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研究生: 鐘晨日
Chen-Jih Chung
論文名稱: 停經婦女攝取山藥對血脂、抗氧化能力與性激素的影響
The effects of dietary Dioscorea on blood lipids, antioxidant status and sex hormones in postmenopausal women
指導教授: 吳文惠
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: 2003
畢業學年度: 91
語文別: 中文
中文關鍵詞: 山藥停經婦女性激素血脂抗氧化雌激素代謝物
英文關鍵詞: Dioscorea, post-menopausal woman, sex hormone, blood lipids, antioxidant, urinary estrogen metabolite
論文種類: 學術論文
相關次數: 點閱:208下載:32
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  • 停經婦女攝取山藥對血脂、抗氧化能力與性激素的影響
    摘要
    本研究為釐清古今中外傳聞山藥有促進性激素活性與瞭解山藥對血脂、抗氧化的影響。招募本校附近健康、飲食規律、半年內無使用雌激素的停經婦女共23位。以山藥餐點取代受試者一天中約2/3的主食 (約390g/天),共29天,期間維持體重不變。食用前後收集血液與尿液共兩次,比較血糖、血脂(血漿及各種脂蛋白中的三酸甘油酯、膽固醇含量)、抗氧化(血清中總抗氧化狀態、LDL氧化遲滯期和 Thiobarbituric acid reactive substance (TBARS)產生量、尿液isoprostane排出量)與性激素﹝血清Estrone、Estradiol、Sex-hormone binding globulin (SHBG)、Dehydroepiandrosterone sulfate (DHEAS)、Testosterone、Androstenedione、Follicle stimulating hormone、Luteinizing hormone與尿液雌激素代謝物﹞的變化。結果顯示,攝食山藥後,身體組成與熱量攝取皆無顯著變化。血漿總膽固醇的濃度降低 (p=0.012),但血漿三酸甘油酯與各種脂蛋白中的膽固醇、三酸甘油酯及血糖無顯著改變;尿液中isoprostane 的濃度顯著減少(p=0.000), LDL在體外以銅氧化的遲滯期延長 (p=0.058),表示山藥提供抗氧化性,但血清總抗氧化狀態與LDL氧化TBARS產生量並無顯著改變;血清中Estrone (p=0.025)、SHBG (p=0.04) 與Estradiol (p=0.075) 的濃度上升,尿液雌激素代謝物總量與16α-OHE1的排出量降低 (p=0.002)。結論,山藥可下降血漿總膽固醇,促進抗氧化能力,增加血液雌激素、性激素結合蛋白質的濃度與降低尿液雌激素的代謝物16α-hydroxyestrone排出量,對停經婦女在乳癌與心血管疾病的預防上也許會有助益。

    The effects of dietary Dioscorea on blood lipids, antioxidant status and sex hormones in postmenopausal women
    Abstract
    To investigate the effects of Dioscorea intake on the levels of blood lipids, antioxidant capacity and sex-hormones, 23 apparently healthy postmenopausal women with regular dietary habit and without hormone replacement therapy for at least 6 months were recruited. During intervention, rice in 2 of 3 meals was replaced by Dioscorea ( ~390 g/d) for 29 days and body weights were maintained constantly. Fasting blood and first morning urine samples were collected before and after Dioscorea intervention for the measurements of blood sugar, blood lipids, antioxidant capacity (the susceptibility of LDL to oxidation, serum total antioxidant status and urinary isoprostane level) and sex hormones (serum Estrone, Estradiol, Sex hormone binding globulin (SHBG), Dehydroepiandrosterone sulfate (DHEAS), Testosterone, Androstenedione, Follicle stimulating hormone, Luteinizing hormone and urinary estrogen metabolites). The results showed that plasma total cholesterol concentration(p=0.012), urinary isoprostane (p=0.000) and genotoxic estrogen metabolite (16α-OHE1) (p=0.002) excretion decreased significantly, serum Estrone (p=0.025) and SHBG (p=0.04) concentrations increased significantly. Estradiol concentrations increased but the increase did not reach a significant level (p=0.075). The lag time of conjugated diene formation of LDL oxidized by copper was longer than at the baseline (p=0.058). There were no significant difference in body composition, total calorie intake, blood sugar, plasma triglycerides, serum total antioxidant status, and other hormones measured when compared with those at the baseline. This study showed that Dioscorea intake improved estrogen status, increased protective SHBG, antioxidative ability and decreased plasma cholesterol in postmenopausal women and might suggest the beneficial effects of Dioscorea in decreasing the risks of breast cancer and cardiovascular diseases.

