米麩榖粉對第 2型糖尿病患血糖、胰島素及血脂質濃度之影響

近年來研究顯示，以米麩油取代烹調用油，能顯著降低高脂血症患者血漿總膽固醇及三酸甘油酯濃度。給予糖尿病大鼠 15% 米麩油介入飲食，能顯著降低血漿中三酸甘油酯濃度及胰島素抗性，增加糞便中性固醇及膽酸的排出。然而，米麩油的介入對第 2 型糖尿病患者的影響仍未知，因此，本研究旨在探討米麩油的攝取對第 2 型糖尿病患者血脂質及胰島素抗性之影響。實驗設計採隨機、單盲、安慰劑對照試驗。受試者為台北醫學大學附設醫院及羅東博愛醫院 30-80 歲第 2 型糖尿病患者共 35 名。將受試者隨機分成兩組：安慰劑組 (Placebo 組 ) 及米麩油組 (RBO 組 ) ， Placebo 組每天攝取 1 瓶 250 mL 大豆油仿製乳 ( 內含 18 g 大豆油 ) ，而 RBO 組每天攝取 1 瓶 250 mL 米麩油仿製乳 ( 內含 18 g 米麩油 ) ，為期 5 週。研究期間，受試者的早餐以米麩油或大豆油仿製乳取代，其餘維持平日飲食、不改變生活習慣及用藥情形。受試者在第 0 及 5 週進行口服葡萄糖耐受試驗並收集血液樣本。結果顯示，RBO 組攝取米麩油仿製乳 5 週後，血清總膽固醇及血漿中多元不飽和脂肪酸顯著降低、低密度脂蛋白膽固醇濃度有降低的趨勢，胰島素抗性指標 HOMA-IR 值無顯著改變。 Placebo 組攝取大豆油仿製乳 5 週後，血清低密度脂蛋白膽固醇濃度及胰島素抗性指標 HOMA-IR 值顯著增加、血漿單元不飽和脂肪酸顯著降低。結論，第 2 型糖尿病患者每天攝取含 18 g 米麩油仿製乳 5 週後，能顯著降低血清總膽固醇，而低密度脂蛋白膽固醇亦有降低的趨勢，胰島素抗性並無顯著的影響。

Effects of rice bran flour on blood glucose, insulin and lipids levels in type 2 diabetic mellitus patients

Rice bran is rich in dietary fiber and unsaturated fatty acids. Rice bran oil could decrease blood cholesterol concentrations. The aim of this study was to investigate the effect of rice bran supplementation for 12 weeks on blood glucose, glycated hemoglobin, insulin and free fatty acid, lipids and adiponectin concentrations in type 2 diabetes mellitus patients. Thirty-eight type 2 diabetes subjects (16 men and 22 women), aged 35 to 78 years volunteered to participate in this study. Based on different glycated hemoglobin values (HbA1c < 7.8 (L) and HbA1c 7.8 (H)) and different flour supplements (rice bran flour (treatment, T) or rice flou≧r (placebo, P)) subjects were divided into four groups, including TL, TH, PL, and PH. Four groups were supplemented either with 20 g of rice bran flour or rice flour every day for 12 weeks. After 0, 4, 8, and 12 weeks, oral glucose tolerance test were conducted. Fasting venous blood from all subjects was examined for basic biochemical parameters, blood glucose, glycated hemoglobin, insulin, free fatty acid, low density lipoprotein cholesterol and adiponectin. All subjects kept dietary records. Results revealed that all subjects of four groups supplemented with two kinds of flour for 12 weeks did not induce any side effects. All subjects did not change their dietary habits. The area under the glucose curve of TH decreased significantly during the 12-wk test period (p < 0.05). HbA1c values of TH also decreased significantly during the 8-wk and 12-wk test periods (p < 0.05) and TL was significantly lower than PL group (p < 0.05). The area under the insulin curve for TH group was significantly higher than that of PH group (p < 0.05). TL and TH plasma free fatty acid concentration during a 4-wk and 8-wk consumption were significantly decreased (p < 0.05). Plasma LDL-C of TH group was significantly lower than that of PH group (p < 0.05). Plasma adiponectin of TL group was significantly lower than that of PL group (p < 0.05). In conclusion, consumptions of rice bran flour may significantly decrease the area under the glucose curve, HbA1c, free fatty acid and LDL-C concentrations and increase the area under the insulin curve and plasma adiponectin concentration