探討節螺藻萃取物複方補充對於慢性腎臟病患者腎功能、代謝指標及氧化壓力之影響

慢性腎臟病 (chronic kidney disease, CKD) 已連續 7 年位居國人十大死因第九位，文獻指出 CKD 患者承受較高的氧化壓力，這可能與抗氧化能力下降或清除氧化物質系統不足有關，亦會引起高血壓、血糖控制不良與血脂異常等代謝問題，這些慢性代謝疾病甚至會加重 CKD 病程。因此本研究目的為透過給予節螺藻萃取物、維生素C及穀胱甘肽補充劑後，探討對於 CKD 患者之腎功能、代謝相關指標與氧化壓力之影響。本研究於中國醫藥大學附設醫院腎臟科門診募集 86 位 CKD 2-3 期患者，並隨機分派給予安慰劑組（n = 21）、低劑量組（節螺藻萃取物250 mg /天，n = 20）、高劑量組（節螺藻萃取物 500 mg/天，n = 24）與複方組（節螺藻萃取物 500 mg/天 + 維生素 C 200 mg/天 + 穀胱甘肽 200 mg/天，n = 21），共介入 12 週。紀錄患者第 0、12 週的基本資料、疾病史及飲食紀錄，並分析患者腎功能、代謝相關指標、氧化壓力及抗氧化能力指標。結果發現高劑量節螺藻萃取物介入後可顯著降低血液尿素氮 (β = -4.84，p = 0.01)。而複方組介入 12 週後患者的三酸甘油酯、胰島素、胰島素阻抗顯著降低，穀胱甘肽還原酶活性顯著增加，硫代巴比妥酸反應物濃度顯著減少。進一步調整干擾因子後，發現給予複方組補充較安慰劑組之三酸甘油酯減少 52.8 mg/dL (p = 0.03)，胰島素減少 4.84 μIU/mL (p = 0.01) 與胰島素阻抗可降低 2.05 (p = 0.02)。因此，本研究證實 CKD 患者補充12週節螺藻萃取物複方後，雖無法改善腎功能，但可顯著改善三酸甘油酯、血糖代謝功能與氧化壓力與增加抗氧化能力。

Chronic kidney disease (CKD) has been ranked ninth among the top ten causes of death in Taiwan for 7 consecutive years, the past study has proposed that CKD patients are under excessive oxidative stress, which may be related to decreased antioxidant capacities or insufficient scavenging system of oxidative substances, which can lead to a cluster of metabolic disorders such as hypertension, uncontrolled blood sugar, and dyslipidemia. The above metabolic disorders may even aggravate the progression of CKD. Therefore, the purpose of this study was to explore the effects of Arthrospira extract, vitamin C and glutathione supplementation on renal function, metabolic indicators and oxidative stress in CKD patients. We recruited 86 stage 2-3 CKD patients from the nephrology outpatient clinics the China Medical University Hospital. Patients were randomly assigned to placebo (n = 21), low dose group (Arthrospira 250 mg/day, n = 20), high dose group (Arthrospira 500 mg/day, n = 24) or compounds group (Arthrospira 500 mg/day + Vitamin C 200 mg/day + Glutathione 200 mg/day) , n = 21) for 12 weeks. We recorded the subjects’ characteristics data, medical history and dietary records at the week 0 and 12th, and analyzed renal function, metabolism indicators, oxidative stress and antioxidant capacity indicators. The result revealed that blood urea nitrogen after intervention were significantly lower than before intervention in the high dose group (β = -4.84，p = 0.01), and the triglycerides, insulin, and insulin resistance were significantly decreased. Glutathione reductase activity was significantly increased, and thiobarbituric acid reactant concentrations were significantly decreased after intervention in compound group. After adjusting the potential confounders, the compound group supplementation significantly reduced the triglycerides by 52.8 mg/dL (p = 0.03), insulin by 4.84 μIU/mL (p = 0.01) and insulin resistance by 2.05 (p = 0.02) compared to the placebo group. In conclusion, this study confirmed that supplementing Arthrospira extract compound in CKD patients had significant beneficial effects on triglyceride and blood glucose metabolism, and decreased oxidative stress and increased antioxidant capacity, but it might not improve renal function in patients with CKD.