第3年 材料與方法
5. 受試者實驗前後血脂質的變化
不論安慰劑組或RB 組，每日額外攝取 38 公克白米穀粉或米麩穀粉對其血脂質含量皆無統 計上差異 (表四)。
研究指出，增加全穀類 (Liese et al., 2003) 及纖維 (Qi et al., 2005) 的攝取可降低餐後血糖 值 (Koh-Banerjee et al., 2003; Mann, 2002)。長時間的攝取全穀類較精緻穀類更能降低血糖值 (Jenkins et al, 1986)。研究指出，給予糖尿病患者每天攝取 40 克米麩纖維，可顯著降低空腹及 餐後血糖值 (Rodrigues et al., 2005)。給予糖尿病患者攝取米麩搭配 AHA Step-1 飲食 60 天 後，可顯著降低9%空腹血糖值 (Qureshi et al., 2002)。在本研究中也發現相似的結果，第 2 型糖尿病患者每天攝取38 公克米麩穀粉 (包含 21.7 公克米麩) 五週後，即能顯著的降低 10.3%
空腹血糖及2.5%糖化血色素。米麩榖粉較白米榖粉含有較高量的膳食纖維及油脂。而本實驗
之受試者所攝取 21.7 公克的米麩榖粉含有約 5.6 公克的膳食纖維及約 4.3 公克的米麩油，而 米麩油含較高量的單元不飽和脂肪酸 (45.2%)。Vessby 等人的研究中發現高量單元不飽和脂 肪 (MUFA) 的飲食較 SFA 飲食能改善胰島素敏感性 (Vessby et al., 2001)。在動物研究中發現 以STZ 誘導之糖尿病大白鼠，給予米麩飲食能有效減緩葡萄糖耐受試驗之血糖變化程度 (賴 等人, 2001)，可能是因為米麩中的膳食纖維可延緩食物的消化吸收，藉此改善餐後血糖反應 及胰島素濃度，有利於降低胰島素抗性及改善葡萄糖之耐受性 (Vinik & Jenkins, 1988)。也有 研究指出，可能是米麩中微量物質 (tocopherol、tocotrienols、γ-oryzanol、polyphenols) 影響 到葡萄糖的吸收、利用及排出，進而能夠改善血糖值 (Rukmini, 2000; Sharma & Rukmini, 1987;
Sugano & Tsuji, 1997; Lichtenstein et al., 1994; Nicolosi et al., 1991; Gerhardt & Gallo, 1998;
Rindi, 1996)。至於米麩影響血糖的機制為何，目前尚不清楚。在動物實驗，攝取米麩油較大 豆油能顯著降低血清低密度脂蛋白膽固醇、三酸甘油酯的濃度及增加胰島素的敏感性 (Chen
& Cheng, 2006)。在此產學計畫的第 2 年的計畫中，第 2 型糖尿病患者攝取 20 公克米麩穀粉 12 週後，可顯著的降低低密度脂蛋白膽固醇的濃度。而在本次第 3 年計畫中，給予受試者攝 取廠商所量產的米麩穀粉五週後對血脂質並無顯著的影響。推測可能是因為實驗期太短，導 致對血脂質並無顯著的影響。
結論
第2 型糖尿病患在攝取米麩穀粉 5 週後，可顯著的降低 2.5%糖化血色素。
Table 1 Characteristics of subjects.
Placebo Rice bran (RB)
Baseline Week 5 Baseline Week 5
men/women (n) 5/19
age (years) 54.0 ± 14.5
BMI (kg/m) 24.5 ± 2.9 24.4 ± 2.9 24.4 ± 2.8 24.5 ± 2.8 Systolic BP (mmHg) 123.2 ± 17.0 121.0 ± 16.6 122.8 ± 19.6 127.0 ± 20.1 Dystolic BP (mmHg) 73.0 ± 9.1 72.8 ± 9.0 73.9 ± 8.6 76.5 ± 8.1 1. Values are mean ± SD.
2. BMI, body mass index; BP, blood pressure.
Table 2 Average daily intake of energy, protein, fat and carbohydrate in twenty-four hour dietary recall in subjects during intervention periods.
