Publication:

苦瓜之多元保健功能研究開發-預防餐後高血脂與發炎反應的苦瓜保健食品研發

心血管疾病是台灣十大死因之一，餐後高血脂是心血管疾病的危險因子，餐後高血脂除了會造成血脂異常及血管內皮細胞功能不正常，也會誘發發炎反應。流行病學的研究顯 示，前期糖尿病是糖尿病及心血管疾病的獨立危險因子，如果脂肪代謝可以正常化，例 如降低餐後高血脂，也許可以避免前期糖尿病患者發展成糖尿病。最近的研究發現苦瓜 可以活化peroxisome proliferator-activated receptor (PPAR)α及PPARγ，臨床上已利用各種 PPARα及PPARγ活化劑，治療血糖血脂異常，以及控制發炎反應。本研究假設苦瓜可以 透過活化PPARα及PPARγ，對健康年輕人以及中年前期糖尿病患者，改善餐後高血脂 及發炎反應。本研究將使用雙盲交叉控制設計，在此三年計畫的第一年，將以20 名健 康年輕男性與20 名女性為對象，探討補充苦瓜萃取物2週(5g/d) 後，對口服脂肪耐受 度試驗後6小時期間，血漿三酸甘油酯、游離脂肪酸、甘油、葡萄糖、胰島素濃度及曲 線下面積的影響，並探討餐後6 小時期間脂肪與醣類氧化速率。第二年將以20名男性與20名女性前期糖尿病患者為對象，探討探討補充苦瓜萃取物2 週後，對口服脂肪耐 受度試驗後6小時期間脂肪代謝的影響。第三年仍以20名男性與20名女性前期糖尿病 患者為對象，探討補充苦瓜萃取物2 週後，對口服脂肪耐受度試驗後6 小時期間，免疫指標的影響，並分析週邊血液單核球中，各項發炎細胞激素mRNA 的表現量。本研究 結果將可提供科學的證據，顯示苦瓜是否有助於一般健康族群，或是前期糖尿病患者，改善餐後脂肪代謝與發炎狀況，進而降低罹患心血管疾病及糖尿病的機率。

Cardiovascular disease is one of the leading causes of death in Taiwan. Postprandial hyperlipidemia has been considered as one of the risk factors for the development of cardiovascular disease. Postprandial hyperlipidemia has been shown to result in atherogenic lipid profiles, endothelial dysfunction and induce a pro-inflammatory state. Several epidemiological studies have shown that prediabetes is an independent risk factor for diabetes and cardiovascular disease. If lipid homeostasis, such as postprandial triglyceride clearance, can be restored in subjects with prediabetes, the risk for diabetes and cardiovascular disease may be reduced. Recently, a potent activation effect on peroxisome proliferator-activated receptor (PPAR)α and PPARγ has been identified in bitter gourd extract. The agonists of PPARα and PPARγ have been widely used in clinical settings to improve glucose and lipid homeostasis and control inflammation. With the effect of dual activation of PPARα and PPARγ, we hypothesize that bitter gourd may ameliorate postprandial hyperlipidemia and inflammation in young healthy and middle-aged prediabetic subjects. This study will use double-blind, cross-over, placebo-controlled design. In the first year of this 3-year project, the effect of a 2-week supplementation of bitter gourd extract (5 g/d) on postprandial lipid metabolism after an oral fat tolerance test will be investigated in 20 young healthy males and 20 females. Plasma concentrations and area under the curve of triglycerides, non-esterified fatty acid, glycerol, glucose and insulin during the 6-hr postprandial period will be measured. The fat and carbohydrate oxidation rate during the postprandial period will also be measured. In Year 2, the effect of a 2-week supplementation of bitter gourd extract on postprandial lipid metabolism after an oral fat tolerance test will be investigated in 20 males and 20 females with prediabetes. In Year 3, plasma inflammation markers will be examined during the 6-hr postpradial period after an oral fat tolerance test in 20 males and 20 females with prediabetes. In addition, the mRNA levels of inflammatory cytokines in peripheral blood mononuclear cells during the same period will be analyzed. The results of this study can provide scientific evidence for the potential role of bitter gourd in preventing cardiovascular disease and diabetes in general and prediabetic populations.