口腔癌病人輔酶Q10、抗氧化維生素濃度及氧化壓力與代謝症候群之相關性探討

在臺灣，口腔癌位居癌症死因第五名；且代謝症候群（metabolic syndrome，MS）之盛行率有逐年增加的趨勢。本研究目的為探討口腔癌病人輔酶Q10、抗氧化維生素濃度及氧化壓力與代謝症候群之相關性。本觀察性研究招募診斷為口腔癌之術前病人（人數200名），測量其腰圍、血壓、空腹血糖、血脂（總膽固醇、三酸甘油酯、低密度脂蛋白膽固醇及高密度脂蛋白膽固醇）、血漿輔酶Q10、β-胡蘿蔔素、維生素A與維生素E、氧化壓力（丙二醛）、抗氧化酵素（超氧化物歧化酶、過氧化氫酶及麩胱甘肽過氧化酶）及發炎指標（高敏感C-反應性蛋白、介白素-6及腫瘤壞死因子-α）。結果發現，口腔癌病人輔酶Q10濃度（中位數280毫微莫耳/升）顯著低於參考濃度下限值（500毫微莫耳/升）。根據MS分組後發現，MS組之氧化壓力（丙二醛，p = 0.04）及發炎指標（高敏感C-反應性蛋白，p = 0.01；介白素-6，p = 0.01；腫瘤壞死因子-α，p < 0.01）濃度顯著高於無MS組；抗氧化酵素活性則顯著低於無MS組（超氧化物歧化酶，p = 0.04；過氧化氫酶，p < 0.05）。另外，MS組相較於無MS組有較低經血脂校正之輔酶Q10及β-胡蘿蔔素濃度（p < 0.05）。利用邏輯斯迴歸分析發現，受試者有較低輔酶Q10濃度時（血漿輔酶Q10/低密度脂蛋白膽固醇濃度小於120毫微莫耳/毫莫耳），顯著增加罹患MS（OR：2.27，p = 0.03）、高三酸甘油酯（OR：3.17，p < 0.01）及較低高密度脂蛋白膽固醇濃度（OR：1.97，p = 0.06）之風險。因此，我們認為罹患代謝症候群之口腔癌病人可能承受較高之氧化壓力及較低之輔酶Q10及抗氧化維生素（β-胡蘿蔔素）狀態，且當口腔癌病人有較低輔酶Q10濃度時，可能與增加罹患MS之風險有關。

關鍵字

輔酶Q10 ；抗氧化維生素；口腔癌；代謝症候群；氧化壓力

並列摘要

In Taiwan, oral cancer is the fifth leading cause of cancer death, and the prevalence of metabolic syndrome (MS) increasing annually. The purpose of this study was to investigate the relationship of coenzyme Q10, antioxidative vitamins, oxidative stress, and the risk of MS in patients with oral cancer. This observational study recruited 200 preoperative patients who were diagnosed with oral cancer. The values of waist circumference, blood pressure, fasting blood glucose, lipid profiles (TC, TG, LDL-C, and HDL-C), plasma coenzyme Q10, β-carotene, vitamins A, vitamin E, oxidative stress (MDA), antioxidant enzymes (SOD, CAT, and GPx), and inflammatory markers (hs-CRP, IL-6, and TNF-α) were measured in the present study. Patients with oral cancer had lower level of coenzyme Q10 (median: 280 nM), which was lower than the reference range (500 nM). The subjects with MS had significantly higher oxidative stress (MDA, p = 0.04), inflammatory markers (hs-CRP, p = 0.01; IL-6, p = 0.01; TNF-α, p < 0.01), and significantly lower antioxidant enzymes activity (SOD, p = 0.04; CAT, p < 0.05) than those in the non-MS group. After adjusting for lipid profiles, the subjects with MS had significantly lower coenzyme Q10 and β-carotene than the non-MS (p < 0.05). In addition, a lower level of coenzyme Q10 (coenzyme Q10/LDL-C < 120 nmol/mmol) was significantly increased the risk of MS (OR: 2.27, p = 0.03), hypertriglyceridemia (OR: 3.17, p < 0.01), and low HDL-C level (OR: 1.97, p = 0.06). In conclusion, oral cancer patients with MS may suffer from higher oxidative stress and lower coenzyme Q10 and antioxidant vitamins (β-carotene) status; and who had low level of coenzyme Q10 may be associated with increase the risk of MS.