Placebo RB
Baseline Week 5 Baseline Week 5
kcal/day 1480.0 ± 444.9 1570.8 ± 483.6 1621.6 ± 427.8 1593.4 ± 421.7 Protein (g) 53.6 ± 21.8 55.3 ± 18.3 55.8 ± 18.3 57.0 ± 19.1 Fat (g) 50.3 ± 19.0 53.1 ± 21.6 53.3 ± 20.0 56.7 ± 20.4 CHO (g) 204.1 ± 76.0 218.2 ± 75.0 226.7 ± 75.2 214.1 ± 62.9 T.D.F (g) 11.3 ± 5.0b 10.8 ± 5.7b 11.3 ± 4.5b 16.8 ± 5.3a Protein (%E) 14.3 ± 3.4 14.1 ± 2.5 13.8 ± 2.8 14.2 ± 2.7 Fat (%E) 31.1 ± 8.9 30.2 ± 8.2 30.1 ± 10.0 32.1 ± 7.8 CHO (%E) 54.9 ± 10.1 55.8 ± 8.9 55.6 ± 10.0 53.8 ± 8.2 1. Values are means ± SD.
2. Values in the same row with different superscripts are significantly different at P < 0.05.
3. CHO, carbohydrate; T.D.F., total dietary fiber; %E, % of energy.
Table 3 Blood glucose and HbA1C levels in intervention periods.
Placebo RB
Baseline Week 5 Change (%) Baseline Week 5 Change (%) Fasting plasma glucose (mg/dL) 140.3 ± 35.9 141.8 ± 42.6 2.3 ± 24.0 156.6 ± 40.3 137.1 ± 39.0* -10.8 ± 20.6 HbA1C (%) 7.57 ± 1.65 7.60 ± 1.55 0.7 ± 4.4 7.90 ± 1.73 7.67 ± 1.57* -2.5 ± 5.2 1. Values are means ± SD.
2. Values with asterisk (*) significantly different from baseline values.
Table 4 Serum lipid profiles in intervention periods.
Placebo RB
Baseline Week 5 Baseline Week 5
TC (mg/dL) 183.8 ± 37.6 188.0 ± 36.6 188.7 ± 42.0 187.0 ± 37.1 TG (mg/dL) 132.4 ± 67.2 137.1 ± 54.8 136.0 ± 67.6 136.0 ± 61.8 HDL (mg/dL) 41.4 ± 9.6 42.9 ± 10.7 43.0 ± 11.1 41.9 ± 8.8 LDL-C (mg/dL) 118.0 ± 33.3 125.1 ± 34.5 124.3 ± 38.4 123.6 ± 39.8 1. Values are means ± SD.
2. TC, total cholesterol; TG, triglyceride; HDL-C, high density lipoprotein cholesterol; LDL-C, low density lipoprotein cholesterol.
0
Figure 1. Mean effect of intervention periods on postprandial plasma glucose areas under curves (AUC) response. Values are mean ± SD.
0
Figure 2. Mean effect of intervention periods on postprandial serum insulin areas under curves (AUC) response. Values are mean ± SD.
總結
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計畫成果自評
1. 研究成果有達預期的結果：第 2 型糖尿病患者在攝取廠商所量產的米麩穀粉 5 週後，亦可
顯著的降低2.5%糖化血色素。所有米麩穀粉的重金屬及農藥含量皆符合安全範圍內。但
希望廠商將38 公克米麩穀粉 (包含 21.7 公克米麩穀粉及 16.3 公克白米穀粉)中白米穀粉量 盡量降低，更有利於第2 型糖尿病患者。因第 2 型糖尿病患每日攝取 20 克米麩榖粉(實驗 室自製)，長期 (12 週) 可顯著降低 5.9%糖化血色素，血糖控制差者在短期 (4 週) 可顯著 的降低3.9%糖化血色素。
成品規格
產品名稱 米麩穀粉(GIE 谷粉)
顏色 灰褐色
水份 6%
膳食纖維 ≥ 20%
油脂 > 15%
蛋白質 ≥ 10%
vitamin E ≥ 100 ppm
重金屬 以鉛計 0.2 ppm；測不出鎘
總生菌數 5 × 105 以下
酵母菌及黴菌 1× 102以下
大腸桿菌群 不得檢出
金黃葡萄球菌 不得檢出
沙門氏桿菌 不得檢出
殺蟲劑 歐殺松Acephate ＜ 0.5 ppm 陶斯松 Chlorpyrifos＜0.1 ppm 加保
利 Carbaryl ＜0.5 ppm 2.此產品已申請專利。
3.已與合作廠商進行技術轉移。