臺灣博碩士論文加值系統

在餵食高脂飲食鼠的研究發現，苦瓜可改善過氧化體增殖劑活化受體α/γ、胰島素阻抗及腹部肥胖，本研究主要目的為評估雜交種F1花蓮4號山苦瓜對臺灣成年人在代謝症候群的作用。本研究為開放標記先導型試驗，對象為符合美國心臟協會/國家心臟、肺臟及血液學會代謝症候群亞洲修訂版準則，研究期間為2008年5月至2009年4月。最後共有42位完成研究，其中21位為男性、21位為女性，平均年齡為45.7±1.8歲(範圍為23-63歲)。研究對象每日服用4.8g山苦瓜凍乾粉末膠囊補充劑3個月，及停止服用後各3個月(共6個月)，監測代謝症候群及其相關指標，以分析治療前後轉變情形。山苦瓜對代謝症候群影響以意向分析(intention-to-treat)準則之廣義線性混合模型統計分析，結果顯示，與開始服用山苦瓜前為參考值做比較，在往後6個月依序可發現有7.1% (平均標準誤差, p值; 3.7%, 0.920)、9.5% (4.3%, 0.451)、19.0% (5.7%, 0.021)、16.7% (5.4%, 0.047)、11.9% (4.7%, 0.229) 及 11.9% (4.7%, 0.229)代謝症候群發生率的降低，再者腰圍亦有改善效果(p<0.05)，大部份受試者對山苦瓜皆有好的耐受度。本研究是第一個有關山苦瓜對代謝症候群作用的報告，可發現在服用第3個月及停止服用山苦瓜第1個月後，代謝症候群之改善可達統計學上顯著差異，本先導型飲食補充試驗可提供未來隨機控制試驗在山苦瓜效用一個良好的研究證據。

Bitter gourd has been shown to activate both PPARα/γ, ameliorate insulin resistance and abdominal obesity in high-fat fed mice. The aim of this study was to evaluate the effect of F1 hybrid Hualien wild bitter gourd No.4 (WBG; Momordica charantia L. var. abbreviata Seringe) on metabolic syndrome (MetS) in Taiwanese adults. A preliminary open-label uncontrolled trial was conducted in eligible fulfilled the diagnosis of MetS based on Asian guidelines of the American Heart Association/National Heart, Lung and Blood Institute between May 2008 and April 2009. Forty-two MetS patients (21 men and 21 women) with mean age of 45.7±1.8 years (range, 23-63 years) were recruited for the study. The subjects were supplemented with 4.8 gram of lyophilized powder of WBG in capsules daily for 3 months. MetS and associated parameters were monitored monthly for six consecutive months including 3 months of supplementation and another 3 months after the discontinuing supplementation. Effects of WBG on MetS were estimated using generalized linear mixed models according to the intention-to-treat principle. There were 7.1% (standard error of mean, p value; 3.7%, 0.920), 9.5% (4.3%, 0.451), 19.0% (5.7%, 0.021), 16.7% (5.4%, 0.047), 11.9% (4.7%, 0.229) and 11.9% (4.7%, 0.229) decrease in the incidence rate of MetS in the end of each month respectively after the start of the supplementation. The waist circumference also significantly decreased after the supplementation (p<0.05). The WBG supplementation was generally well-tolerated. This is the first report to show that WBG improved MetS. It reached the statistical significance in the third month and in the first month after discontinuing WBG supplementation. These preliminary results provide a firm base for further randomized control trials to evaluate the efficacy of WBG supplementation.

中文摘要 I
英文摘要 III
誌謝 V
目錄 VII
表目錄 XII
圖目錄 XIV
縮寫說明 XVI
第一章 前言 1
1.1 研究背景 2
1.2 研究目的 3
第二章 文獻探討 8
2.1 苦瓜之介紹 8
2.2 研究文獻之搜尋策略 16
2.3 苦瓜品系 17
2.4 苦瓜與血糖調節 18
2.5 苦瓜在調節代謝性相關疾患之活性成份及可能的作用或機轉 19
2.5.1 苦瓜活性成份 19
2.5.2 苦瓜於代謝性疾患可能的作用或機轉 25
2.6 苦瓜對於血糖控制之人體試驗 64
2.7 苦瓜製備劑型及劑量 72
2.7.1 苦瓜製備劑型 72
2.7.2 服用苦瓜劑量 72
2.8 服用苦瓜之副作用 73
2.8.1 苦瓜在動物試驗之副作用 73
2.8.2 苦瓜在人體試驗之副作用 73
2.9 代謝症候群 76
2.9.1 代謝症候群名稱及相關研究之沿革 89
2.9.2 常用之代謝症候群臨床準則 90
2.9.3 因素分析在代謝症候群診斷之角色 92
2.9.4 ABCDE方法在代謝症候群之全面性處置 94
2.9.5 ABCD診斷AHA/NHLBI之代謝症候群 96
2.9.6 胰島素阻抗 99
2.10 文獻總結 101
第三章 材料與方法 103
3.1 研究時間及對象 103
3.2 樣本數評估 103
3.3 步驟與方法 104
3.3.1 個案納入條件 104
3.3.2 個案排除條件 104
3.3.3 山苦瓜凍乾粉末補充劑 107
3.3.4 山苦瓜補充試驗流程 109
3.3.5 研究進度 110
3.3.6 試驗評估項目 112
3.4 血液樣品 114
3.5 統計分析 114
3.6 預期效益 118
第四章 結果與討論 119
4.1 受試者初始(VISIT 1)特徵 119
4.2 不同性別受試者特徵之差異分析 124
4.3 山苦瓜對受試者代謝症候群治療前後轉變率 128
4.3.1 山苦瓜對代謝症候群 5大指標之作用 134
4.3.2 山苦瓜對代謝症候群其他相關指標之作用 149
4.3.3 山苦瓜對血脂肪作用的綜合探討 156
4.4 服用山苦瓜之自覺症狀及副作用 158
4.5 研究限制 160
4.6 結論 161
4.7 未來研究方向 162
參考文獻 163
附錄 203
1. 各臨床試驗期別定義、目標與特色 203
2. 與本研究相關之發表論文摘要 204
簡歷 211
現任 211
學歷 211
經歷 211
專長 212
榮譽 213
國家型研究計劃(共同主持人) 213
其他研究計劃 213
SCI 論文 215
國內雜誌論文 216
學術研討會 223

表目錄
表1.1台灣十大死因 ............................................................................................ 4
表1.2 國人代謝症候群相關疾病醫療費用 ....................................................... 5
表1.3 ABCDE方法在代謝症候群之全面性處置 ............................................. 6
表 2.1 苦瓜名稱 ................................................................................................. 13
表 2.2 苦瓜成份 ................................................................................................. 15
表 2.3 苦瓜在調節代謝性相關疾患之可能活性成份 .................................... 23
表 2.4 苦瓜在調節代謝性相關疾患之可能作用或機轉 ................................ 27
表 2.5 過氧化體增殖劑活化受體特性 ............................................................. 40
