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素食飲食型態對台灣老人維生素B營養狀況與血漿同半胱胺酸濃度的影響
Effect of a Vegetarian Diets on the Vitamin B Status and Homocysteine Levels in Elderly Taiwanese
摘要
為探討素食飲食型態對台灣老人維生素B營養狀況與血漿同半胱胺酸濃度的影響，本研究以衛生署「台灣地區老人營養健康狀況調查1999-2000」(Elderly Nutrition and Heath survey in Taiwan; Elderly NAHSIT)計畫中的65歲以上老人為研究對象，素食47人、偶而素食314人及非素食1056人，共計1417人，以全自動冷光分析儀測定分析血漿葉酸與同半胱胺酸濃度。結果顯示，素食的老人血漿同半胱胺酸濃度總平均為14.3±0.6µmol/L，顯著高於偶而素食的老人(12.5±0.3µmol/L)及非素食的老人(12.3±0.1µmol/L)。血中維生素B生化值，素食的老人血漿葉酸濃度平均值為13.2±0.8ng/mL，顯著高於偶而素食與非素食的老人；維生素B2生化指標紅血球麩胱甘肽還原醃活性係數(erythrocvte glutathione reductase activity coefficient: EGRAC)平均值為1.00±0.02，亦顯著優於偶而素食及非素食的老人；維生素B6則無顯著差異；只有血清維生素B12濃度平均值為381±36pmol/L，顯著低於偶而素食及非素食的老人，並且維生素B12不足比率為28.1%，顯著較高。素食的老人血漿同半胱胺酸濃度高於15pmol/L之盛行率為30.5%，也顯著高於偶而素食與非素食的老人。而素食的老人維生素B2不足比率為12.0%，維生素B6不足比率為8.0%，皆顯著低於偶而素食與非素食的老人；葉酸的不足比率，則在素食、偶而素食與非素食間並無顯著差異。當控制多項影響因子後，維生素Bl2不足的老人，素食者的同半胱胺酸濃度顯著高於偶而素食與非素食者；但是葉酸、維生素B2或B12不足的老人，不論素食與否，血中同半胱胺酸濃度並無顯著差異。以上結果顯示維生素B12充足與否對避免素食的老人血漿同半胱胺酸濃度上升，十分重要。此外，本研究中偶而素食的飲食型態，高同半胱胺酸盛行率最低、維生素B2和B12的不足率也較非素食組低，是否偶而吃素的飲食形態較全素食或非素食理想，仍待進一步探討。
並列摘要
To investigate the effects of a vegetarian diets on the vitamin B status and homocysteine (Hcy) levels in elderly Taiwanese, we analyzed plasma folate and Hcy levels in 47 vegetarians, 314 occasional vegetarians and 1056 non-vegetarians aged ＞65 years, sampled from the Elderly Nutrition and Health Survey in Taiwan (1999-2000) (Elderly NAHSIT). Results showed that the average plasma Hcy levels of vegetarians (14.3 ± 0.6 µmol/L) were significantly higher than those of occasional vegetarians (12.5 ± 0.3 µmol/L) and non-vegetarians (12.3 ±0.1 µmol/L). The vegetarians had significantly higher levels of plasma folate (13.1 ± 0.8ng/mL) than the occasional vegetarians (11.1 ± 0.3ng/mL) and non-vegetarians (11.4 ± 0.2ng/mL), and a better vitamin B2 status assessed by the levels of the erythrocyte glutathione reductase activity coefficient (EGRAC, 1.00 ± 0.02), but lower levels of serum vitamin B12 (381 ± 36pmol/L). There were significantly higher prevalences of vitamin B12 insufficiency and hyperhomocysteinemia (Hcy ＞15µmol/L), but lower prevalences of vitamin B2 or B6 insufficiency in the vegetarians group than those in occasional vegetarians and non-vegetarians groups. After adjusting for several effect factors, the plasma Hcy levels in the elderly with a vitamin B12 insufficiency were significantly higher in vegetarians than those in occasional vegetarians and non-vegetarians, but in those with folate, vitamin B2 or B6 insufficiency did not significantly differ among the three diet groups. Therefore, maintaining a good vitamin B12 status should be emphasized for vegetarian subjects to avoid elevated Hcy levels. In addition, occasional vegetarians had the lowest prevalences of hyperhomocysteinemia and lower prevalences of vitamin B2 or B12 insufficiency compared to non-vegetarians, suggesting that further study may be worth while to investigate whether an occasional vegetarian diet is more beneficial for the elderly.