薑黃改善糖尿病前期患者餐後工作記憶之代謝研究

Turmeric Improves Post-Prandial Working Memory in Pre-Diabetes Independent of Insulin

Meei-Shyuan Lee ； Mark L Wahlqvist ； Yu-Ching Chou ； Wen-Hui Fang ； Jiunn-Tay Lee ； Jen-Chun Kuan ； Hsiao-Yu Liu ； Ting-Mei Lu ； Lili Xiu ； Chih-Cheng Hsu ； Zane B Andrews ； Wen-Harn Pan

《Asia Pacific Journal of Clinical Nutrition》 預刊文章 Pp. 1-11

https://doi.org/10.6133/apjcn.2014.23.4.24

摘要

背景：認知功能失調伴隨糖尿病前期與失智症是糖尿病的併發症之一。天然食品如薑黃及肉桂可改善此致病機轉。本研究為評估薑黃肉桂如何影響糖尿病前期患者認知功能之代謝研究。方法：對象為三軍總醫院參加老人健檢者，納入條件為其空腹血糖介於100-126mg/dL，共計48位參與者。經由雙盲性別分層隨機分派至服用口服降血糖藥物或其組合、薑黃、肉桂或其組合及控制組共4組，每組12名，男女各半。參與者須於報到後抽取空腹血液、實施工作記憶前測及測量基本體位資料。再於8時服用早餐及受試藥物，各組分別為安慰劑、薑黃1克、肉桂2克、肉桂2克與薑黃1克等。隨後每隔2小時採集血液，共4次，於最後1 次抽血完畢後，再測工作記憶分數。利用RT-PCR技術測得APP、PS1、PS2、GSK-3βmRNA表現量。利用t檢定及卡方檢定比較天然食品使用者及非使用者平均值之差異；魏克森符號等級檢定工作記憶前測及後測的分數。利用雙因子變異數分析檢定薑黃與肉桂兩植物成分之交互作用。複迴歸模式分析校正身體質量指數、血糖、胰島素濃度、阿茲海默症相關之生物標記後，薑黃肉桂對工作記憶之影響。結果：薑黃與肉桂兩植物成分並無交互作用產生。有服用薑黃者工作記憶平均分數由2.6增加至2.9分，為邊緣性顯著（p=0.05），服用肉桂者工作記憶前後測平均分數沒有顯著差異。工作記憶分數之改善與胰島素阻抗呈負相關 （r=-0.418, p＜0.01），但與阿茲海默症之相關生物標記無顯著相關。複迴歸分析結果顯示服用薑黃、BMI及胰島素阻抗為工作記憶分數最佳預測因子。結論：本研究觀察到的薑黃改善認知效果，可能並非透過假設之降血糖途徑或降低生物標記基因表現量而來，推測薑黃有其他保護神經元機制。

關鍵字

認知功能 ； 阿茲海默症 ； 薑黃素 ； 肉桂 ； 胰島素阻抗

並列摘要

Background and Objectives: Cognitive impairment develops with pre-diabetes and dementia is a complication of diabetes. Natural products like turmeric and cinnamon may ameliorate the underlying pathogenesis. Methods: People≥60 years (n = 48) with newly-recognised untreated pre-diabetes were randomised to a double-blind metabolic study of placebo, turmeric (1g), cinnamon (2g) or both (1g & 2g respectively), ingested at a white bread (119g) breakfast. Observations were made over 6 hours for pre- and post-working memory (WM), glycaemic and insulin responses and biomarkers of Alzheimer's disease (AD)(0,2,4 and 6 hours): amyloid precursor protein (APP), γ-secretase subunits presenilin-1 (PS1), presenilin-2 (PS2), and glycogen synthase kinase (GSK-3β). Differences between natural product users and non-users were determined by Students t and chi square tests; and between pre-test and post-test WM by Wilcoxon signed rank tests. Interaction between turmeric and cinnamon was tested by 2-way ANOVA. Multivariable linear regression (MLR) took account of BMI, glycaemia, insulin and AD biomarkers in the WM responses to turmeric and cinnamon. Results: No interaction between turmeric and cinnamon was detected. WM increased from 2.6 to 2.9 out of 3.0 (p = 0.05) with turmeric, but was unchanged with cinnamon. WM improvement was inversely associated with insulin resistance (r = -0.418, p＜0.01), but not with AD biomarkers. With MLR, the WM responses to turmeric were best predicted with an R^2 of 34.5%; and with significant turmeric, BMI and insulin/glucose AUC beta-coefficients. Conclusions: Co-ingestion of turmeric with white bread increases working memory independent of body fatness, glycaemia, insulin, or AD biomarkers.

並列關鍵字

cognition ； Alzheimer's disease ； curcumin ； cinnamon ； insulin resistance