表 2.6 以DIABETES M綜觀糖尿病處置 .......................................................... 56
表 2.7 美國糖尿病學會與歐洲糖尿病學會降血糖步驟之共識 .................... 63
表 2.8 苦瓜在血糖控制之人體試驗(依發表年代排序) .................................. 67
表 2.9 苦瓜之副作用 ......................................................................................... 75
表 2.10 代謝症候群之沿革 ............................................................................... 79
表 2.11 常用之代謝症候群臨床定義 ............................................................... 82
表 2.12 修正前、後之臺灣版20歲以上成人代謝症候群判定標準對照表 84
表 2.13 ABCD診斷NCEP ATP III代謝症候群 .............................................. 86
表 2.14 1998年正常體重者之代謝性肥胖(MONW)診斷標準 ...................... 97
表3.1 研究進度甘特表 ................................................................................... 111
表4.1受試者特徵(N=42) ................................................................................. 121
表4.2 受試者生活習慣及病史特徵(N=42) .................................................... 122
表4.3 受試者代謝症候群指標檢查特徵(N=42) ............................................ 123
表4.4 不同性別受試者特徵之差異分析 ....................................................... 125
表4.5山苦瓜對受試者治療前後代謝症候群之發生率 ................................ 131
表4.6山苦瓜對受試者腰圍之作用(N=42) ..................................................... 137

圖目錄
圖 2.1苦瓜不同生長階段、各種不同苦瓜與苦瓜種子 ................................. 10
圖 2.2 國內外苦瓜製劑 ..................................................................................... 14
圖 2.3 9C, 11T, 13T-共軛次亞麻油酸 .............................................................. 22
圖 2.4磺醯尿素類藥物活化作用路徑圖 ......................................................... 32
圖 2.5過氧化體增殖劑活化受體之5個蛋白質功能區塊保留序列 ............. 39
圖 2.6過氧化體增殖劑活化受體活化作用路徑圖 ......................................... 44
圖 2.7 轉譯活化作用及轉譯活化抑制 ............................................................. 46
圖 2.8醫師在臨床發現之代謝性疾病個案只是冰山一角 ............................. 85
圖 2.9 代謝症候群：臨床醫師的共同課題 ..................................................... 87
圖3.1 研究流程及檢測項目 ........................................................................... 106
圖3.2 山苦瓜人體試驗前置作業及服用劑型 ............................................... 108
圖3.3研究計劃進度 ........................................................................................ 109
圖4.1 受試者流程 ........................................................................................... 120
圖4.2 山苦瓜對治療前後代謝症候群之發生率 ........................................... 132
圖4.3 以45 歲為界分組檢測山苦瓜對代謝症候群之發生率 .................... 133
圖4.4山苦瓜於治療前後腰圍之改變 ............................................................ 136
圖4.5山苦瓜對血糖之作用 ............................................................................ 140
圖4.6山苦瓜對醣化血色素之作用 ................................................................ 141
圖4.7山苦瓜對三酸甘油酯之作用 ................................................................ 142
圖4.8山苦瓜對高密度脂蛋白膽固醇之作用 ................................................ 143
圖4.9山苦瓜對血壓之作用 ............................................................................ 144
圖4.10山苦瓜在胰島素敏感度檢測LOGHOMA之作用 ............................. 146
圖4.11山苦瓜在定量胰島素敏感度檢測指標(QUICKI)之作用 ................... 147
圖4.12山苦瓜在胰島素敏感度檢測MCAULEY指標之作用 ....................... 147
圖4.13山苦瓜在胰島素敏感度LOGHOMA, QUICKI, MCAULEY之作用 ..... 148
圖4.14山苦瓜對體重之作用 .......................................................................... 151
圖4.15山苦瓜對身體質量指數之作用 .......................................................... 151
圖4.16山苦瓜對總膽固醇之作用 .................................................................. 152
圖4.17山苦瓜對低密度脂蛋白膽固醇之作用 .............................................. 152
圖4.18 山苦瓜對胰島素之作用 ..................................................................... 153
圖4.19山苦瓜對尿酸之作用 .......................................................................... 153
圖4.20山苦瓜對同半胱胺酸之作用 .............................................................. 154
圖4.21 山苦瓜對纖維素原之作用 ................................................................. 154
圖4.22 山苦瓜對睪固酮之作用 ..................................................................... 155
圖4.23 山苦瓜對高敏感度C-反應蛋白之作用 ............................................ 155

1.Lakka H. M., Laaksonen D. E., Lakka T. A., Niskanen L. K., Kumpusalo E., Tuomilehto J., Salonen J. T., “The metabolic syndrome and total and cardiovascular disease mortality in middle-aged men”, JAMA, Vol. 288, No. 21, pp. 2709-2716 (2002).
