- 學位論文
台灣某地區教學醫院使用Metformin®糖尿病人飲食與血清維生素B12之探討
The descriptive study of dietary and serum vitamin B12 among administrative Metformin® diabetic patients in a Taiwan regional teaching hospital
摘要
根據衛生福利部（2013）年所公佈『2012年國人十大死因』資料顯示，糖尿病位居第五位。糖尿病的治療以飲食、運動及藥物三方面來控制，在糖尿病口服降血糖藥Metformin?斥g常是臨床治療糖尿病為第一線口服血糖藥物。1971年起研究指出Metformin?扑|導致降低維生素B12 的吸收，2009年也有研究學者發現使用Metformin?扑|導致血清維生素B12含量減少，因此建議長期使用Metformin?左滲f人建議監測血中維生素B12的濃度及補充維生素B12攝取。維生素B12是人體所不可或缺的營養素之一，它對於人體細胞之生長、紅血球之形成及上皮（epithelium）細胞更新及神經髓鞘質（myelin）之維持扮演著非常重要的角色。維生素B12缺乏容易產生巨細胞性貧血和神經系統疾病，如神經病變，脊髓病變，記憶障礙，失智症，抑鬱症，腦萎縮，腦血管等疾病。研究目的：擬於台灣中部某地區醫院，觀察糖尿病病人使用口服血糖藥物Metformin?布O否會造成血中維生素B12含量較低。實驗設計與方法：本研究為橫斷性研究，受試者年齡為20-85歲之第2型糖尿病病人，排除全素者、胃切除者及每週大於3天以上固定服用營養補充劑者。研究收集受試者體位測量、血液資料、飲食資料（24小時回憶與飲食頻率問卷）。結果：共收集200位，男性121位，女性79位，平均年齡為61.6 ± 9.7 yrs.， 平均每日熱量攝取為1544.6 ± 356.0大卡，24小時飲食回憶維生素B12攝取量為1.8±1.7μg/day，飲食頻率問卷維生素B12攝取量為3.7 ± 2.6μg/day，血清維生素B12 含量為493.6 ± 318.3 pg/ml。資料中顯示以24小時與飲食頻率問卷得飲食維生素B12攝取量相關性強（p < 0.000）；但，血清維生素B12與飲食維生素B12相關性不強（p > 0.05）。口服降血糖藥及Metformin?左瑣窄q對血液維生素B12、飲食維生素B12間亦無顯著影響。結論：在台灣中部某地區教學醫院使用Metformin?奶尿}尿病病人無發現血清維生素B12缺乏情形。
並列摘要
Diabetes was the fifth of top ten leading death in Taiwan according to the report of 2012 Minstry of Health and Welfare, Executive Yuan. R.O.C. Diet, exercise and medication are three aspects treatment to control diabetes. Metformin?? is the first line of oral hypoglycemic agents. 1971 study noted that Metformin?? reduced absorption of vitamin B12 has been noted since 1971. Metformin?? decrease serum vitamin B12 levels which was proposed in 2009. It is recommended that monitoring blood vitamin B12 and vitamin B12 intake for long-term use Metformin?? patient. Vitamin B12 is one of the essential nutrients in the body, for the human cells growth, red blood cells formation and mantain epithelium (epithelium) and nerve myelin (myelin). The symptoms of vitamin B12 deficiency include percious anemia and nervous system disorders, such as neuropathy, spinal cord lesions, memory disorders, dementia, depression, brain atrophy, and cerebrovascular disease. Objective: To observe whether Metformin?? use causes low blood levels of vitamin B12 or not. Experimental design and methods: This was a cross-sectional study and recruited type 2 DM subjects aged from 20-85 yrs., excluded vegans, gastric resection and took vitamin supplements more than thrice a week regularly. We collected anthropometric and blood data, dietary information (24 hour recall and food frequency questionnaire). Results: Total 200 subjects were recruited in this study, 121 males and 79 females, mean age was 61.6 ± 9.7 yrs., average daily calorie intake was 1544.6 ± 356.0 kcal, vitamin B12 intake was 1.8 ± 1.7μg/day by 24- hour dietary recalls, 3.7 ± 2.6μg/day by food frequency questionnaire, serum vitamin B12 levels was 493.6 ± 318.3 pg / ml. There were strong correlation between 24 hours and food frequency questionnaire (p < 0.000) in vitamin B12 intake, but no correlation between dietary vitamin B12 and serum vitamin B12 (p > 0.05). No significant correlation existed among Metformin?? dosage and dietary vitamin B12, blood vitamin B12 level. Conclusion: No correlation between Metformin?? and dietary, serum vitamin B12 among administrative Metformin?? diabetic patients in a Taiwan regional teaching hospital.
參考文獻
延伸閱讀
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