    目 錄 中文摘要 1 英文摘要 2 第一章 緒論 ……………………………………………………………… 3 第一節 研究背景與動機………………………………………………… 3 第二節 研究目的………………………………………………………… 5 第三節 名詞界定………………………………………………………… 5 第四節 縮寫……………………………………………………………… 6 第二章 文獻探討…………………………………………………………………… 8 第一節 山藥的簡介………………………………………………………… 8 一、山藥的源起…………………………………………………………… 8 二、山藥的物種…………………………………………………………… 8 三、山藥之一般成分與特殊成分………………………………………… 9 第二節 山藥的生理作用…………………………………………………… 12 一、性激素方面…………………………………………………………… 12 二、血脂與抗氧化方面…………………………………………………… 14 三、對血糖與腎功能的影響……………………………………………… 16 四、其他方面的影響……………………………………………………… 17 第三節 停經婦女的生理及性激素的變化………………………………… 18 一、停經婦女的定義與生理變化………………………………………… 18 二、停經婦女性激素的變化……………………………………………… 19 (一)、雌激素與雄性激素………………………………………………… 19 (二)、雌激素代謝物( 2-OHE1和16α-OHE1) …………………………… 23 (三)、性激素結合球蛋白(sex hormone binding globulin;SHBG ) …… 25 第三章 研究設計與實施……………………………………………………………… 27 第一節 研究對象…………………………………………………………… 27 第二節 研究設計…………………………………………………………… 28 第三節 實驗器材…………………………………………………………… 31 第四節 實驗材料…………………………………………………………… 32 第五節 分析項目與方法…………………………………………………… 35 一、山藥成分分析………………………………………………………… 35 二、血液的收集…………………………………………………………… 37 三、血漿的分離…………………………………………………………… 37 四、尿液的收集…………………………………………………………… 38 五、尿液與血液creatinine含量測定……………………………………… 38 六、血漿中抗氧化狀態的測定…………………………………………… 39 七、血糖的測定…………………………………………………………… 39 八、低密度脂蛋白的透析及其蛋白質濃度的測定……………………… 40 九、TBA (Thiobarbituric Acid)反應生成物測定………………………… 40 十、Conjugated Diene 生成之測量……………………………………… 41 十一、尿液中isoprostane含量分析……………………………………… 41 十二、血液脂質之分析…………………………………………………… 44 十三、血液Estrone 之分析……………………………………………… 46 十四、Estradiol……………………………………………………………… 47 十五、Dehydroepiandrosterone sulfate (DHEAS) ………………………… 48 十六、Androstenedione…………………………………………………… 48 十七、Testosterone………………………………………………………… 49 十八、FSH與LH…………………………………………………………… 49 十九、SHBG………………………………………………………………… 50 二十、尿液Estrogen代謝物2-OHE1/16α-OHE1含量測定……………… 51 二十一、身體組成分析……………………………………………………. 52 第六節 實驗品質控制……………………………………………………… 53 第七節 統計分析方法……………………………………………………… 55 第八節 實驗限制…………………………………………………………… 56 第四章 結果………………………………………………………………………… 57 第一節 山藥成分分析……………………………………………… 57 第二節 受試者招募情形、基本資料與問卷調查結果…………………. 57 一、受試者招募…………………………………………………………… 57 二、受試者基本資料……………………………………………………… 58 三、受試者飲食、藥物服用與運動習慣調查…………………………… 58 四、受試者臨床表徵方面………………………………………………… 59 第三節 生化分析……………………………………………………. 60 一、血清中性激素濃度的變化情形……………………………….... 60 二、尿液中雌激素代謝物分布的情形………………………………. 61 三、血液與各種脂蛋白中膽固醇濃度的變化…………………….… 61 四、血液與各種脂蛋白中三酸甘油脂濃度的變化………………….. 61 五、LDL氧化conjugated diene 形成之lag time 及變化情形……….. 