 70:412-9.
Lu HL, Wang HW, Wen Y, Zhang MX ＆ Lin HH (2006) Roles of adipocyte derived hormone adiponectin and resistin in insulin resistance of type 2 diabetes. World J Gastroenterol 12:1747-51.
Marquart L, Wiemer KL, Jones JM ＆ Jacob B (2003) Whole grains health claims in the USA and other efforts to increase whole-grain consumption. Proc Nutr Soc 62:151-60. Review.
Marshall JA, Bessesen DH ＆ Hamman RF (1997) High saturated fat and low starch and fibre are associated with hyperinsulinaemia in a non-diabetic population: the San Luis Valley Diabetes Study. Diabetologia 40:430-8.
Matsubara M, Maruoka S & Katayose S (2000) Decrease plasma adiponectin concentration in women with dyslipidemia. J Clin Endocrinol Metab 87:2764-2769.
McTernan CL, McTernan PG, Harte AL, Levick PL, Barnett AH & Kumar S (2002) Resistin, central obesity, and type 2 diabetes. Lancet 359:46-47.
Meyer KA, Kushi LH, Jacobs DR Jr, Slavin J, Sellers TA ＆ Folsom AR (2000) Carbohydrates, dietary fiber, and incident type 2 diabetes in older women. Am J Clin Nutr 71:921-30.
Montonen J, Knekt P, Jarvinen R, Aromaa A & Reunanen A (2003) Whole-grain and fiber intake and the incidence of type 2 diabetes. Am J Clin Nutr 77:622-629.
Nakanishi N, Shiraishi T ＆ Wada M (2005) Association between C-reactive protein and insulin resistance in a Japanese population: the Minoh Study. Intern Med 44:542–7
Okamoto Y, Arita Y, Nishida M, Muraguchi M, Ouchi N, Takahashi M, Igura T, Inui Y, Kihara S, Nakamura T, Yamashita S, Miyagawa J, Funahashi T & Matsuzawa Y (2000) An adipocyte-derived plasma protein, adiponectin, adheres to injured vascular walls. Horm Metab Res 32:47-50.
Pradhan AD, Cook NR, Buring JE, Manson JE ＆ Ridker PM (2003) C-reactive protein is independently associated with fasting insulin in nondiabetic women. Arterioscler Thromb Vasc Biol 23:650–655.
Park S, Kim YW, Kim JY, Jang EC, Doh KO ＆ Lee SK (2001) Effect of high fat diet on insulin resistance: dietary fat versus visceral fat mass. J Korean Med Sci 16:386-90.
Pereira MA, Jacobs DR Jr, Pins JJ, Raatz SK, Gross MD, Slavin JL ＆ Seaquist ER (2002) Effect of whole grains on insulin sensitivity in overweight hyperinsulinemic adults. Am J Clin Nutr 75:848-55.
Prosky L, Asp NG, Fuda I, Devries JW, Schweizer TF ＆ Harland BF (1990) Total dietary fiber in foods. Enzymatic-Gravimetric Method. J Assoc Off Anal Chem 73:1105-1106.
Qi L, Rimm E, Liu S, Rifai N ＆ Hu FB (2005) Dietary glycemic index, glycemic load, cereal fiber, and plasma adiponectin concentration in diabetic men: Diabetes Care 28:1022-8.
Qi L, van Dam RM, Liu S, Franz M, Mantzoros C & Hu FB (2006) Whole-Grain, Bran, and Cereal Fiber Intakes and Markers of Systemic Inflammation in Diabetic Women. Diabetes Care 29:207-211.
Qureshi AA, Sami SA  Khan FA (2002) Effects of stabilized rice bran, its soluble and fiber fractions on blood glucose levels and serum lipid parameters in humans with diabetes mellitus Types I and II. J Nutr Biochem 13:175-187.
Riddle MC, McDaniel PA & Tive LA (1997) Glipizide-GITS does not increase the hypoglycemic effect of mild exercise during fasting in NIDDM. Diabetes Care 20:992-994.
Rodrigues Silva C, Dutra de Oliveira JE, de Souza RA  Silva HC (2005) ffect of a rice bran fiber diet on serum glucose levels of diabetic patients in Brazil. EArch Latinoam Nut 55:23-7.
Rutter MK, Meigs JB, Sullivan LM, D,Agostino RB Sr & Wilson PW (2004) C-reactive protein, the metabolic syndrome, and prediction of cardiovascular events in the Framingham Offspring Study. Circulation 110:380-385.
Salmeron J, Ascherio A, Rimm E, Colditz G, Spiegelman D & Willett WC (1997b) Dietary fiber, glycemic load, and risk of non-insulin dependent diabetes mellitus among women. J Am Med Assoc 277:472-477.
Salmeron J, Manson JE, Stampfer MJ, Colditz GA, Wing AL, Jenkins D, Stampfer M, Wing A & Willett WC (1997a) Dietary fiber, glycemic load, and risk of NIDDM in men. Diabetes Care 20:545-550.
