薑黃素降血脂作用使用於代謝症候群患者的比較分析

Lipid-Lowering Effects of Curcumin in Patients with Metabolic Syndrome

陳素卿(Su-Ching Chen)

指導教授 ： 蔡菁華 ； 翁國昌

中山醫學大學/醫學院/醫學研究所/碩士(2015年)

https://doi.org/10.6834/CSMU.2015.00070

摘要

研究目的： 心血管疾病多年來都是國人主要死因之一，在衛生署公布的國人死因排行僅次於癌症，且罹病年齡層有下降趨勢。心血管疾病的主要危險因子有高血壓、高血糖、高血脂，而這些患者易進展成代謝症候群，使得健康亮起紅燈。本研究想探討使用薑黃素於代謝症候群患者降血糖、血脂效用的分析比較。
研究方法及資料：本研究期間為2013年1月到2013年12月於中山醫學大學附設醫院已經穩定治療至少6個月的代謝症候群患者，使用隨機，雙盲，安慰劑對照設計，使用薑黃素萃取物相對於安慰劑維持12週，將導致代謝參數和體重顯著改善的假說。參與者被隨機分配為薑黃素組或安慰劑組，利用獨立t檢定(t-test)，來進行研究和分析，所有的統計分析採用SPSS15.0進行。
研究結果：共收錄了65位患者被隨機分為兩組，其中33位是薑黃素萃取物組，另外32位是安慰劑膠囊組。在持續使用薑黃素萃取物12週後，高密度脂蛋白膽固醇的數值從40.96±8.59 mg/dL顯著增加至43.76±2.79 mg/dL（P＝0.027），低密度脂蛋白膽固醇也顯著降低120.55±36.81至106.51±25.02 mg/dL（P＝0.011）。本研究也發現降低了三酸甘油酯的數值，共減少了65 mg/dL（P＝0.029）；在小群組分析中，使用薑黃素於男性患者可能降低膽固醇的效果，用於女性患者可增加高密度脂蛋白膽固醇的作用，這兩者都減少了總膽固醇／高密度脂蛋白膽固醇的比值。每天服用3000 mg的薑黃素萃取物持續12週與降血脂作用有相關性，但沒有改善代謝症候群患者的體重和血糖的穩定度。
結論與討論：本研究主要發現每天攝取3000 mg的薑黃素維持12週與抗脂質作用有關，但沒有改善代謝症候群患者的體重和血糖的狀態，因此，每日使用薑黃素於代謝症候群患者身上可能是另一個替代的選擇來改善相關的代謝參數。因為這是一個小樣本和短期間的研究，因為隨機化導致了一些變數的高標準偏差。雖然本研究的樣本量較少，但顯示使用薑黃素和抗脂質作用之間可能存在的關係。但是，改善血脂肪的數值並不一定意味著薑黃素是有效對抗心血管疾病，因此，需要進一步的研究以證明薑黃素是否可以對心血管疾病有好處。

關鍵字

薑黃素 ； 代謝症候群 ； 降血脂作用

並列摘要

Objective: Cardiovascular disease is one of the major causes of mortality in Taiwan, which is second only to cancer. The average age of getting cardiovascular disease becomes younger in recent years. The major risk factors of cardiovascular disease included hypertension, hyperglycemia, hyperlipidemia, all result in metabolic syndrome. This study tends to investigate the effect of Curcumin on blood glucose and lipid in metabolic syndrome patients.
Methods and Materials: The study included 65 patients in Chun Shan Medical hospital, who were diagnosed of metabolic- syndrome and received treatment at least for 6 months during January, 2013 to December, 2013. The design of this study was randomized, double blinded, and divided into Curcumin intervention group and placebo group. We hypothesized that receiving the retraction of Curcumin for 12 weeks will lead to the improvement of metabolic index and decrease body weight when compares to the placebo group. The statistical methods we use are t-test and SPSS 15.0 model.
Results: Sixty five patients were randomized into two groups. Thirty three patients were Curcumin intervention group, and thirty two patients were in placebo. We found that maintenance of the Curcumin for 12 weeks , the high-density lipoprotein (HDL) level increased from 40.96±8.59 mg/dL to 43.76±2.79 mg/dL (p=0.027), and the level of low-density lipoprotein (LDL) decreased from 120.55±36.81 mg/dL to 106.51 ± 25.02 mg/dL (p=0.027), and a reduction of 65 mg/dL triglyceride (TG) level in the Curcumin intervention group. In subgroups analysis, the Curcumin intervention group had a reduction of cholesterol level, and a increased HDL level in female and patients, respectively. Both of the effect can lead to a decreased ratio of cholesterol and HDL in two subgroups.
Conclusion and Discussion: This study showed that daily intake 3000 mg of Curcumin for 12 weeks was associated with improvement of hyperlipidemia, but did not decrease body weight and fail to stabilize blood sugar in metabolic syndrome patients. Thus, daily intake of Curcumin may be an alternative choice to improve metabolic index. Our study indicates the relationship between Curcumin and lipid-lowering effects. However, this study had a small sample and limited following time, and these are preliminary data which leading to high statistic bias. Furthermore, whether reduction in lipid level via Curcumin intervention would have the effect on preventing cardiovascular disease is unknown. Further research is required to prove that Curcumin has benefits for cardiovascular disease. Moreover, we can’t explain the gender differences of the results.

並列關鍵字

Curcumin ； Metabolic syndrome ； lipid-lowering effect

參考文獻

2.李瑞淼（2010/12/01）．高血脂症的治療與預防．北市中醫會刊，16（4）：88-92。

5..邱琴瑟、郭堉析（2011/09/01）．薑黃素的成分與應用．中華體育季刊，25（3）：410-418。

6.郭昶甫、余光輝、陳右明、黃兆山、李虹儀、沈昱名、史麗珠（2010/07/01）．代謝症候群盛行率的性別差異．台灣醫學，14（4）：384-392。

10.陳怡寧（2013）．探討血脂異常者營養衛教之影響（碩士論文）．台中：中山醫學大學營養學研究所。

11.楊宜瑱、盧英立、王威傑、黃建寧（2014）．糖尿病生活品質及相關因素之探討．社團法人中華民國糖尿病衛教學會。