61 六、LDL氧化TBARS產生及變化情形…………………………… 62 七、血漿中總抗氧化狀態與尿液中氧化物isoprostane濃度變化……. 62 八、血液中血糖濃度與血清中creatinine濃度的變化………………. 62 第四節 攝取山藥前後,各測試值變化量之相關性…………………… 63 第五章 討論 ……………………………………………………………. 64 第一節 山藥成分分析……………………………………………….. 64 一、蛋白質……………………………………………………….... 64 二、膳食纖維……………………………………………………… 64 三、草酸…………………………………………………………... 65 四、薯蕷皂甘……………………………………………………… 66 第二節 受試者基本資料與攝食情形…………………………………. 66 一、受試者體位…………………………………………………... 66 二、受試者個人資料與攝食情形…………………………………... 67 第三節 血清中性激素濃度的變化……………………………………. 68 一、雌激素(estrogen)與雄性激素(androgen)………………………… 68 二、FSH與LH……………………………………………….…... 70 三、SHBG………………………………………………………... 70 第四節 尿液中雌激素代謝物分布的變化…………………………….. 72 第五節血液與各種脂蛋白中膽固醇與三酸甘油脂濃度的變化……….…. 74 一、血液與各種脂蛋白中膽固醇濃度的變化……………………….. 74 二、血液與各種脂蛋白中三酸甘油脂濃度的變化…………………... 74 第六節抗氧化性的變化…………………………………………..….. 75 第七節血糖濃度的變化…………………………………………….... 76 第六章 結論…………………………………………………………… 77 參考文獻 ………………………………………………………………… 78 附錄一 邀請停經婦女參加攝食山藥之計劃……………………………... 119 附錄二 問卷調查………………………………………………………. 121 附錄三 同意書…………………………………………………………. 124 附錄四 收集尿液與血液注意事項………………………………………. 125 附錄五 循環菜單………………………………………………………. 126 表目錄 表一、 山藥成分分析………………………………………………….. 97 表1.1、 山藥中薯蕷皂甘配基之檢測含量………………………………. 98 表二、 受試者基本資料……………………………………………….. 99 表三、 受試者身體組成的變化…………………………………………. 100 表四、 受試者食用山藥期間體重的變化情形…………………………… 101 表五、 受試者食用山藥前後總熱量與碳水化合物、蛋白質與脂肪的攝取情形……………………………………………………………... 102 表六、 受試者食用山藥前後血清中性激素之濃度………………………. 103 表七、 受試者食用山藥前後,尿液雌激素代謝物(2-OHE1 and 16α-OHE1)的分佈……………………………………………………….…... 104 表八、 受試者食用山藥前後血漿與各種脂蛋白中膽固醇的濃度………… 105 表九、 受試者食用山藥前後血漿與各種脂蛋白中三酸甘油脂的濃度…….. 106 表十、 受試者食用山藥前後LDL以銅離子催化氧化反應時conjugated diene形成之lag time 與TBARS 產生量及變化情形…………….. 107 表十一、 受試者食用山藥前後血漿中總抗氧化狀態與尿液中氧化物的濃度.. 108 表十二、 受試者食用山藥前後血液中血糖與肌酸酐的濃度……………….. 109 表十三、 攝食山藥後受試者血液中性激素、血脂、抗氧化、尿液中雌激素代謝物及isoprostane測量值變化量之間的相關……………………. 110 表十四、 Comparison of the values of urinary excretion of 2-OHE1 and 16α-OHE1 assayed in this and other studies ……………………….. 111 表十五、 本研究攝取山藥與其他補充黃豆異黃酮研究對停經婦女血液SHBG、FSH 與 E2影響之差異………………………………… 112 表十六、 本研究與其他研究血液性激素之數值比較………………………. 113 圖目錄 圖一、 Diosgenin 化學結構圖…………………………………………. 11 圖二、 性激素的合成途徑……………………………………………... 21 圖三、 雌激素的代謝途徑……………………………………………... 22 圖四、 受試者食用山藥期間體重的變化情形…………………………… 101 圖五、 本研究山藥塊莖與葉片圖………………………………………. 33 圖六、 每位受試者在食用山藥前後,血液中SHBG濃度的變化量………. 116 圖七、 每位受試者在食用山藥前後,以銅離子催化LDL氧化反應時conjugated diene 形成之lag time 的變化………………………… 117 圖八、 每位受試者在食用山藥前後,尿液雌激素代謝物16α-OHE1 的變化量……………………………………………………………… 118

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