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研究生: 王翠芬
論文名稱: 素食停經婦女體內Isoflavones與DHA狀態之探討
指導教授: 吳文惠
Wu, Wen-Huey
呂紹俊
Lu, Shao-Chun
學位類別: 碩士
Master
系所名稱: 人類發展與家庭學系
Department of Human Development and Family Studies
論文出版年: 2002
畢業學年度: 90
語文別: 中文
中文關鍵詞: 素食者停經婦女異黃酮DHA心臟血管疾病2OHE116αOHE1
論文種類: 學術論文
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  • 為探討素食者體內異黃酮與DHA狀態及對健康之影響,在台北地區招募身體健康、無高血脂且無使用荷爾蒙之葷食停經婦女26位,與素食停經婦女39位,進行實驗一:比較葷食與素食停經婦女血漿異黃酮狀態(daidzein 與 genistein)及尿液雌激素代謝物(2-hydroxyestrone,2OHE1 ; 16α-hydroxyestrone,16αOHE1) 排出,及兩者之相關性,結果顯示素食者血漿中daidzein 與 genistein皆明顯比葷食者高,反應了素食者黃豆製品攝取量確實高於葷食者。素食者尿液中2OHE1/creatinine以及2OHE1/16αOHE1 比值皆明顯較葷食者高,而血漿中daidzein含量與尿液中2OHE1/16αOHE1 比值有顯著正相關(R=0.53, p=0.004),與16αOHE1/creatinine有負相關,但未達統計上的顯著意義(R=-0.318,p=0.108),因此推論素食停經婦女雌激素代謝途徑傾向較低致癌性,且可能是受到飲食中高異黃酮攝取的影響。
    實驗二以素食停經婦女為對象,評估補充DHA後,對其心臟血管疾病危險因子之影響,首先依據素食停經婦女血中三酸甘油酯與膽固醇含量分為正常血脂者(<200 mg/dl)與血脂偏高者(≧200 mg/dl),所有素食者每日服用6 ml安慰劑(corn oil),經過2週適應期(run-in)後,,正常血脂者一半補充corn oil (6 ml/d)為placebo (normal)組(n=12),另一半補充來自藻類的DHA oil (6 ml/d,2.1 g DHA)為DHA (normal)組(n=12),血脂偏高者皆補充DHA oil (6 ml/d,2.1 g DHA)為DHA (hyperlipidemic)組(n=9)。於六週實驗期前後收集共兩次血液與尿液樣本。結果顯示補充DHA 後,DHA (normal)組LDL氧化1小時、2小時與3小時之TBARS產生量增加,且血漿中α-tocopherol含量明顯下降,而DHA (hyperlipidemic)組尿液中nitric oxide濃度高於補充前。DHA補充後normal組與hyperlipidemic組LDL中DHA含量明顯增加,placebo組則不變。血漿中總抗氧化狀態、lipoprotein(a)、以及尿液中F2α-isoprostane 含量不受DHA補充影響。整體來看,素食停經婦女補充DHA會使體外LDL氧化增加但對體內氧化壓力無明顯改變,對於血脂質則無明顯好處,唯可增加血脂偏高的素食停經婦女nitric oxide生成,因此,本研究僅發現補充DHA對於素食停經婦女的心臟血管疾病危險因子的微小影響。

    第一章 前言………………………………………………………. 1 第二章 文獻探討………………………………………………. 3 第一節葷素飲食者營養攝取狀態之差異……………….. 3 第二節 Isoflavones之相關研究……………………………… 4 一、Isoflavones之簡介……………………………………….. 4 二、Isoflavones的生理作用………………………………….. 4 三、雌激素(Estrogen)的代謝………………………………… 5 四、Isoflavones對雌激素代謝產物的影響………………….. 6 第三節 葷素飲食脂肪攝取與對健康影響……………8 一、葷素飲食者血清中脂肪酸含量之差異…………………. 8 二、葷素飲食者血脂質濃度之差異………………………….. 8 三、葷素飲食對疾病發生的影響……………………………. 8 四、素食者與攝取大量魚類者之差異………………………. 9 第四節 N-3多元不飽和脂肪酸對心血管疾病危險因子的影響… 10 一、N-3多元不飽和脂肪酸之簡介 ………………………… 10 二、流行病學的發現…………………………………………. 10 三、N -3 多元不飽和脂肪酸預防心臟血管疾病可能的機轉. 11 四、臨床實驗的發現…………………………………………... 12 (一)魚油………………………………………………….. 12 (二)不同種魚類的魚油………………………………….. 18 (三)純化的EPA或DHA………………………………… 19 第五節 心臟血管疾病危險因子之探討………………………... 21 一、LDL氧化…………………………………………………. 21 二、血漿中Lipoprotein (a)濃度………………………………. 22 三、尿液中F2α-isoprostane濃度…………………………… 23 四、尿液中Nitric oxide濃度………………………………… 24 五、停經………………………………………………………. 26 第三章 研究方法……………………………………………. 28 第一節 研究對象……………………………………………... 28 第二節 研究設計…………………………………………... 29 第三節 實驗器材……………………………………………... 32 第四節 實驗材料……………………………………………... 34 第五節 分析項目與方法……………………………………... 36 一、血液的收集………………………………………………. 36 二、血漿的分離………………………………………………. 36 三、尿液的收集………………………………………………. 36 四、尿液creatinine含量測定………………………………… 37 五、尿液Estrogen代謝物2-OH1/16αOHE1含量測定…… 37 六、血漿中isoflavones含量測定…………………………….. 38 七、血漿脂質之分析………………………………………….. 39 八、低密度脂蛋白的透析及其蛋白質濃度的測定…………. 41 九、TBA(Thiobarbituric Acid)反應生成物測定……………… 42 十、Conjugated Diene 生成之測量…………………………… 42 十一、血漿中總抗氧化狀態(Total Antioxidant Status)測定 43 十二、血漿中Lipoprotein(a)…………………………………. 43 十三、血漿α-tocopherol含量的測定……………………….. 43 十四、低密度脂蛋白脂肪酸組成分析………………………. 45 十五、尿液Isoprostane含量測定……………………………. 46 十六、尿液中Nitric oxide含量測定………………………….. 48 第六節 實驗品質控制……………………………………... 49 第七節 統計分析…………………………………………... 51 第八節 研究限制…………………………………………... 52 第四章 結果…………………………………………………. 54 實驗一、葷食與素食停經婦女血漿Isoflavones濃度與尿液中Estrogen代謝物排出量之比較……………………………. 