2.Haffner S. M., Lehto S., Ronnemaa T., Pyorala K., Laakso M., “Mortality from coronary heart disease in subjects with type 2 diabetes and in nondiabetic subjects with and without prior myocardial infarction”, N Engl J Med, Vol. 339, No. 4, pp. 229-234 (1998).
3.Malmberg K., Yusuf S., Gerstein H. C., Brown J., Zhao F., Hunt D., Piegas L., Calvin J., Keltai M., Budaj A., “Impact of diabetes on long-term prognosis in patients with unstable angina and non-q-wave myocardial infarction: Results of the oasis (organization to assess strategies for ischemic syndromes) registry”, Circulation, Vol. 102, No. 9, pp. 1014-1019 (2000).
4.Expert panel on detection, expert, and treatment of high blood cholesterol in adults, “Executive summary of the third report of the national cholesterol education program (NCEP) expert panel on detection, evaluation, and treatment of high blood cholesterol in adults (adult treatment Panel III)”, JAMA, Vol. 285, No. 19, pp. 2486-2497 (2001).
5.行政院衛生署，「死因統計統計表(2009) 」，Department of health， Executive Yuan R.O.C. (Taiwan) http://www.doh.gov.tw/CHT2006/DM/DM2_2_p02.aspx?class_no=440&now_fod_list_no=10642&level_no=3&doc_no=73104，(2010)。
6.Tsai C. H., Li T. C., Lin C. C., “Metabolic syndrome as a risk factor for nonalcoholic fatty liver disease”, South Med J, Vol. 101, No. 9, pp. 900-905 (2008).
7.Ford E. S., Giles W. H., Dietz W. H., “Prevalence of the metabolic syndrome among us adults: Findings from the third national health and nutrition examination survey”, JAMA, Vol. 287, No. 3, pp. 356-359 (2002).
8.Chuang S. Y., Chen C. H., Tsai S. T., Chou P., “Clinica identification of the metabolic syndrome in Kinmen”, Acta Caridol Sin, Vol. 18, pp. 16-23 (2002).
9.Lin C. C., Liu C. S., Lai M. M., Li C. I., Chen C. C., Chang P. C., Lin W. Y., Lee Y. D., Lin T., Li T. C., “Metabolic syndrome in a Taiwanese metropolitan adult population”, BMC Public Health, Vol. 7, pp. 239-234 (2007).
10.蔡崇煌、黃素雲、林高德，「代謝症候群與其相關因子之研究 - 健檢資料分析」，台灣家醫誌，第16卷，第2期，第112-122頁(2006)。
11.Mozumdar A., Liguori G.,“Persistent increase of prevalence of metabolic syndrome among u.S. Adults: NHANES III to NHANES 1999-2006”, Diabetes Care, Vol. 34, No. 1, pp. 216-219 (2011).
12.Haffner S. M., Stern M. P., Hazuda H. P., Mitchell B. D., Patterson J. K., “Cardiovascular risk factors in confirmed prediabetic individuals. Does the clock for coronary heart disease start ticking before the onset of clinical diabetes?”, JAMA, Vol. 263, No. 21, pp. 2893-2898 (1990).
13.Blaha M. J., Bansal S., Rouf R., Golden S. H., Blum R. S., “A practical "ABCDE" approach to the metabolic syndrome”, Mayo Clin Proc, Vol. 83, pp. 932-943 (2008).
14.DerMarderosian A., Beutler J., “The review of natural products. St Louis, Mo: Wolters kluwer health”, (2006).
15.Basch E., Gabardi S., Ulbricht C., “Bitter melon (Momordica charantia): A review of efficacy and safety”, Am J Health Syst Pharm, Vol. 60, No. 4, pp. 356-359 (2003).
16.Tsai C. H., Chen E. C. F., Tsay H. S., Huang C. j., “Bitter gourd (Momordica charantia): A review of efficacy and safety on glucose homeostasis”, Nutr Sci J, Vol. 35, No. 3, pp. 115-126 (2010).
17.Krawinkel M. B., Keding G. B., “Bitter gourd (Momordica charantia): A dietary approach to hyperglycemia”, NutrRev, Vol. 64, No. 7, pp. 331-337 (2006).
18.Yeh G. Y., Eisenberg D. M., Kaptchuk T. J., Phillips R. S., “Systematic review of herbs and dietary supplements for glycemic control in diabetes”, Diabetes Care, Vol. 26, No. 4, pp. 1277-1294 (2003).
19.Feng P. C., Haynes L. J., Magnus K. E., Plimmer J. R., Sherratt H. S., “Pharmacological screening of some west indian medicinal plants”, J Pharm Pharmacol, Vol. 14, pp. 556-561 (1962).
20.Ojewole J. A., Adewole S. O., Olayiwola G., “Hypoglycaemic and hypotensive effects of Momordica charantia Linn. (Cucurbitaceae) whole-plant aqueous extract in rats”, Cardiovasc J S Afr, Vol. 17, No. 5, pp. 227-232 (2006).
