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研究生:趙佩君
研究生(外文):Chao Pei
論文名稱:分析醬料醣化產物含量以及探討糖尿病人飲食中醣化產物與血液中氧化、發炎因子的相關性
論文名稱(外文):Analysis of glycative products in sauces, and investigating the association between dietary AGEs and circulating levels of oxidative and inflammatory factors in type 2 DM patients
指導教授:徐成金徐成金引用關係殷梅津殷梅津引用關係王銘富王銘富引用關係
學位類別:博士
校院名稱:中山醫學大學
系所名稱:營養學研究所
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:2010
畢業學年度:98
語文別:中文
論文頁數:97
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糖尿病盛行於全世界,大約有2.5億罹病人口。跟據2009國家衛生研究院指出,在台灣每10個人就有1人罹患第二型糖尿病,且有逐年上升且年輕化的驅勢。流行病學的研究證實糖尿病人的血糖控制良好與否,與心血管併發症有密切關係,其中醣化終產物(advanced glycation endproducts; AGEs)的生成及累積與醣化傷害有高相關。本研究旨在分析在亞洲及台灣常用的調味醬中,和高蛋白質食物中梅納反應產物(Maillard reaction products; MRPs)含量;並探討糖尿病患者飲食中AGEs的量與其氧化及發炎因子的相關性。
第一部份分析醬油、糖醋醬、蕃茄醬和烤肉醬以及富含蛋白質的雞肉、豬肉、牛肉、鮭魚和鱈魚五種食材的MRPs含量,例如戊糖素、羧甲賴氨酸和呋喃素。這些食材會因不同的醬料處理及油炸、煎、燒烤等不同烹調方式而有不同的MRPs含量。因此第一部分的研究結果可以提供與醣化有關疾病的食物選擇。
第二部份研究探討,第二型糖尿病患飲食中AGEs的含量,包括食物醬料的使用及烹調的方法;並分析病患血液中與氧化及發炎反應相關因子的關連性。結果發現,飲食中的AGEs與血液中介白素-1α、單核球趨化因子-1及超氧歧化脢的活性有高相關。此部分研究結果有助於了解長期AGEs的攝取加重糖尿病患者氧化及發炎傷害的可能原因。

Diabetes is a chronic disease which affects around 250 million people worldwide. According to a study recently released by the National Health Research Institutes (NHRI, 2009), nearly one in every 10 people in Taiwan is suffering from diabetes. The disease also becomes increasingly prevalent in Taiwan. Epidemiological studies have confirmed that hyperglycemia is the most important factor in the onset and progress of vascular complications in diabetes mellitus. The formation of advanced glycation end-products (AGEs) highly correlates with poor glycemic control. Our present study analysed the content of AGEs or so called Maillard reaction products (MRPs) in easily commercially available sauces as well as foods rich in protein in Taiwan and Asia, and the chronic effects of long-term or habitual dietary AGEs intake on oxidative and inflammatory stress in type 2 diabetic patients.
In the first part, we analysed the content of MRPs such as pentosidine, CML and furosine in commercially available soybean sauce, soursweet sauce, tomato sauce and barbecue sauce as well as foods rich in protein such as chicken, pork, beef, salmon and cod. The influence of boiling, frying or baking treatment upon MRP formation in foods and sauce-treated foods was also determined. The results of this study could provide novel information for people with glycation associated diseases to make appropriate dietary choices.
Secondly, we examined the association of habitual dietary AGEs intake with oxidative and inflammatory status in type 2 diabetic patients. Dietary information including used sauces and cooking methods were collected, and the circulating levels of several biomarkers such as 8-isoprostane, glutathione, interleukin (IL)-1α, tumor necrosis factor (TNF)-α, monocyte chemoattractant protein (MCP)-1 and superoxide dismutase (SOD) activity in these diabetic patients were measured.
The results of this study partially explained the contribution of dietary AGEs upon oxidative and inflammatory injury in type 2 DM patients.


ABBREVIATIONS…………………………............................. IV

CHINESE ABSTRACT………………………………………... VI

ABSTRACT……………………………………………………. VIII

LITERATURE REVIEW………………………………………. 1

Diabetes Mellitus………………………………………………………. 2

Contribution of Polyol Pathway to Diabetes-Induced Oxidative Stress

Advanced Glycation End Products as Mediators of Diabetic Complications…………………………………………………………... 7

Biochemistry of Advanced Glycation End Products…………………… 15

Advanced Glycation End Products and Nutrition……………………… 18

PURPOSES…………………………………………………….. 22

STUDY DESIGN………………………………………………. 24


CHAPTER I

Analysis of glycative products in sauces and sauce-treated foods……………………………………………………………27
Abstract………………………………………………………… 28

Introduction…………………………………………………….. 29

Materials and methods…………………………………………. 31

Sauce and food sample………………………………………………… 31

Lipid oxidation measurement………………………………………….. 31

Measurement of reducing sugars………………………………………. 32

Food preparation……………………………………………………….. 33

Determination of carboxymethyllysine (CML) and pentosidine……….34

Determination of furosine……………………………………………… 35

Statistical analysis……………………………………………………... 36

Results…………………………………………………………. 37

Discussion……………………………………………………… 39

Tables…………………………………………………………… 46

Figures………………………………………………………….. 51



CHAPTER II

Association of dietary AGEs with circulating AGEs, glycated LDL, IL-1a and MCP-1 levels in type 2 diabetic patients……...
52

Abstract………………………………………………………… 53

Introduction…………………………………………………….. 55

Materials and methods…………………………………………. 57

Patients and healthy subjects…………………………………………... 57

Dietary record and nutrients analyses………………………………….. 58

Blood biochemical measurements……………………………………... 58

Determination of furosine, CML and pentosidine in plasma………….. 60

Measurement of glycated LDL in plasma……………………………...
60
Statistical analysis……………………………………………………… 60

Results…………………………………………………………. 62

Discussion……………………………………………………… 64

Tables…………………………………………………………… 69

Figures………………………………………………………….. 73


CONCLUSION…………………………………………………..74
REFERANCE…………………………………………………… 76

APPENDIXES………………....................................................... 91

Appendix 1 Approval Institutional Review Board of Chung Shan Medical Hospital Informed Consent…………………………………….92

Appendix 2 Informed consent (intervention)…………………………… 93

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