苦瓜於血糖控制之功效及安全性回顧

Bitter Gourd (Momordica charantia): A Review of Its Efficacy and Safety for Glucose Homeostasis

蔡崇煌(Chung-Huang Tsai) ； 陳靖棻(Emily Chin-Fun Chen) ； 蔡新聲(Hsin-Sheng Tsay) ； 黃青真(Ching-Jang Huang)

《臺灣營養學會雜誌》 35卷3期 (2010/09) Pp. 115-126

https://doi.org/10.6691/NSJ.201009_35(3).0004

摘要

苦瓜是熱帶地區常見蔬菜，近年來的研究證實其有調節血糖之作用。本文針對苦瓜有關糖尿病的效用及副作用做文獻回顧。許多高血糖鼠實驗，證實苦瓜具降血糖活性，對高脂飲食誘發肥胖或遺傳性肥胖鼠之胰島素阻抗，亦有矯正功效。文獻顯示，苦瓜或其萃取物可抑制腸道醣水解酶活性及腸道吸收葡萄糖，保護胰島β-細胞，增進胰島素分泌，促進肝中葡萄糖代謝利用、抑制糖質新生，改善胰島素阻抗。在活性成分方面，有研究指出苦瓜含有活化過氧化體增殖劑活化受器PPARα及γ成分，近來之研究分離鑑定出幾種4環葫蘆烷型三萜類糖苷(cucurbitane-type triterpenoid glycosides)或其苷元(aglycone)，於動物及細胞實驗呈現調節血糖活性，大部份人體試驗亦顯示其具有降血糖功效，目前人體試驗報導之副作用都屬輕微，最常見之副作用為胃腸不適。根據證據醫學之評估，目前其確切療效尚未定論，或許在人體可能有降血糖作用。但對於苦瓜品種及其製備劑型、劑量，皆未標準化及品管保證，因此尚要有更多、更進一步之研究設計及實驗觀察。

關鍵字

苦瓜 ； 血糖 ； 過氧化體增殖劑活化受器 ； 糖尿病 ； 4環葫蘆烷型三萜類

並列摘要

Bitter gourd (BG; Momordica charantia) is a common tropical vegetable which was shown to modulate blood glucose homeostasis. In this paper, we reviewed studies on BG's efficacy and safety for glucose homeostasis. Numerous studies demonstrated that BG or its extract administered orally lowered serum glucose in diabetic rodents, and in obese rodents fed a high fat diet or with a genetic defect. The mechanisms involved include inhibiting intestinal α-glucosidase and glucose transport, protecting islet β-cells, enhancing insulin secretion, increasing hepatic glucose disposal, decreasing gluconeogenesis, and improving insulin resistance. Other studies demonstrated that BG extracts can activate and upregulate the expressions of peroxisome proliferator-activated receptors (PPARs). Quite a few triterpenoid glycosides and aglycones were identified as active compounds. A moderate hypoglycemic effect was observed in some clinical trials. Reported adverse effects of BG are modest, including hypoglycemic coma in two children taking BG before breakfast, a favism-like syndrome caused by vicine in BG seeds, gastrointestinal discomfort especially abdominal pain and diarrhea in human trials, reduced fertility in mice, and increased serum y-glutamyltransferase and alkaline phosphatase levels in animals. Currently, the efficacy of BG as a hypoglycemic therapeutic agent has not been substantiated based on evidence-based medicine, mainly because BG preparations and doses have not been standardized, and an inadequate number of subjects has been tested. Existing data, however, support the potential worth of further research and development of BG as a functional food for glucose homeostasis. Adequately powered, randomized, placebo-controlled trials with standardized BG preparations and appropriate subjects are especially needed.

並列關鍵字

Momordica charantia ； blood glucose ； peroxisome proliterator-activated receptor ； diabetes ； cucurbitanetype triterpenoid