营养失调与治疗杂志

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临床营养学 2019：利用番茄类胡萝卜素平衡血压和皮肤健康的临床前和临床研究 - Yoav Sharoni - 内盖夫本·古里安大学

约阿夫·沙罗尼

氧化应激与高血压的发病机制有关，而高血压是心血管发病率和死亡率的危险因素。多项人体研究表明，番茄类胡萝卜素会影响人体健康的各个方面。在本次演讲中，作者将讨论两个问题：a) 平衡皮肤细胞对紫外线照射的反应；b) 减轻升高的生命体征。a) 多项人体研究表明，番茄类胡萝卜素可通过减少红斑和改善胶原蛋白生成与分解之间的平衡来减少紫外线引起的损伤。我们推测，番茄类胡萝卜素和多酚的混合物可能比它们活性总和所预期的保护皮肤的效果更好。事实上，我们了解到，番茄营养复合物（含番茄红素）与迷迭香提取物（含多酚鼠尾草酸）的混合物可协同降低炎症标志物并诱导皮肤细胞的抗氧化活性，以减少基质金属蛋白酶 (MMP) 为显著目标，从而可能减少胶原蛋白分解并延缓皮肤老化。 b) 高血压可能是心血管发病和死亡的危险因素。我们进行了剂量反应分析，以发现番茄营养复合补充剂在高血压患者中维持正常体征的最佳有效剂量。

 

为了测试类胡萝卜素的生物利用度，帮助者接受了为期四周的治疗，同时接受了 2、5 或 15 毫克番茄红素的 TNC 治疗。番茄红素、八氢番茄红素和八氢番茄红素的血液水平激增与剂量有关。结果表明，只有 15 毫克或更高剂量的 TNC 所达到的类胡萝卜素水平与高血压患者 SBP 的有益影响相关，而较低剂量和单独的番茄红素则不相关。结果表明，通过给予 8 周的番茄营养复合物（包含 15 毫克或 30 毫克番茄红素）治疗，收缩压生命体征显著降低。

 

用较低剂量或单独用 15 毫克合成番茄红素治疗没有显示出巨大的效果。为了检查类胡萝卜素的生物利用度，志愿者接受了四周的 TNC 治疗，TNC 提供 2、5 或 15 毫克番茄红素。番茄红素、八氢番茄红素和八氢番茄红素血液水平的上升与剂量有关。在使用不同剂量的番茄营养复合物治疗后，大多数番茄类胡萝卜素番茄红素、八氢番茄红素和八氢番茄红素的人体生物利用度与剂量有关。

 

Tomato Nutrient Complex, a proprietary tomato extract, was supplied by Lycored Ltd., Beer Sheva, Israel at doses like 5, 15 and 30 mg lycopene. Lycored also provided identically eyeing capsules with 15 mg synthetic lycopene (18–20% cis isomers) and placebo capsules containing soybean oil.

 

Sample size calculations were performed by using appropriate formulas based on 80% power and a two-sided α = 0.05 with assumption of a standard deviation of DBP equal to 3.8 mmHg. A clinically significant difference in DBP was determined at 3.0 mmHg. For the grit, the model size was 26 patients in each usage arm—in all, 130 participants.

 

The paired t-test or non-parametric signed-rank test was applied for testing the differences of the continuous assessments between all visits to the baseline. An ANOVA ideal consuming the Duncan method was smeared for testing the alterations in blood pressure changes between all study groups. Altogether examinations practical were two-tailed, and a p-value of 5% or less was measured statistically important. The data were analyzed using the SAS^® version 9.1 for Windows (SAS Institute, Cary, North Carolina). The lost data for initial extractions who were not substituted and who joined at smallest four weeks of the double-blind placebo-controlled phase of the study were handled as LOCFs (last observation carried forward).

 

61 patients with BP values in the choice of 130 < SBP < 145 mmHg or 80 < DBP < 95 mmHg were registered in the training and began treatment with a four-week single-blind placebo run-in phase. These patients were randomized for the double-blind placebo-controlled treatment phase. At registration, there remained 12 topics in each of the subsequent arms: TNC 5 mg, TNC 15 mg, synthetic lycopene 15 mg and placebo, in addition to 13 subjects in the TNC 30-mg arm. 46 subjects accomplished the eight-week action period and 15 (3 in each arm) released out of the study prematurely. There stood neither contrary effects stated throughout the whole study old-fashioned nor any significant changes in glucose, urea, creatinine, uric acid, sodium, potassium, chloride, cholesterol, triglycerides, AST, ALT, ALP, LDH, HDL, LDL levels, or in the blood count parameters.

 

The treatment arms were comparable with respect to all demographic and baseline characteristics. Baseline SBP and DBP measurements were not statistically significantly different. The mean age was 52.4 ± 8.2 years, and 73.8% were male. The mean SBP and DBP were 135.2 ± 7.4 mmHg and 82.0 ± 11.7 mmHg, respectively. There remained no statistically noteworthy alterations between the five arms in the baseline plasma lycopene concentrations; however, the mean concentration of the TNC 15-mg arm was somewhat higher than the other arms.

 

合成番茄红素效果较差的一个解释是番茄提取物制剂中存在其他活性营养素。事实上，在之前的研究中，我们开始发现番茄提取物中存在的类胡萝卜素和其他植物营养素（例如番茄红素、八氢番茄红素和八氢番茄红素）的抗癌作用在于它们的联合作用，这种联合作用比每种化合物单独的作用更具协同作用。为了测量其他番茄成分对降压效果的可能影响，我们在 25 名健康志愿者中分析了使用不同剂量 TNC 治疗后这些类胡萝卜素的生物利用度。虽然这些志愿者的特征与 BP 研究参与者的特征不同，但有关三种主要番茄类胡萝卜素剂量反应差异的信息可以阐明 BP 研究的结果，正如所讨论的那样。血液中番茄红素、植物黄烯和植物氟烯浓度的上升与剂量有关，TNC 15 mg 组显著高于 TNC 5 mg 组。治疗两周后，血浆中番茄红素、植物黄烯和植物氟烯浓度明显增加。

 

含有 15 毫克和 30 毫克番茄红素的 NC 耐受性良好，并显示出降低 HT 人群收缩压的功效，而较低剂量和独立的纯番茄红素不足以引起类似的效果。

 

^{底部注释：该研究部分在 2019 年 3 月 4 日至 6 日于西班牙巴塞罗那举行的第 24届} 国际临床营养会议上发表。