21.Chuang C. Y., Hsu C., Chao C. Y., Wein Y. S., Kuo Y. H., Huang C. J., “Fractionation and identification of 9c, 11t, 13t-conjugated linolenic acid as an activator of PPARalpha in bitter gourd (Momordica charantia L.)”, J Biomed Sci, Vol. 13, No. 6, pp. 763-772 (2006).
22.Platel K., Shurpalekar K. S., Srinivasan K., “Influence of bitter gourd (Momordica charantia) on growth and blood constituents in albino rats”, Nahrung, Vol. 37, No. 2, pp. 156-160 (1993).
23.Jayasooriya A. P., Sakono M., Yukizaki C., Kawano M., Yamamoto K., Fukuda N., “Effects of Momordica charantia powder on serum glucose levels and various lipid parameters in rats fed with cholesterol-free and cholesterol-enriched diets”, J Ethnopharmacol, Vol. 72, No. 1-2, pp. 331-336 (2000).
24.Ahmed I., Lakhani M. S., Gillett M., John A., Raza H., “Hypotriglyceridemic and hypocholesterolemic effects of anti-diabetic Momordica charantia (karela) fruit extract in streptozotocin-induced diabetic rats”, Diabetes Res Clin Pract, Vol. 51, No. 3, pp. 155-161 (2001).
25.Shih C. C., Lin C. H., Lin W. L., “Effects of Momordica charantia on insulin resistance and visceral obesity in mice on high-fat diet”, Diabetes Res Clin Pract, Vol. 81, No. 2, pp. 134-143 (2008).
26.Popovich D. G., Li L., Zhang W., “Bitter melon (Momordica charantia) triterpenoid extract reduces preadipocyte viability, lipid accumulation and adiponectin expression in 3t3-l1 cells”, Food Chem Toxicol, Vol. 48, No. 6, pp. 1619-1626 (2010).
27.Vernochet C., Peres S. B., Davis K. E., McDonald M. E., Qiang L., Wang H., Scherer P. E., Farmer S. R., “C/EBPalpha and the corepressors CtBP1 and CtBP2 regulate repression of select visceral white adipose genes during induction of the brown phenotype in white adipocytes by peroxisome proliferator-activated receptor gamma agonists”, Mol Cell Biol, Vol. 29, No. 17, pp. 4714-4728 (2009).
28.Lee J. H., Jun H. J., Jia Y., Kim W., Choi S. G., Lee S. J., “Critical role of peroxisome proliferator activated receptor-delta on body fat reduction in C57BL/6J and human apolipoprotein E2 transgenic mice fed delipidated soybean”, J. Agric. Food. Chem., Vol. 59, No. 21, pp. 11872-11881 (2011).
29.Blum A., Loerz C., Martin H. J., Staab-Weijnitz C. A., Maser E., “Momordica charantia extract, a herbal remedy for type 2 diabetes, contains a specific 11beta-hydroxysteroid dehydrogenase type 1 inhibitor”, J Steroid Biochem Mol Biol, Vol. 128, No. 1-2, pp. 51-55 (2012).
30.Dans A. M., Villarruz M. V., Jimeno C. A., Javelosa M. A., Chua J., Bautista R., Velez G. G., “The effect of Momordica charantia capsule preparation on glycemic control in type 2 diabetes mellitus needs further studies”, J Clin Epidemiol, Vol. 60, No. 6, pp. 554-559 (2007).
31.Li C. L., Lin J. D., Lee S. J., Tseng R. F., “Associations between the metabolic syndrome and its components, watching television and physical activity”, Public Health, Vol. 121, No. 2, pp. 83-91 (2007).
32.Department of Health; Executive Yuan Taiwan, “Food composition and analysis in Taiwan”, (1998).
33.杜金池，蕭吉雄，「台灣地區現有作物栽培品種名錄-苦瓜 2」，台灣省農業試驗所特刊 26 號(1990)。
34.全中和、林砡竹，「苦瓜新品種育成及 Gap 體系之建立」，苦瓜產業與保健功效研討會刊，第51-70頁。
35.李威著，「現代中草藥的製造與品質管制」，國際藥用植物產業發展研討會專刊，第283-292頁(2004)。
36.賴宏亮，「以科學化驗證中草藥之開發與利用」，農科新世紀，第7卷，第32-37頁(2007)。
37.全中和、楊素絲，「苦瓜新品種花蓮4 號」，農技報導，第78卷，第1-3頁(2009)。
38.鍾宜錚，呂子輝，「2009農業技術交易展 新品種令人目不暇給」，植物種苗電子報，第0105卷，http:// www.e-seed.agron.ntu. edu.tw/0105/0105variety.htm#2009。
39.Yadav M., Lavania A., Tomar R., Prasad G. B., Jain S., Yadav H., “Complementary and comparative study on hypoglycemic and antihyperglycemic activity of various extracts of eugenia jambolana seed, Momordica charantia fruits, gymnema sylvestre, and trigonella foenum graecum seeds in rats”, Appl Biochem Biotechnol, Vol. 160, No. 8, pp. 2388-2400 (2010).
40.Nivitabishekam S. N., Asad M., Prasad V. S., “Pharmacodynamic interaction of Momordica charantia with rosiglitazone in rats”, Chem Biol Interact, Vol. 177, No. 3, pp. 247-253 (2009).
