杏仁果飲食介入對第 2 型糖尿病患者之心血管疾病危險因子的影響

Effects of Almond Diet Intervention on Cardiovascular Disease Risk Factors in Type 2 Diabetic Subjects

劉燕樺(Yen-Hua Liu)

指導教授 ： 劉珍芳

臺北醫學大學/公共衛生暨營養學院/保健營養學研究所/碩士(2008年)

https://doi.org/10.6831/TMU.2008.00033

摘要

本研究以杏仁果作為研究材料，並以飲食介入的方式，來探討對於具有高脂血症的第 2 型糖尿病患者其胰島素抗性、高血糖、血脂異常、氧化壓力，及發炎反應等心血管疾病危險因子之影響。此為隨機的、2×2交叉的飲食介入試驗。受試者為 20 位具有高脂血症的第 2 型糖尿病病患，年齡介於40∼80歲間。受試者在經 2 週的適應期後，隨機給予為期 4 週的控制組飲食或杏仁果飲食，並在 2 週的排空期之後，受試者交叉進入為期 4 週的另一飲食介入期。控制組飲食為一般糖尿病飲食；杏仁果飲食則是以杏仁果取代控制組飲食中20% 總熱量來源的飲食。在每個飲食介入期的開始前及結束後，受試者皆須進行體位測量及血液樣本的採集。實驗結果顯示，相較於控制組飲食，受試者食用為期4週的杏仁果飲食後，可顯著改善其體脂肪百分率、空腹血糖濃度、胰島素抗性指標－HOMA-IR、TC 濃度、LDL-C 濃度、Apo B 濃度、FFA 濃度、LDL-C: HDL-C 的比值，和 Apo B: Apo A-1 的比值；此外，杏仁果飲食介入後，受試者有顯著較高的血漿維生素 E 濃度及較長的 LDL 氧化遲滯時間，並且有顯著較低的蛋白質氧化傷害指標－protein carbonyl濃度及發炎反應指標－IL-6 及 CRP 濃度。本研究證實，以杏仁果提供 20% 總熱量來源的富含杏仁果飲食，具有改善第 2 型糖尿病患者其心血管疾病危險因子的正面益處。

關鍵字

杏仁果 ； 第 2 型糖尿病 ； 胰島素抗性 ； 高血糖 ； 血脂異常 ； 氧化壓力 ； 發炎反應 ； 心血管疾病

並列摘要

This study was to investigate the effects of almond diet intervention on CVD risk factors, including insulin resistance, hyperglycemia, dyslipidemia, oxidative stress and inflammatory response in type 2 diabetic subjects. The study was a randomized, crossover, controlled clinical trial. Subjects were 20 type 2 diabetic men and women with hyperlipidemia, aged 40~80 years. After a 2-wk run-in period, subjects were fed control diet or almond diet for each 4 wk, with a 2-wk washout period between each diet period. Control diet was designed as a general Asia diet for diabetes, while almond diet was replaced 20% of total energy of control diet with almonds. Anthropometric data and blood samples were collected before and at the end of each diet period. Compared with control diet, the results showed that almond diet induced significant reductions in body fat percentage, fasting blood sugar, HOMA-IR, total cholesterol, LDL-cholesterol, apolipoprotein B and free fatty acids concentration, and the ratio of LDL- to HDL-cholesterol and of apolipoprotein B to apolipoprotein A-1. The plasma vitamin E level and LDL lag time were significantly higher, and the protein carbonyl, interleukin-6 and C-reactive protein concentration were significantly lower with almond diet. The conclusion in our study were that almond-enriched diet, in which almonds contributed 20% of total energy, has beneficial effects on the cardiovascular disease risk factors, including insulin resistance, hyperglycemia, dyslipidemia, oxidative stress and inflammatory response of type 2 diabetic subjects.

並列關鍵字

almonds ； type 2 diabetic subjects ； insulin resistance ； hyperglycemia ； dyslipidemia ； oxidative stress ； inflammatory response ； cardiovascular disease

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