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
Effects of rice bran oil on serum lipids and insulin resistance in type
2 diabetic patients
中文摘要 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。 英文摘要Recent studies have shown that hyperlipidemic individuals who replace cooking oils with rice bran oil have significant decreases in plasma total cholesterol and
triglyceride concentrations. In animal studies, diabetic rats fed a 15% rice bran oil diet had lower plasma triglyceride levels and lower insulin resistance, as well as greater fecal neutral sterol and bile acid excretion. In spite of such studies, the effects of rice bran oil on patients with type 2 diabetes mellitus are not yet fully understood.
Therefore, the aim of this study was to investigate the effect of rice bran oil
supplementation for 5 weeks on concentrations of plasma lipids and insulin resistance in individuals with type 2 diabetes mellitus. This was a randomized, single-blind, placebo-controlled trial. Thirty-five type 2 diabetic patients, 30 to 80 years of age, volunteered to participate in this study, which was conducted at Taipei Medical
(1) a placebo group that consumed soybean oil and (2) a group that consumed rice bran oil (RBO group). The placebo group consumed soybean oil in imitation milk (a 250-mL/serving provided 18 g soybean oil in 1 serving/day), and the RBO group consumed rice bran oil in imitation milk (a 250-mL/serving provided 18 g rice bran oil in 1serving/day) for 5 weeks. During the intervention period, the subjects made no other changes in their usual diets, lifestyles, or medications. The only dietary change was the addition of soybean oil or rice bran oil in imitation milk at breakfast. Oral glucose tolerance tests were administered at the beginning and the fifth week of the study. After 5 weeks of rice bran oil consumption, subjects in the RBO group had significant decreases in serum total cholesterol concentration and plasma
polyunsaturated fatty acids level, and tends to reduce low density lipoprotein cholesterol concentration, but no significant difference in insulin resistance indexes (HOMA-IR). After 5 weeks of soybean oil supplementation, subjects in the placebo group had significant increases in serum low-density lipoprotein cholesterol
concentrations and in HOMA-IR indexes, but significant decreases in plasma
monounsaturated fatty acid levels. In conclusion, ingestion of 18 g rice bran oil daily for 5 weeks in type 2 diabetic patients significantly decreases serum total cholesterol concentration, and tends to reduce low density lipoprotein cholesterol concentration, however, dose not affect insulin resistance.
