Journal of Nutrition and Health

The Korean Nutrition Society (한국영양학회)
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Association of total dietary antioxidant capacity with oxidative stress and metabolic markers among patients with metabolic syndrome

대사증후군 환자 및 위험군의 식사 내 총 항산화능과 산화스트레스 및 대사 지표의 연관성

  • Ham, Dongwoo (Department of Public Health, Graduate School of Public Health, Seoul National University) ;
  • Jun, Shinyoung (Department of Public Health, Graduate School of Public Health, Seoul National University) ;
  • Kang, Minji (Center for Gendered Innovations in Science and Technology Researches (GISTER), Korea Federation of Women's Science & Technology Associations) ;
  • Shin, Sangah (Department of Preventive Medicine, College of Medicine, Seoul National University) ;
  • Wie, Gyung-Ah (Department of Clinical Nutrition, Research Institute & Hospital, National Cancer Center) ;
  • Baik, Hyun Wook (Department of Internal Medicine, Division of Gastroenterology & Clinical Nutrition, DMC Bundang Jesaeng Hospital) ;
  • Joung, Hyojee (Department of Public Health, Graduate School of Public Health, Seoul National University)
  • 함동우 (서울대학교 보건대학원 보건학과) ;
  • 전신영 (서울대학교 보건대학원 보건학과) ;
  • 강민지 (한국여성과학기술단체총연합회 젠더혁신연구센터) ;
  • 신상아 (서울대학교 의과대학 예방의학교실) ;
  • 위경애 (국립암센터 임상영양실) ;
  • 백현욱 (분당제생병원 임상영양내과) ;
  • 정효지 (서울대학교 보건대학원 보건학과)
  • Received : 2017.05.04
  • Accepted : 2017.05.29
  • Published : 2017.06.30
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Abstract

Purpose: This study aimed to investigate the association of total dietary antioxidant capacity (TAC) with oxidative stress and metabolic markers among patients with metabolic syndrome according to gender. Methods: A total of 346 subjects aged 30~59 years with two or more risk factors of metabolic syndrome were recruited from a general hospital near Seoul in South Korea between 2010 and 2012 based on data from the medical checkup. Biochemical indices for oxidative stress and metabolic markers were measured. Food consumption data from 3-day food records were linked with the antioxidant capacity database for commonly consumed Korean foods to estimate individual's TAC. Results: Average dietary TAC of the study subjects was 132.0 mg VCE/d/1,000 kcal in men and 196.4 mg VCE/d/1,000 kcal in women. Levels of ${\gamma}$-glutamyltransferase (GGT), systolic blood pressure, diastolic blood pressure, and blood triglycerides were reduced significantly according to increasing TAC in men, but there was no significant trend in women. Intakes of total flavonoids and carotenoids were significantly negatively correlated with GGT (p < 0.05) and d-ROMs (p < 0.01) in men, whereas those of ${\alpha}$-tocopherol (p < 0.05) and ${\gamma}$-tocopherol (p < 0.05) were positively correlated with biological antioxidant potential (BAP) in women. The odds ratio of high oxidative stress indices and abnormal metabolic markers according to TAC level were not significant in either men or women. Conclusion: The results show that dietary TAC was partially associated with oxidative stress and metabolic markers among patients with metabolic syndrome. Further research is required for elucidating the association between dietary TAC and incidence of metabolic syndrome and chronic diseases within a large population in prospective studies.

본 연구에서는 수도권에 위치한 일개 종합병원의 건강검진 수검자 중 대사증후군 위험요인을 두 가지 이상 보유한 346명을 대상으로 건강검진과 설문조사 자료, 한국인 상용식품의 총 항산화능 데이터베이스와 연계한 식사 자료를 분석하여 성별에 따라 대사증후군 환자 및 위험군의 식사 내 총 항산화능과 그에 따른 산화스트레스 및 대사 지표의 특성을 파악하였다. 대상자들의 식사 내 평균 총 항산화능은 여성이 196.4 mg VCE/d/1,000 kcal, 남성이 132.0 mg VCE/d/1,000 kcal로 남성은 총 항산화능 수준이 높을 수록 GGT로 추정한 산화스트레스 수준과 수축기 이완기 혈압, 혈중 중성지질 농도의 이상자 비율이 유의하게 낮았던 반면 여성은 그렇지 않았다. 또한 남성은 플라바논, 안토시아니딘을 비롯한 플라보노이드의 섭취밀도가 GGT와, ${\alpha}$-카로틴, ${\beta}$-카로틴, 루테인/제아잔틴을 비롯한 카로티노이드의 섭취밀도가 d-ROMs과 유의한 음의 상관관계를 보인 반면 여성에서는 ${\alpha}$-토코페롤과 ${\gamma}$-토코페롤만이 BAP와 양의 상관관계를 보였다. 식사 내 총 항산화능 수준에 따른 높은 산화스트레스 수준과 대사 지표 이상자의 유병률 차이는 남녀 모두 유의하지 않았다. 추후 식사 내 총 항산화능과 대사증후군을 비롯한 만성질환의 관련성을 규명하기 위하여 대규모의 표본으로 전향적 연구를 진행할 필요가 있을 것이라 사료된다.