Samaha FF, Iqbal N, Seshadri P, Chicano KL, Daily DA, McGrory J, Williams T, Williams M, Gracely EJ & Stern L (2003) A low carbohydrate as compared with a low fat diet in severe obesity. N Engl J Med 348:2074-2081.
Sattar N, Gaw A, Scherbakova O, Ford I, O'Reilly DS, Haffner SM, Isles C, Macfarlane PW, Packard CJ, Cobbe SM & Shepherd J (2003) Metabolic syndrome with and without C- reactive protein as a predictor of coronary heart disease and diabetes in the West of Scotland Coronary Prevention Study. Circulation 108:141-149.
Scherer PE, Williams S, Fogliano M, Baldini G & Lodish HF (1995) A novel serum protein similar to C1q, produced exclusively in adipocytes. J Biol Chem 270:26746-26749.
Smith SR, Bai F, Charbonneau C, Janderova L ＆ Argyropoulos G (2003) A promoter genotype and oxidative stress potentially link resistin to human insulin resistance. Diabetes 52:1611-1618.
Spranger J, Kroke A, Mohlig M, Bergmann MM, Ristow M, Boeing H & Pfeiffer AF (2003) Adiponectin and protection against type 2 diabetes mellitus. Lancet 361:226-8.
Stamler J, Vaccaro O, Neaton JD & Wentworth D (1993) Diabetes, other risk factor, and 12-yr cardiovasclur mortality for men screened in the multiple risk factor Intervention Trial. Diabetes Care 16:434-444.
Stratton IM, Adler AI, Neil HA, Matthews DR, Manley SE, Cull CA, Hadden D, Turner RC ＆ Holman RR (2000) Association of glycaemia with macrovascular and microvascular complications of type 2 diabetes (UKPDS 35): prospective observational study. BMJ 321:405-12.
Soinio M, Marniemi J, Laakso M, Lehto S ＆ Ronnemaa T (2006) High-sensitivity C-reactive protein and coronary heart disease mortality in patients with type 2 diabetes: a 7-year follow-up study. Diabetes Care 29:329-33.
Trayhurn P ＆ Beattie JH (2001) Physiological role of adipose tissue: white adipose tissue as an endocrine and secretory organ. Proc Nutr Soc 60:329-39. Review.
Truswell AS (2002) Cereal grains and coronary heart disease. Eur J Clin Nutr 56:1-14. Review.
Tschritter O, Fritsche A, Thamer C, Haap M, Shirkavand F, Rahe S, Staiger H, Maerker E, Haring H ＆ Stumvoll M (2003) Plasma adiponectin concentrations predict insulin sensitivity of both glucose and lipid metabolism. Diabetes 52:239-43.
Villaume C, Beck B, Gariot P, Desalme A ＆ Debry G (1984) Long-term evolution of the effect of bran ingestion on meal-induced glucose and insulin responses in healthy man. Am J Clin Nutr 40:1023-6.
Wang H, Chu WS, Hemphill C & Elbein SC (2002) Human resistin gene: molecular scanning and evaluation of association with insulin sensitivity and type 2 diabetes in aucasians. J Clin Endocrinol Metab 87:2520-2524.
Warburton DE, Gledhill N & Quinney A (2001) Musculoskeletal fitness and health. Can J Appl Physiol 26:217-37.
Wei JN, Sung FC, Lin CC, Lin RS, Chiang CC ＆ Chuang LM (2003) National surveillance for type 2 diabetes mellitus in Taiwanese children. JAMA 290:1345-50.
Weyer C, Funahashi T, Tanaka S, Hotta K, Matsuzawa Y, Pratley RE & Tataranni PA (2001) Hypoadiponectinemia in obesity and type 2 diabetes: close association with insulin resistance and hyperinsulinemia. J Clin Endocrinol Metab 86:1930-1935.
Willett WC (1998) The dietary pyramid: does the foundation needrepair? Am J Clin Nutr 68:218-219.
Yki-Jarvinen H (1997) Acute and chronic effects of hyperglycaemia on glucose metabolism: implications for the development of new therapies. Diabet Med 14:S32-37.
Yusof RM ＆ Said M (2004) Effect of high fibre fruit (Guava - psidium guajava L.) on the serum glucose level in induced diabetic mice. Asia Pac J Clin Nutr 13: S135.
Zimmet PZ (1999) Diabetes epidemiology as a tool to trigger diabetes research and care. Diabetologia 42:499-518.
Zimmet P, Alberti KG & Shaw J (2001) Global and societal implications of the diabetes epidemic. Nature 414:782-787.
王曉霖 (1991) 食物模型之建立及其應用於飲食回顧之效度研究。國防醫學院公共衛生研究所營養組碩士論文。
傅偉光 (2002) 食物膳食纖維之機能與其分析方法。食品工業34:3-10.
傅振宗、戴東原 (1996) 糖尿病的大血管疾病。內科學誌 7: 182-189。
黃心怡 (2005) 米麩榖粉對第2型糖尿病患血糖、胰島素及血脂質濃度之影響。
臺北醫學大學保健營養學研究所碩士論文。