41.Chao C. Y., Huang C. j., “In vitro activation of peroxisome proliferator-activated receptor α by some extracts from food materials”, J Food Drug Anal, Vol. 16, pp. 62-69 (2008).
42.Chao C. Y., Huang C. j., “Bitter gourd (Momordica charantia) extract activates peroxisome proliferator-activated receptors and upregulates the expression of the acyl CoA oxidase gene in H4IIEC3 hepatoma cells”, J Biomed Sci, Vol. 10, No. 6 Pt 2, pp. 782-791 (2003).
43.Chou Y. M., Chao C. Y., “Wild bitter gourd extracts activate the transcription factor, PPARγ, and inhibit LPS-induced inflammatory responses in Raw264.7 cells”, Nutr Sci J, Vol. 33, No. 3, pp. 108-115 (2008).
44.Huang T. H., Kota B. P., Razmovski V., Roufogalis B. D., “Herbal or natural medicines as modulators of peroxisome proliferator-activated receptors and related nuclear receptors for therapy of metabolic syndrome”, Basic Clin Pharmacol Toxicol, Vol. 96, No. 1, pp. 3-14 (2005).
45.Sasa M., Inoue I., Shinoda Y., Takahashi S., Seo M., Komoda T., Awada T., Katayama S., “Activating effect of momordin, extract of bitter melon (Momordica charantia L.), on the promoter of human PPARdelta”, J Atheroscler Thromb, Vol. 16, No. 6, pp. 888-892 (2009).
46.Berger J. P., Akiyama T. E., Meinke P. T., “PPARs: Therapeutic targets for metabolic disease”, Trends Pharmacol Sci, Vol. 26, No. 5, pp. 244-251 (2005).
47.Huang H. L., Hong Y. W., Wong Y. H., Chen Y. N., Chyuan J. H., Huang C. J., Chao P. M., “Bitter melon (Momordica charantia L.) inhibits adipocyte hypertrophy and down regulates lipogenic gene expression in adipose tissue of diet-induced obese rats”, Br J Nutr, Vol. 99, No. 2, pp. 230-239 (2008).
48.Sridhar M. G., Vinayagamoorthi R., Arul Suyambunathan V., Bobby Z., Selvaraj N., “Bitter gourd (Momordica charantia) improves insulin sensitivity by increasing skeletal muscle insulin-stimulated IRS-1 tyrosine phosphorylation in high-fat-fed rats”, Br J Nutr, Vol. 99, No. 4, pp. 806-812 (2008).
49.Okabe H., Miyahara Y., Yamauchi T., “Studies of the constituents of Momordica charantia L. IV. Characterization of the new cucurbitacin glycosides of the immature fruits.(2). Structures of the bitter glycosides, momordicosides K and L”, Chem Pharm Bull, Vol. 30, No. 12, pp. 4334-4340 (1982).
50.Yasuda M., Iwamoto M., Okabe H., Yamauchi T., “Structures of momordicines I, II, and III. The bitter principles in the leaves and vines of Momordica charantia L.”, Chem Pharm Bull, Vol. 32, pp. 2044-2047 (1984).
51.Jager S., Trojan H., Kopp T., Laszczyk M. N., Scheffler A., “Pentacyclic triterpene distribution in various plants - rich sources for a new group of multi-potent plant extracts”, Molecules, Vol. 14, No. 6, pp. 2016-2031 (2009).
52.de Melo C. L., Queiroz M. G. R., Fonseca S. G. C., Bizerra A. M. C., Lemos T. L. G., Melo T. S., Santos F. A., Rao V. S., “Oleanolic acid, a natural triterpenoid improves blood glucose tolerance in normal mice and ameliorates visceral obesity in mice fed a high-fat diet”, Chem Biol Interact, Vol. 185, No. 1, pp. 59-65 (2010).
53.Parkash A., Ng T. B., Tso W. W., “Purification and characterization of charantin, a napin-like ribosome-inactivating peptide from bitter gourd (Momordica charantia) seeds”, J Pept Res, Vol. 59, No. 5, pp. 197-202 (2002).
54.Handa G. J., Singh M. L., Sharma A., Kaul N., Zafar R., “Hypoglycemic principle of Momordica charantia seeds”, Indian J Nat Prod, Vol. 6, No. 1, pp. 16-19 (1990).
55.Chandrasekar B., Mukherjee B., Mukherjee S. K., “Blood sugar lowering potentiality of selected cucurbitaceae plants of Indian origin”, Indian J Med Res, Vol. 90, pp. 300-305 (1989).
56.Srivastava Y., “Antidiabetic and adaptogenic properties of Momordica charantia extract: An experimental and clinical evaluation”, Phytother Res, Vol. 7, pp. 785-789 (1993).
57.Khanna P., Jain S. C., Panagariya A., Dixit V. P., “Hypoglycemic activity of polypeptide-p from a plant source”, J Nat Prod, Vol. 44, No. 6, pp. 648-655 (1981).
58.Matsuur H., Asakawa C., Kurimoto M., Mizutani J., “Alpha-glucosidase inhibitor from the seeds of balsam pear (Momordica charantia) and the fruit bodies of grifola frondosa”, Biosci Biotechnol Biochem, Vol. 66, No. 7, pp. 1576-1578 (2002).
59.Tan M. J., Ye J. M., Turner N., Hohnen-Behrens C., Ke C. Q., Tang C. P., Chen T., Weiss H. C., Gesing E. R., Rowland A., James D. E., Ye Y., “Antidiabetic activities of triterpenoids isolated from bitter melon associated with activation of the ampk pathway”, Chem Biol, Vol. 15, No. 3, pp. 263-273 (2008).
