探討素食飲食與血脂質之相關性

Association between Vegetarian Diet and Blood Lipid Profiles

柯沛潔(Pei-Chieh Ko)

指導教授 ： 廖勇柏

中山醫學大學/健康管理學院/公共衛生學系碩士班/碩士(2014年)

https://doi.org/10.6834/CSMU.2014.00020

摘要

研究目的: 已知素食飲食可能有較低的心血管疾病及死亡風險，部分原因是因其可能對血脂質(高密度脂蛋白膽固醇、低密度脂蛋白膽固醇和三酸甘油酯)產生影響。在台灣，仍無按性別，甚至依女性經期狀況探討素食飲食與血脂質之相關研究，因此，本研究將針對男、女性分層探討素食飲食與血脂質之相關性，再將女性分為未、已停經做更進一步的探討。

材料方法: 資料取自西元2002年「台灣地區高血糖、高血脂、高血壓盛行率調查」，探討素食飲食與血脂質之相關性。本研究將依不同性別(女性再依經期進一步分層)對受試者之基本資料進行描述性統計，再檢定不同飲食型態者之差異。另外，利用多變項線性迴歸分析，探討素食飲食對血脂質之影響。

研究結果: 共計3,255位男性及3,551位女性(2,397位未停經者，1,154未已停經者)納入本研究，且其均為未使用降血脂藥物者。利用多變項線性迴歸分析，在男性部分，結果發現全素者(ß=-7.19, P=0.001)之HDL-C平均濃度明顯低於葷食者，而全素者(ß=-12.6, P=0.001)及蛋奶素者(ß=-7.59, P=0.018)之LDL-C平均濃度也均低於葷食者；在女性部分，結果發現全素者(ß=-5.84, P=<.0001)及蛋奶素者(ß=-4.66, P=0.0002)之HDL-C平均濃度也都低於葷食者，而蛋奶素者(ß=-4.95, P=0.031)相較於葷食者亦有較低的LDL-C濃度，女性進一步依經期狀況分層，在未停經女性，結果發現全素者(ß=-7.63, P=0.001)及蛋奶素者(ß=-4.87, P=0.001)之HDL-C相較於葷食者濃度低，而蛋奶素者(ß=-7.14, P=0.008)之LDL-C平均濃度亦較葷食者低，另外，全素者(ß=23.37, P=0.008)之TG濃度也較葷食者高；在已停經女性，結果則發現全素者(ß=-4.90, P=0.014)及蛋奶素者(ß=-4.47, P=0.047)之HDL-C均較葷食者低。

結論: 無論是男性或女性，均發現全素飲食有較低的HDL-C濃度。此外，蛋奶素飲食可降低LDL-C濃度，因此，可能更適合男性及未停經女性。

關鍵字

高密度脂蛋白膽固醇 ； 低密度脂蛋白膽固醇 ； 三酸甘油酯 ； 全素飲食 ； 蛋奶素飲食

並列摘要

Background: Vegetarian diet has been associated with lower risk of cardiovascular diseases and mortality, partly due to its effects on serum lipid profiles. Lipid profiles [high density lipoprotein-cholesterol (HDL-C), low density lipoprotein-cholesterol (LDL-C) and triglycerides (TG)] have not been fully elucidated by gender and either in pre and postmenopausal vegan or in ovo-lacto vegetarians in Taiwan. This study aimed to compare lipid profiles among vegans, ovo-lacto vegetarians and omnivores.

Methods: Demographic data and lipid profiles were obtained from the 2002 Taiwanese Survey on Hypertension, Hyperglycemia and Hyperlipidemia (TwSHHH). Multivariate linear regression analysis was used to examine factors significantly and independently associated with different categories of vegetarianism and to estimate the β value of lipid profiles in the dietary types.

Results: A total of 3,255 male and 3,551 female (2,397 premenopausal and 1,154 postmenopausal) participants who did not receive lipid lowering drugs were enrolled. Multivariate linear regression analyses showed that vegans decreased HDL-C levels(ß=-7.19, P=0.001) in males. There were also significant associations of lower LDL-C between vegan (ß=-12.76, P=0.001) and ovo-lacto vegetarian diets(ß=-7.59, P =0.018), compared with omnivorous diet. Females reported to have consumed either a vegan or an ovo-lacto vegetarian diets were at the risk of having low HDL-C unlike those that consumed omnivorous diets (ß=-5.84, P=<.0001 and ß=-4.66, P=0.0002).The results also showed that ovo-lacto vegetarian diets decreased LDL-C levels (ß=-4.95, P=0.031).When stratified by menopausal status, vegan and ovo-lacto vegetarian diets decreased HDL-C levels in premenopausal females (ß=-7.63, P=0.001 and ß=-4.87, P=0.001).There were significant associations between lower LDL-C and ovo-lacto vegetarians(ß=-7.14, P=0.008), and between TG and vegans (ß=23.37, P=0.008), compared with omnivorous. Postmenopausal females reported to have consumed either a vegan and ovo-lacto vegetarian diets were at the risk of having low HDL-C unlike those that consumed omnivorous diets (ß=-4.90, P=0.014 and ß=-4.47, P=0.047).

Conclusions: Vegan diet was associated with reduced HDL-C concentrations in both gender. Because the ovo-lacto vegetarian diet was effective in lowering LDL-C, it may be more appropriate for males and premenopausal females.

並列關鍵字

HDL-C ； LDL-C ； Triglycerides ； Vegan ； Ovo-lacto vegetarian

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