左旋肉鹼補充劑介入（1000 毫克/天）對冠狀動脈心臟病患抗氧化及發炎之影響

The effects of L-carnitine supplementation on antioxidation and inflammation in patients with coronary artery disease

林君碩(Jun-Shuo Lin)

指導教授 ： 林娉婷

中山醫學大學/健康管理學院/營養學研究所/碩士(2014年)

https://doi.org/10.6834/CSMU.2014.00148

摘要

許多臨床研究指出，冠狀動脈心臟病（coronary artery disease，CAD）患者與高氧化壓力及慢性發炎有關。在細胞與動物研究已發現，左旋肉鹼（L-carnitine，LC）是很好的抗氧化劑。因此，本研究目的為給予CAD受試者LC補充劑（1000毫克/天），觀察其對抗氧化及抗發炎之影響。CAD受試者從臺中榮民總醫院心臟內科募集，經心導管檢查冠狀動脈狹窄程度大於或等於50 %者（n = 47），隨機分派至安慰劑組（n = 24）及LC補充劑組（n = 23），介入期間為12週。於介入前後測量受試者之LC濃度、脂質過氧化物（丙二醛）濃度、抗氧化酵素活性（過氧化氫酶、超氧化物歧化酶及麩胱甘肽過氧化酶）及發炎指標濃度（C-反應蛋白、介白素-6及腫瘤壞死因子-α）。本研究共有39位CAD受試者完成介入試驗（安慰劑，n = 19；LC組，n = 20）。結果發現，LC補充劑介入後，顯著增加其血清LC濃度（P = 0.04）及抗氧化酵素活性（過氧化氫酶，P = 0.02；超氧化物歧化酶，P < 0.01；麩胱甘肽過氧化酶，P = 0.01），並顯著降低丙二醛（P = 0.02）及發炎指標濃度（C-反應蛋白，P < 0.01；介白素-6，P = 0.03；腫瘤壞死因子-α，P = 0.07）。此外，介入後之血清LC濃度與抗氧化酵素活性呈顯著正相關（過氧化氫酶，β = 0.87，P = 0.02；超氧化物歧化酶，β = 0.72，P < 0.01），與發炎指標呈顯著負相關（腫瘤壞死因子-α，β = -0.10，P = 0.04）。因此，本研究認為，CAD病人每天使用1000毫克的LC補充劑，可提升其抗氧化力及降低發炎反應。

關鍵字

LC補充劑 ； 氧化壓力 ； 抗氧化 ； 發炎 ； 冠狀動脈心臟病

並列摘要

High oxidative stress and chronic inflammation contribute to the pathogenesis of coronary artery disease (CAD). Cell and animals studies have shown that L-carnitine (LC) is a good antioxidant. Thus, the purpose of this study was to investigate the effects of LC supplementation (1000 mg/d) on anti-oxidation and anti-inflammation in patients with CAD. CAD patients were recruited from the cardiology clinic of Taichung Veterans General Hospital. Patients who were identified by cardiac catheterization as having at least 50 % stenosis of one major coronary artery and who were treated with statins for at least one month were enrolled in this study (n = 47). The subjects were randomly assigned to the placebo (n = 24) and LC groups (n = 23). The intervention was administered for 12 weeks. The levels of LC, lipid peroxide (malondialdehyde, MDA), antioxidant enzymes [catalase (CAT), superoxide dismutase (SOD), and glutathione peroxidase (GPx)] activities, and inflammation markers [C-reactive protein (CRP), interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α)] were measured in the 39 subjects (placebo, n = 19; LC, n = 20) who completed the study. The levels of LC (P = 0.04) and antioxidant enzyme activities (CAT, P = 0.02; SOD, P < 0.01; GPx, P < 0.01) were significantly increased; and the levels of MDA (P = 0.02) and inflammation markers (CRP, P < 0.01; IL-6, P = 0.03; TNF-α, P = 0.07) were significantly decreased after LC supplementation. In addition, the level of LC was significantly positively correlated with the antioxidant enzymes activity (CAT, β = 0.87, P = 0.02; SOD, β = 0.72, P <0.01) and negatively correlated with the inflammation marker (TNF-α, β = -0.10, P = 0.04) after intervention. In conclusion, LC supplement at a dose of 1000 mg/d may increase the antioxidative capacity and reduce the inflammation status in patients with CAD.

並列關鍵字

L-carnitine supplement ； oxidative stress ； antioxidation ； inflammation ； coronary artery disease

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