54 (一)基本資料…………………………………………………… 54 (二)血漿中Isoflavones濃度………………………………….. 54 (三)尿液中雌激素代謝產物………………………………….. 54 (四)血漿中Isoflavones濃度與尿液中雌激素代謝產物之間的相關性……………………………..……………………… 55 實驗二、素食停經婦女補充藻類DHA對其心臟血管疾病危險因子之影響…………………………………………………….. 56 (一)受試者人數……………………………………………….. 56 (二)樣本數…………………………………………………….. 56 (三)血脂正常之受試者的結果……………………………….. 56 (四)血脂偏高之受試者的結果……………………………….. 59 (五) DHA補充後尿液中Estrogen代謝產物的變化…………. 60 第五章 討論…………………………………………………. 61 實驗一、葷食與素食停經婦女血漿Isoflavones濃度與尿液中Estrogen代謝物排出量之比較………………………… 61 實驗二、素食停經婦女補充藻類DHA對其心臟血管疾病危險因子之影響……………………………………………….. 63 (一)血脂正常之受試者……………………………………….. 63 (二)血脂偏高之受試者……………………………………….. 67 (三) DHA補充後尿液中Estrogen代謝產物的變化…………… 70 第六章 結論……………………………………………... 71 參考文獻……………………………………………. 127 附錄一 受試者邀請書………………………………………... 152 附錄二 問卷……………………………………………………... 155 附錄三 同意書…………………………………………………... 158 附錄四 收集尿液及抽血注意事項…………………………... 159 表 目 錄 表一、Basic characteristics of omnivores and vegetarians…………………. 73 表二、Plasma content of daidzein and genistein in omnivores and vegetarians…………………………………………………. 74 表三、Urinary excretion of 2OHE1 and 16αOHE1 in omnivores and vegetarians…………………………………………………. 75 表四、Correlation1 between urinary 2OHE1/creatinine, 16αOHE1/creatinine or 2OHE1/16αOHE1 and plasma isoflavones concentration………... 76 表五、Basic characteristics of normolipidemic subjects……77 表六、Concentration of plasma and VLDL-triglyceride before and after supplementation in normolipidemic subjects… 78 表七、The changes of plasma and lipoproteins triglyceride concentration before and after supplementation in normolipidemic subjects…… 79 表八、Concentration of plasma and lipoproteins-cholesterol before and after supplementation in normolipidemic subjects……………………… 82 表九、The changes of plasma and lipoproteins cholesterol concentration before and after supplementation in normolipidemic subjects…… 89 表十、Concentration of plasma lipoprotein (a) before and after supplementation in normolipidemic subjects…… 90 表十一、Thiobarituric acid reactive substances (TBARS) production and lag time of conjugated dienes formation of LDL oxidized by copper before and after supplementation in normolipidemic subjects……. 92 表十二、Plasma total antioxidant status (TAS) after supplementation…….. 93 表十三、Concentration of plasma α-tocopherol before and after supplementation in normolipidemic subjects……… 94 表十四、Urinary excretion of isoprostane before and after supplementation in normolipidemic subjects………….... 96 表十五、Urinary excretion of nitric oxide before and after oil supplement 98 表十六、Concentration of LDL-EPA&DHA before and after supplementation in normolipidemic subjects……….…... 100 表十七、Basic characteristics of hyperlipidemic subjects…103 表十八、Concentration of plasma anf VLDL-triglyceride before and after supplementation in hyperlipidemic group……104 表十九、Concentration of plasma and lipoproteins-cholesterol before and after supplementation in hyperlipidemic group………….……… 107 表二十、Concentration of plasma lipoprotein (a) before and after supplementation in hyperlipidemic group………… 114 表二十一、Thiobarituric acid reactive substances (TBARS) production and lag time of conjugated diene formation of LDL oxidized by copper before and after supplementation in hyperlipidemic group………………………………………… 116 表二十二、Concentration of plasma α-tocopherol before and after supplementation in hyperlipidemic group……... 