Keywords

References

  1. Grundy SM, Cleeman JI, Daniels SR, Donato KA, Eckel RH, Franklin BA, Gordon DJ, Krauss RM, Savage PJ, Smith SC Jr, Spertus JA, Costa F; American Heart Association; National Heart, Lung, and Blood Institute. Diagnosis and management of the metabolic syndrome: an American Heart Association/National Heart, Lung, and Blood Institute Scientific Statement. Circulation 2005; 112(17): 2735-2752. https://doi.org/10.1161/CIRCULATIONAHA.105.169404
  2. Kang JS, Kang HS, Yun EK, Choi HR. Factors influencing health behavior compliance of patients with metabolic syndrome. Korean J Adult Nurs 2012; 24(2): 191-199. https://doi.org/10.7475/kjan.2012.24.2.191
  3. Kang Y, Kim J. Soft drink consumption is associated with increased incidence of the metabolic syndrome only in women. Br J Nutr 2017; 117(2): 315-324. https://doi.org/10.1017/S0007114517000046
  4. Lee CJ, Joung H. Milk intake is associated with metabolic syndrome: using data from the Korea National Health and Nutrition Examination Survey 2007-2010. Korean J Community Nutr 2012; 17(6): 795-804. https://doi.org/10.5720/kjcn.2012.17.6.795
  5. Sabate J, Wien M. A perspective on vegetarian dietary patterns and risk of metabolic syndrome. Br J Nutr 2015; 113 Suppl 2: S136-S143. https://doi.org/10.1017/S0007114514004139
  6. Hong S, Song Y, Lee KH, Lee HS, Lee M, Jee SH, Joung H. A fruit and dairy dietary pattern is associated with a reduced risk of metabolic syndrome. Metabolism 2012; 61(6): 883-890. https://doi.org/10.1016/j.metabol.2011.10.018
  7. Esmaillzadeh A, Kimiagar M, Mehrabi Y, Azadbakht L, Hu FB, Willett WC. Dietary patterns, insulin resistance, and prevalence of the metabolic syndrome in women. Am J Clin Nutr 2007; 85(3): 910-918. https://doi.org/10.1093/ajcn/85.3.910
  8. Song S, Kim EK, Hong S, Shin S, Song Y, Baik HW, Joung H, Paik HY. Low consumption of fruits and dairy foods is associated with metabolic syndrome in Korean adults from outpatient clinics in and near Seoul. Nutr Res Pract 2015; 9(5): 554-562. https://doi.org/10.4162/nrp.2015.9.5.554
  9. Chung S, Ha K, Lee HS, Kim CI, Joung H, Paik HY, Song Y. Soft drink consumption is positively associated with metabolic syndrome risk factors only in Korean women: data from the 2007- 2011 Korea National Health and Nutrition Examination Survey. Metabolism 2015; 64(11): 1477-1484. https://doi.org/10.1016/j.metabol.2015.07.012
  10. Block G. The data support a role for antioxidants in reducing cancer risk. Nutr Rev 1992; 50(7): 207-213. https://doi.org/10.1111/j.1753-4887.1992.tb01329.x
  11. Chen J, He J, Hamm L, Batuman V, Whelton PK. Serum antioxidant vitamins and blood pressure in the United States population. Hypertension 2002; 40(6): 810-816. https://doi.org/10.1161/01.HYP.0000039962.68332.59
  12. Diaz MN, Frei B, Vita JA, Keaney JF Jr. Antioxidants and atherosclerotic heart disease. N Engl J Med 1997; 337(6): 408-416. https://doi.org/10.1056/NEJM199708073370607
  13. Bonomini F, Rodella LF, Rezzani R. Metabolic syndrome, aging and involvement of oxidative stress. Aging Dis 2015; 6(2): 109-120. https://doi.org/10.14336/AD.2014.0305
  14. Hirashima O, Kawano H, Motoyama T, Hirai N, Ohgushi M, Kugiyama K, Ogawa H, Yasue H. Improvement of endothelial function and insulin sensitivity with vitamin C in patients with coronary spastic angina: possible role of reactive oxygen species. J Am Coll Cardiol 2000; 35(7): 1860-1866. https://doi.org/10.1016/S0735-1097(00)00616-1