60.Harinantenaina L., Tanaka M., Takaoka S., Oda M., Mogami O., Uchida M., Asakawa Y., “Momordica charantia constituents and antidiabetic screening of the isolated major compounds”, Chem Pharm Bull (Tokyo), Vol. 54, No. 7, pp. 1017-1021 (2006).
61.Cheng H. L., Huang H. K., Chang C. I., Tsai C. P., Chou C. H., “A cell-based screening identifies compounds from the stem of Momordica charantia that overcome insulin resistance and activate amp-activated protein kinase”, J Agric Food Chem, Vol. 56, No. 16, pp. 6835-6843 (2008).
62.Nhiem N. X., Kiem P. V., Minh C. V., Ban N. K., Cuong N. X., Tung N. H., Ha le M., Ha do T., Tai B. H., Quang T. H., Ngoc T. M., Kwon Y. I., Jang H. D., Kim Y. H., “Alpha-glucosidase inhibition properties of cucurbitane-type triterpene glycosides from the fruits of Momordica charantia”, Chem Pharm Bull (Tokyo), Vol. 58, No. 5, pp. 720-724 (2010).
63.Ma J., Whittaker P., Keller A. C., Mazzola E. P., Pawar R. S., White K. D., Callahan J. H., Kennelly E. J., Krynitsky A. J., Rader J. I., “Cucurbitane-type triterpenoids from Momordica charantia”, Planta Med, Vol. 76, No. 15, pp. 1758-1761 (2010).
64.Mahomoodally M. F., Gurib-Fakim A., Subratty A. H., “Effect of exogenous ATP on Momordica charantia Linn. (cucurbitaceae) induced inhibition of d-glucose, l-tyrosine and fluid transport across rat everted intestinal sacs in vitro”, J Ethnopharmacol, Vol. 110, No. 2, pp. 257-263 (2007).
65.Oishi Y., Sakamoto T., Udagawa H., Taniguchi H., Kobayashi-Hattori K., Ozawa Y., Takita T., “Inhibition of increases in blood glucose and serum neutral fat by Momordica charantia saponin fraction”, Biosci Biotechnol Biochem, Vol. 71, No. 3, pp. 735-740 (2007).
66.Torres W. D., “Momordica charantia Linn. (family: Cucurbitaceae) –chemistry & pharmacology ” http://www.charanteausa.com/ampalaya_archive/studies/1.doc .
67.Kumar D., Sharathnath K., Yogeswaran P., Harani A., Sudhakar K., Sudha P., Banji D., “A medicinal potency of Momordica charantia”, Int J Pharm Sci Rev Res, Vol. 1, No. 2, pp. 95-100 (2010).
68.Dutta P., Chakravarty A., Chowdhury U., Pakrashi S., “Vicine, a favism-inducing toxin from Momordica charantia Linn. Seeds”, Indian J Chem, Vol. 20, pp. 669-671 (1981).
69.Baldwa V., Bhandra C., Pangaria A., Goyal R., “Clinical trials in patients with diabetes mellitus of an insulin-like compound obtained from plant source”, Upsala J Med Sci, Vol. 82, pp. 39-41 (1977).
70.蔡崇煌、陳靖棻、蔡新聲、黃青真，「苦瓜於血糖控制之功效及安全性回顧」，台灣營養學雜誌，第35卷，第3期，第115-126頁(2010)。
71.Uebanso T., Arai H., Taketani Y., Fukaya M., Yamamoto H., Mizuno A., Uryu K., Hada T., Takeda E., “Extracts of Momordica charantia suppress postprandial hyperglycemia in rats”, J Nutr Sci Vitaminol (Tokyo), Vol. 53, No. 6, pp. 482-488 (2007).
72.Meir P., Yaniv Z., “An in vitro study on the effect of Momordica charantia on glucose uptake and glucose metabolism in rats”, Planta Med, Vol. 51, No. 1, pp. 12-16 (1985).
73.Ahmed I., Adeghate E., Sharma A. K., Pallot D. J., Singh J., “Effects of Momordica charantia fruit juice on islet morphology in the pancreas of the streptozotocin-diabetic rat”, Diabetes Res Clin Pract, Vol. 40, No. 3, pp. 145-151 (1998).
74.Singh N., Gupta M., “Regeneration of beta cells in islets of langerhans of pancreas of alloxan diabetic rats by acetone extract of Momordica charantia (Linn.) (bitter gourd) fruits”, Indian J Exp Biol, Vol. 45, No. 12, pp. 1055-1062 (2007).
75.Singh N., Gupta M., Sirohi P., Varsha, “Effects of alcoholic extract of Momordica charantia (Linn.) whole fruit powder on the pancreatic islets of alloxan diabetic albino rats”, J Environ Biol, Vol. 29, No. 1, pp. 101-106 (2008).
76.Xiang L., Huang X., Chen L., Rao P., Ke L., “The reparative effects of Momordica charantia Linn. Extract on hit-t15 pancreatic beta-cells”, Asia Pac J Clin Nutr, Vol. 16 Suppl 1, pp. 249-252 (2007).
77.Yibchok-Anun S., Adisakwattana S., Yao C. Y., Sangvanich P., Roengsumran S., Hsu W. H., “Slow acting protein extract from fruit pulp of Momordica charantia with insulin secretagogue and insulinomimetic activities”, Biol Pharm Bull, Vol. 29, No. 6, pp. 1126-1131 (2006).
