第二型糖尿病、葷食、素食、年紀及性別對尿液 中代謝物核磁共振值之影響

The effect of type 2 diabetes mellitus, non-vegetarian, vegetarian, age and gender on urinary metabolite NMR values

洪于禾(Yu-Ho Hong)

指導教授 ： 陳百勳

高雄醫學大學/醫學院/生物化學研究所/碩士(2007年)

https://doi.org/10.6832/KMU.2007.00052

摘要

1H NMR核磁共振是研究生物體液很有用之工具，尤其對含氫之物質。此種技術能迅速提供代謝物狀況，又不需前處理。尿液檢體因為比血液之蛋白含量少而更容易及時處理分析，NMR技術提供之數據除了使吾人了解代謝狀況，也能提供對腎功能之了解。
本研究針對高雄醫學大學附設醫院門診第二型糖尿病患及正常葷食、素食者、大學生利用1H-NMR核磁共振，探討葷食、素食、年紀、性別及第二型糖尿病患者，其對尿中代謝物(包括alanine、lactate、glycine、citrate、acetone、acetate、dimetylamine (DMA)、trimethlamine –N-oxide (TMAO)、hippuric acid)值之影響。
結果顯示素食者其glycine、 DMA較葷食者高，而hippurate值在素食者較葷食者低。葷食、素食混合組與第二型糖尿病者其尿液中代謝物比較，顯示出第二型糖尿病人其尿液中lactate、glycine、TMAO及hippurate值均較葷、素食混合組者高。年紀較輕大學生與成年人之葷、素食者之比較，大學生尿中acetate及hippurate值有意義地增高，而glycine值較低。成年葷、素食者中男性僅hippurate值較有意義高於女性者。第二型糖尿病患尿中無檢出糖分或輕微糖分者與有中、重度糖分者其尿液代謝物NMR值均無有意義之差異。第二型糖尿病患尿液中無檢出蛋白或輕微蛋白者其尿中acetate值，DMA值均較中、重度蛋白者高(P值分別為0.023及0.043)。
1H-核磁共振光譜儀能探討葷食、素食、年紀、性別及第二型糖尿病尿液中許多代謝物之間之關係，也能使吾人得到有關此疾病其病患狀況之許多資訊。本研究應用尿液中各種代謝物值以NMR技術測定，便吾人能夠進一步了解人體內不同飲食(葷食、素食) 、不同年紀、不同性別以及第二型糖尿病對尿液中lactate、alanine、acetate、glycine、acetone、citric acid、TMAO、DMA、Hippurate值均有不同程度之影響。在以NMR判讀尿液中各種代謝物值時，不同飲食、年紀、性別均應為考量因素。

關鍵字

核磁共振 ； 第二型糖尿病 ； 尿液中代謝物 ； 葷食 ； 素食 ； 年紀 ； 性別

並列摘要

1H nuclear magnetic resonance (NMR) is a powerful technique that allows study of biological fluids, providing an overview of important H-containing substances in samples. The main advantage of this technique is that it can furnish a rapid metabolic picture with little or no pretreatment of samples. NMR spectroscopy of urine samples might represent an eligible analytical method and a powerful diagnostic tool. Urine samples are more readily analyzed than blood because of their low protein content, and the registered signals may give important information about renal function in addition to the metabolic status of the subject. For those out-patients of Kaohsiung Medical University Hospital and normal non-vegetarian, vegetarian and college students, we investigate the effect of type II diabetes, non-vegetarian, vegetarian, age and gender on the NMR values of urinary metabolites including lactate, alanine, acetate, glycine, acetone, citrate, TMAO, DMA and hippurate.
Our results revealed that non-vegetarian group had significantly lower urinary glycine, DMA and higher hippurate values than that of vegetarian. Type II diabetes patients had higher urinary lactate, glycine, TMAO and hippurate values than that of combined non-vegetarian and vegetarian group. College students had significantly higher urinary acetate and hippurate, lower glycine values than that of combined non-vegetarian and vegetarian group. For adult male and female groups, except urinary hippurate, other urinary metabolites revealed no significant differences. In type II diabetes patients, those no or mild glucosuria group revealed no significant difference than that of moderate to severe glucosuria group. For diabetes patients, no or mild proteinuria group had higher urinary acetate and DMA values than that of moderate to severe proteinuria group.
NMR spectroscopy permitted us to explore the relationships among the metabolites present in the urine samples of different diet, age, gender and to obtain information about the disease status in type II diabetic patients. Type II diabetes, non-vegetarian, vegetarian, different age and gender had different effect on NMR urinary metabolites. It is also necessary to consider diet, age and gender factors in interpreting urinary NMR values.

並列關鍵字

NMR ； type 2 diabetes ； urinary metabolite ； age ； sex ； non-vegetarian ； vegetarian ； gender

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