  15. Som S, Basu S, Mukherjee D, Deb S, Choudhury PR, Mukherjee S, Chatterjee SN, Chatterjee IB. Ascorbic acid metabolism in diabetes mellitus. Metabolism 1981; 30(6): 572-577. https://doi.org/10.1016/0026-0495(81)90133-5
  16. Van De Wier B, Koek GH, Bast A, Haenen GR. The potential of flavonoids in the treatment of non-alcoholic fatty liver disease. Crit Rev Food Sci Nutr 2017; 57(4): 834-855. https://doi.org/10.1080/10408398.2014.952399
  17. Kim JH, Baik HW, Yoon YS, Joung HJ, Park JS, Park SJ, Jang EJ, Park SW, Kim SJ, Kim MJ, Jeon DO, Cho HJ, Lee SJ, Im SG, Jang SK. Measurement of antioxidant capacity using the biological antioxidant potential test and its role as a predictive marker of metabolic syndrome. Korean J Intern Med 2014; 29(1): 31-39. https://doi.org/10.3904/kjim.2014.29.1.31
  18. Bulusu S, Sharma M. What does serum ${\gamma}$-glutamyltransferase tell us as a cardiometabolic risk marker? Ann Clin Biochem 2016; 53(Pt 3): 312-332. https://doi.org/10.1177/0004563215597010
  19. Mun JH, Lee SJ, Park JD. The risk factors of metabolic syndrome and its relation with ${\gamma}$-GTP in steel-mill workers. Korean J Occup Environ Med 2007; 19(1): 17-25.
  20. Tamaki N, Tomofuji T, Maruyama T, Ekuni D, Yamanaka R, Takeuchi N, Yamamoto T. Relationship between periodontal condition and plasma reactive oxygen metabolites in patients in the maintenance phase of periodontal treatment. J Periodontol 2008; 79(11): 2136-2142. https://doi.org/10.1902/jop.2008.080082
  21. Akcakaya H, Tok S, Dal F, Cinar SA, Nurten R. ${\beta}$-carotene treatment alters the cellular death process in oxidative stress-induced K562 cells. Cell Biol Int 2017; 41(3): 309-319. https://doi.org/10.1002/cbin.10727
  22. Jacob RA. The integrated antioxidant system. Nutr Res 1995; 15(5): 755-766. https://doi.org/10.1016/0271-5317(95)00041-G
  23. Jun S, Shin S, Joung H. Estimation of dietary flavonoid intake and major food sources of Korean adults. Br J Nutr 2016; 115(3): 480-489. https://doi.org/10.1017/S0007114515004006
  24. Jun S, Hong E, Joung H. Flavonoid intake according to food security in Korean adults: based on the Korea National Health and Nutrition Examination Survey 2007-2012. J Nutr Health 2015; 48(6): 507-518. https://doi.org/10.4163/jnh.2015.48.6.507
  25. Kim SA, Jun S, Joung H. Estimated dietary intake of vitamin A in Korean adults: based on the Korea National Health and Nutrition Examination Survey 2007-2012. J Nutr Health 2016; 49(4): 258-268. https://doi.org/10.4163/jnh.2016.49.4.258
  26. Kim SA, Jun S, Joung H. Estimated dietary flavonoids intake of Korean adolescent: based on the Korea National Health and Nutrition Examination Survey 2007-2012. J Nutr Health 2015; 48(6): 496-506. https://doi.org/10.4163/jnh.2015.48.6.496
  27. Cocate PG, Natali AJ, Alfenas RC, de Oliveira A, dos Santos EC, Hermsdorff HH. Carotenoid consumption is related to lower lipid oxidation and DNA damage in middle-aged men. Br J Nutr 2015; 114(2): 257-264. https://doi.org/10.1017/S0007114515001622
  28. Paschalis V, Theodorou AA, Kyparos A, Dipla K, Zafeiridis A, Panayiotou G, Vrabas IS, Nikolaidis MG. Low vitamin C values are linked with decreased physical performance and increased oxidative stress: reversal by vitamin C supplementation. Eur J Nutr 2016; 55(1): 45-53.
  29. Yang M, Chung SJ, Chung CE, Kim DO, Song WO, Koo SI, Chun OK. Estimation of total antioxidant capacity from diet and supplements in US adults. Br J Nutr 2011; 106(2): 254-263. https://doi.org/10.1017/S0007114511000109