78.Fernandes N. P., Lagishetty C. V., Panda V. S., Naik S. R., “An experimental evaluation of the antidiabetic and antilipidemic properties of a standardized Momordica charantia fruit extract”, BMC Complement Altern Med, Vol. 7, pp. 29 (2007).
79.Rotshteyn Y., Zito S. W., “Application of modified in vitro screening procedure for identifying herbals possessing sulfonylurea-like activity”, J Ethnopharmacol, Vol. 93, No. 2-3, pp. 337-344 (2004).
80.Shibib B. A., Khan L. A., Rahman R., “Hypoglycaemic activity of coccinia indica and Momordica charantia in diabetic rats: Depression of the hepatic gluconeogenic enzymes glucose-6-phosphatase and fructose-1,6-bisphosphatase and elevation of both liver and red-cell shunt enzyme glucose-6-phosphate dehydrogenase”, Biochem J, Vol. 292 ( Pt 1), pp. 267-270 (1993).
81.Rathi S. S., Grover J. K., Vats V., “The effect of Momordica charantia and mucuna pruriens in experimental diabetes and their effect on key metabolic enzymes involved in carbohydrate metabolism”, Phytother Res, Vol. 16, No. 3, pp. 236-243 (2002).
82.Sarkar S., Pranava M., Marita R., “Demonstration of the hypoglycemic action of Momordica charantia in a validated animal model of diabetes”, Pharmacol Res, Vol. 33, No. 1, pp. 1-4 (1996).
83.Nerurkar P. V., Lee Y. K., Motosue M., Adeli K., Nerurkar V. R., “Momordica charantia (bitter melon) reduces plasma apolipoprotein b-100 and increases hepatic insulin receptor substrate and phosphoinositide-3 kinase interactions”, Br J Nutr, Vol. 100, No. 4, pp. 751-759 (2008).
84.Kumar R., Balaji S., Uma T. S., Sehgal P. K., “Fruit extracts of Momordica charantia potentiate glucose uptake and up-regulate GLUT-4, PPAR gamma and PI3K”, J Ethnopharmacol, Vol. 126, No. 3, pp. 533-537 (2009).
85.Aslam M., Stockley I. H., “Interaction between curry ingredient (karela) and drug (chlorpropamide)”, Lancet, Vol. 1, No. 8116, pp. 607 (1979).
86.Lii C. K., Chen H. W., Yun W. T., Liu K. L., “Suppressive effects of wild bitter gourd (Momordica charantia Linn. var. abbreviata Ser.) fruit extracts on inflammatory responses in Raw264.7 macrophages”, J Ethnopharmacol, Vol. 122, No. 2, pp. 227-233 (2009).
87.Huang C. j., Wu M. C., “Differential effects of foods traditionally regarded as ''heating'' and ''cooling'' on prostaglandin E(2) production by a macrophage cell line”, J Biomed Sci, Vol. 9, No. 6 Pt 2, pp. 596-606 (2002).
88.Kumar R., Balaji S., Sripriya R., Nithya N., Uma T. S., Sehgal P. K., “In vitro evaluation of antioxidants of fruit extract of Momordica charantia L. On fibroblasts and keratinocytes”, J Agric Food Chem, Vol. 58, No. 3, pp. 1518-1522 (2010).
89.Horax R., Hettiarachchy N., Chen P., “Extraction, quantification, and antioxidant activities of phenolics from pericarp and seeds of bitter melons (Momordica charantia) harvested at three maturity stages (immature, mature, and ripe)”, J Agric Food Chem, Vol. 58, No. 7, pp. 4428-4433 (2010).
90.Thenmozhi A. J., Subramanian P., “Antioxidant potential of Momordica charantia in ammonium chloride-induced hyperammonemic rats”, eCAM, pp. 1-7 (2010).
91.Chaturvedi P., George S., “Momordica charantia maintains normal glucose levels and lipid profiles and prevents oxidative stress in diabetic rats subjected to chronic sucrose load”, J Med Food, Vol. 13, No. 3, pp. 520-527 (2010).
92.Tsai T. Y., Chu L. H., Lee C. L., Pan T. M., “Atherosclerosis-preventing activity of lactic acid bacteria-fermented milk-soymilk supplemented with Momordica charantia”, J Agric Food Chem, Vol. 57, No. 5, pp. 2065-2071 (2009).
93.Kumar G. S., Shetty A. K., Salimath P. V., “Modulatory effect of bitter gourd (Momordica charantia Linn.) on alterations in kidney heparan sulfate in streptozotocin-induced diabetic rats”, J Ethnopharmacol, Vol. 115, No. 2, pp. 276-283 (2008).
94.Ahmed I., Adeghate E., Cummings E., Sharma A. K., Singh J., “Beneficial effects and mechanism of action of Momordica charantia juice in the treatment of streptozotocin-induced diabetes mellitus in rat”, Mol Cell Biochem, Vol. 261, No. 1-2, pp. 63-70 (2004).
95.Srivastava Y., Venkatakrishna-Bhatt H., Verma Y., Prem A. S., “Retardation of retinopathy by Momordica charantia L. (bitter gourd) fruit extract in alloxan diabetic rats”, Indian J Exp Biol, Vol. 25, No. 8, pp. 571-572 (1987).
96.Grover J. K., Rathi S. S., Vats V., “Amelioration of experimental diabetic neuropathy and gastropathy in rats following oral administration of plant (eugenia jambolana, mucuna pruriens and tinospora cordifolia) extracts”, Indian J Exp Biol, Vol. 40, No. 3, pp. 273-276 (2002).
