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  • 學位論文

山苦瓜改善代謝症候群之先導型飲食補充試驗

Wild Bitter Gourd (Momordica charantia L. var. abbreviata Seringe) Improves Metabolic Syndrome: A Preliminary Dietary Supplementation Trial

指導教授 : 蔡新聲
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摘要


在餵食高脂飲食鼠的研究發現,苦瓜可改善過氧化體增殖劑活化受體α/γ、胰島素阻抗及腹部肥胖,本研究主要目的為評估雜交種F1花蓮4號山苦瓜對臺灣成年人在代謝症候群的作用。本研究為開放標記先導型試驗,對象為符合美國心臟協會/國家心臟、肺臟及血液學會代謝症候群亞洲修訂版準則,研究期間為2008年5月至2009年4月。最後共有42位完成研究,其中21位為男性、21位為女性,平均年齡為45.7±1.8歲(範圍為23-63歲)。研究對象每日服用4.8g山苦瓜凍乾粉末膠囊補充劑3個月,及停止服用後各3個月(共6個月),監測代謝症候群及其相關指標,以分析治療前後轉變情形。山苦瓜對代謝症候群影響以意向分析(intention-to-treat)準則之廣義線性混合模型統計分析,結果顯示,與開始服用山苦瓜前為參考值做比較,在往後6個月依序可發現有7.1% (平均標準誤差, p值; 3.7%, 0.920)、9.5% (4.3%, 0.451)、19.0% (5.7%, 0.021)、16.7% (5.4%, 0.047)、11.9% (4.7%, 0.229) 及 11.9% (4.7%, 0.229)代謝症候群發生率的降低,再者腰圍亦有改善效果(p<0.05),大部份受試者對山苦瓜皆有好的耐受度。本研究是第一個有關山苦瓜對代謝症候群作用的報告,可發現在服用第3個月及停止服用山苦瓜第1個月後,代謝症候群之改善可達統計學上顯著差異,本先導型飲食補充試驗可提供未來隨機控制試驗在山苦瓜效用一個良好的研究證據。

並列摘要


Bitter gourd has been shown to activate both PPARα/γ, ameliorate insulin resistance and abdominal obesity in high-fat fed mice. The aim of this study was to evaluate the effect of F1 hybrid Hualien wild bitter gourd No.4 (WBG; Momordica charantia L. var. abbreviata Seringe) on metabolic syndrome (MetS) in Taiwanese adults. A preliminary open-label uncontrolled trial was conducted in eligible fulfilled the diagnosis of MetS based on Asian guidelines of the American Heart Association/National Heart, Lung and Blood Institute between May 2008 and April 2009. Forty-two MetS patients (21 men and 21 women) with mean age of 45.7±1.8 years (range, 23-63 years) were recruited for the study. The subjects were supplemented with 4.8 gram of lyophilized powder of WBG in capsules daily for 3 months. MetS and associated parameters were monitored monthly for six consecutive months including 3 months of supplementation and another 3 months after the discontinuing supplementation. Effects of WBG on MetS were estimated using generalized linear mixed models according to the intention-to-treat principle. There were 7.1% (standard error of mean, p value; 3.7%, 0.920), 9.5% (4.3%, 0.451), 19.0% (5.7%, 0.021), 16.7% (5.4%, 0.047), 11.9% (4.7%, 0.229) and 11.9% (4.7%, 0.229) decrease in the incidence rate of MetS in the end of each month respectively after the start of the supplementation. The waist circumference also significantly decreased after the supplementation (p<0.05). The WBG supplementation was generally well-tolerated. This is the first report to show that WBG improved MetS. It reached the statistical significance in the third month and in the first month after discontinuing WBG supplementation. These preliminary results provide a firm base for further randomized control trials to evaluate the efficacy of WBG supplementation.

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