117 表二十三、Urinary excretion of nitric oxide before and after DHA supplementation in hyperlipidemic group… 119 表二十四、Urinary excretion of isoprostane before and after DHA oil supplement in hyperlipidemic group……. 121 表二十五、Concentration of LDL-EPA&DHA before and after supplementation in hyperlipidemic group…….. 123 表二十六、Effect of DHA oil supplementation on in vegetarians…………. 126 圖 目 錄 圖一、Concentration of plasma triglyceride before and after supplementation in normolipidemic subjects……………… 80 圖二、Concentration of plasma VLDL-triglyceride before and after in supplementation in normolipidemic subjects……81 圖三、Concentration of plasma cholesterol before and after supplementation in normolipidemic subjects……………… 83 圖四、Concentration of plasma VLDL-cholesterol before and after supplementation in normolipidemic subjects…………84 圖五、Concentration of plasma LDL-cholesterol before and after supplementation in normolipidemic subjects…………85 圖六、Concentration of plasma HDL-cholesterol before and after supplementation in normolipidemic subjects……………86 圖七、Concentration of plasma HDL2-cholesterol before and after supplementation in normolipidemic subjects……… 87 圖八、Concentration of plasma HDL3-cholesterol before and after supplementation in normolipidemic subjects……………88 圖九、Concentration of plasma lipoprotein (a) before and after supplementation in normolipidemic subjects…………91 圖十、Concentration of plasma α-tocopherol before and after supplementation in normolipidemic subjects……… 95 圖十一、Urinary excretion of isoprostane before and after supplementation in normolipidemic subjects………….. 97 圖十二、Urinary excretion of nitric oxide before and after supplementation in normolipidemic subjects………….. 99 圖十三、Concentration of LDL-EPA before and after supplementation in normolipidemic subjects……………… 101 圖十四、Concentration of LDL-DHA before and after supplementation….. 102 圖十五、Concentration of plasma triglyceride before and after supplementation in hyperlipidemic group………… 105 圖十六、Concentration of plasma VLDL-triglyceride before and after supplementation in hyperlipidemic group………106 圖十七、Concentration of plasma cholesterol before and after supplementation in hyperlipidemic group…………. 108 圖十八、Concentration of plasma VLDL-cholesterol before and after supplementation in hyperlipidemic group………… 109 圖十九、Concentration of plasma LDL-cholesterol before and after supplementation in hyperlipidemic group…………. 110 圖二十、Concentration of plasma HDL-cholesterol before and after supplementation in hyperlipidemic group………… 111 圖二十一、Concentration of plasma HDL2-cholesterol before and after supplementation in hyperlipidemic group…… 112 圖二十二、Concentration of plasma HDL3-cholesterol before and after supplementation in hyperlipidemic group…………113 圖二十三、Concentration of plasma lipoprotein (a) before and after supplementation in hyperlipidemic group…… 115 圖二十四、Concentration of plasma α-tocopherol before and after supplementation………………………………………... 118 圖二十五、Urinary excretion of nitric oxide before and after supplementation…………………………………….. 120 圖二十六、Urinary excretion of isoprostane before and after supplementation……………………………………………….. 122 圖二十七、Concentration of LDL-DHA before and after supplementation… 124 圖二十八、Concentration of LDL-EPA before and after supplementation… 125

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