  30. Godala MM, Materek-Kusmierkiewicz I, Moczulski D, Rutkowski M, Szatko F, Gaszynska E, Tokarski S, Kowalski J. Lower plasma levels of antioxidant vitamins in patients with metabolic syndrome: a case control study. Adv Clin Exp Med 2016; 25(4): 689-700. https://doi.org/10.17219/acem/41049
  31. Ishikawa S, Kayaba K, Gotoh T, Nakamura Y, Kajii E. Metabolic syndrome and C-reactive protein in the general population: JMS Cohort Study. Circ J 2007; 71(1): 26-31. https://doi.org/10.1253/circj.71.26
  32. Lee S, Park HS, Kim SM, Kwon HS, Kim DY, Kim DJ, Cho GJ, Han JH, Kim SR, Park CY, Oh SJ, Lee CB, Kim KS, Oh SW, Kim YS, Choi WH, Yoo HJ. Cut-off points of waist circumference for defining abdominal obesity in the Korean population. Korean J Obes 2006; 15(1): 1-9.
  33. Jun S, Chun OK, Joung H. Estimation of dietary total antioxidant capacity of Korean adults. Eur J Nutr. Forthcoming 2017.
  34. Diacron International s.r.l. (IT). d-ROMs Test [Internet]. Grosseto: Diacron International s.r.l.; [cited 2017 Apr 5]. Available from: http://www.diacron.com/index.php/en/products/kits-carratelli-panel/d-roms-test.
  35. Diacron International s.r.l. (IT). BAP Test [Internet]. Grosseto: Diacron International s.r.l.; [cited 2017 Apr 5]. Available from: http://www.diacron.com/index.php/en/products/kits-carratellipanel/bap-test.
  36. Lee K, Han J, Kim SG. Increasing risk of diabetes mellitus according to liver function alterations in electronic workers. J Diabetes Investig 2014; 5(6): 671-676. https://doi.org/10.1111/jdi.12202
  37. World Health Organization. C-reactive protein concentrations as a marker of inflammation or infection for interpreting biomarkers of micronutrient status [Internet]. Geneva: World Health Organization; 2014 [cited 2017 Jan 2]. Available from: http://apps.who.int/iris/bitstream/10665/133708/1/WHO_NMH_NHD_EPG_14.7_eng.pdf.
  38. Simao AN, Dichi JB, Barbosa DS, Cecchini R, Dichi I. Influence of uric acid and gamma-glutamyltransferase on total antioxidant capacity and oxidative stress in patients with metabolic syndrome. Nutrition 2008; 24(7-8): 675-681. https://doi.org/10.1016/j.nut.2008.03.021
  39. Demirbag R, Yilmaz R, Gur M, Celik H, Guzel S, Selek S, Kocyigit A. DNA damage in metabolic syndrome and its association with antioxidative and oxidative measurements. Int J Clin Pract 2006; 60(10): 1187-1193. https://doi.org/10.1111/j.1742-1241.2006.01042.x
  40. Faienza MF, Francavilla R, Goffredo R, Ventura A, Marzano F, Panzarino G, Marinelli G, Cavallo L, Di Bitonto G. Oxidative stress in obesity and metabolic syndrome in children and adolescents. Horm Res Paediatr 2012; 78(3): 158-164. https://doi.org/10.1159/000342642
  41. Skalicky J, Muzakova V, Kandar R, Meloun M, Rousar T. Oxidative stress and metabolic syndrome in obese adults with and without controlled diet restriction. Bratisl Lek Listy 2009; 110(3): 152-157.
  42. Puchau B, Zulet MA, de Echavarri AG, Hermsdorff HH, Martinez JA. Dietary total antioxidant capacity is negatively associated with some metabolic syndrome features in healthy young adults. Nutrition 2010; 26(5): 534-541. https://doi.org/10.1016/j.nut.2009.06.017
  43. Gregorio BM, De Souza DB, de Morais Nascimento FA, Pereira LM, Fernandes-Santos C. The potential role of antioxidants in metabolic syndrome. Curr Pharm Des 2016; 22(7): 859-869. https://doi.org/10.2174/1381612822666151209152352
  44. Han GM, Meza JL, Soliman GA, Islam KM, Watanabe-Galloway S. Higher levels of serum lycopene are associated with reduced mortality in individuals with metabolic syndrome. Nutr Res 2016; 36(5): 402-407. https://doi.org/10.1016/j.nutres.2016.01.003

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