97.Rathi S. S., Grover J. K., Vikrant V., Biswas N. R., “Prevention of experimental diabetic cataract by indian ayurvedic plant extracts”, Phytother Res, Vol. 16, No. 8, pp. 774-777 (2002).
98.Chaturvedi P., “Role of Momordica charantia in maintaining the normal levels of lipids and glucose in diabetic rats fed a high-fat and low-carbohydrate diet”, Br J Biomed Sci, Vol. 62, No. 3, pp. 124-126 (2005).
99.Braca A., Siciliano T., D''Arrigo M., Germano M. P., “Chemical composition and antimicrobial activity of Momordica charantia seed essential oil”, Fitoterapia, Vol. 79, No. 2, pp. 123-125 (2008).
100.Frame A. D., Rios-Olivares E., De Jesus L., Ortiz D., Pagan J., Mendez S., “Plants from puerto rico with anti-mycobacterium tuberculosis properties”, P R Health Sci J, Vol. 17, No. 3, pp. 243-252 (1998).
101.Ogata F., Miyata T., Fujii N., Yoshida N., Noda K., Makisumi S., Ito A., “Purification and amino acid sequence of a bitter gourd inhibitor against an acidic amino acid-specific endopeptidase of streptomyces griseus”, J Biol Chem, Vol. 266, No. 25, pp. 16715-16721 (1991).
102.Yesilada E., Gurbuz I., Shibata H., “Screening of turkish anti-ulcerogenic folk remedies for anti-helicobacter pylori activity”, J Ethnopharmacol, Vol. 66, No. 3, pp. 289-293 (1999).
103.Cunnick J. E., Sakamoto K., Chapes S. K., Fortner G. W., Takemoto D. J., “Induction of tumor cytotoxic immune cells using a protein from the bitter melon (Momordica charantia)”, Cell Immunol, Vol. 126, No. 2, pp. 278-289 (1990).
104.Bourinbaiar A. S., Lee-Huang S., “The activity of plant-derived antiretroviral proteins map30 and gap31 against herpes simplex virus in vitro”, Biochem Biophys Res Commun, Vol. 219, No. 3, pp. 923-929 (1996).
105.K-ATP channel, “Pancreatic beta cell k-ATP channel http://bigtomato.org/diabetes/mody/isletcell.php”, (2012).
106.Han C., Hui Q., Wang Y., “Hypoglycaemic activity of saponin fraction extracted from Momordica charantia in peg/salt aqueous two-phase systems”, Nat Prod Res, Vol. 22, No. 13, pp. 1112-1119 (2008).
107.Roffey B. W., Atwal A. S., Johns T., Kubow S., “Water extracts from Momordica charantia increase glucose uptake and adiponectin secretion in 3t3-l1 adipose cells”, J Ethnopharmacol, Vol. 112, No. 1, pp. 77-84 (2007).
108.Cummings E., Hundal H. S., Wackerhage H., Hope M., Belle M., Adeghate E., Singh J., “Momordica charantia fruit juice stimulates glucose and amino acid uptakes in l6 myotubes”, Mol Cell Biochem, Vol. 261, No. 1-2, pp. 99-104 (2004).
109.Miura T., Itoh C., Iwamoto N., Kato M., Kawai M., Park S. R., Suzuki I., “Hypoglycemic activity of the fruit of the Momordica charantia in type 2 diabetic mice”, J Nutr Sci Vitaminol (Tokyo), Vol. 47, No. 5, pp. 340-344 (2001).
110.Chen Q., Chan L. L., Li E. T., “Bitter melon (Momordica charantia) reduces adiposity, lowers serum insulin and normalizes glucose tolerance in rats fed a high fat diet”, J Nutr, Vol. 133, No. 4, pp. 1088-1093 (2003).
111.洪雅雯，「山苦瓜改善高油高糖餵食大鼠腹部體脂堆積及胰島素抗性」，碩士論文，中國醫藥大學，臺中(2005)。
112.Marx N., Duez H., Fruchart J. C., Staels B., “Peroxisome proliferator-activated receptors and atherogenesis: Regulators of gene expression in vascular cells”, Circ Res, Vol. 94, No. 9, pp. 1168-1178 (2004).
113.Ziouzenkova O., Plutzky J., “Lipolytic PPAR activation: New insights into the intersection of triglycerides and inflammation?”, Curr Opin Clin Nutr Metab Care, Vol. 7, No. 4, pp. 369-375 (2004).
114.Pini R., Cavallini M. C., Stagliano L., Tarantini F., Marchionni N., Di Bari M., Devereux R. B., Masotti G., Roman M. J., “Blood pressure normalization is associated with normal left ventricular mass but not carotid geometry: The icare dicomano study”, J Hypertens, Vol. 24, No. 5, pp. 973-979 (2006).
115.Issemann I., Green S., “Activation of a member of the steroid hormone receptor superfamily by peroxisome proliferators”, Nature, Vol. 347, No. 6294, pp. 645-650 (1990).
116.Dreyer C., Krey G., Keller H., Givel F., Helftenbein G., Wahli W., “Control of the peroxisomal beta-oxidation pathway by a novel family of nuclear hormone receptors”, Cell, Vol. 68, No. 5, pp. 879-887 (1992).
117.Issemann I., Green S., “Cloning of novel members of the steroid hormone receptor superfamily”, J Steroid Biochem Mol Biol, Vol. 40, No. 1-3, pp. 263-269 (1991).
118.Schmidt A., Endo N., Rutledge S. J., Vogel R., Shinar D., Rodan G. A., “Identification of a new member of the steroid hormone receptor superfamily that is activated by a peroxisome proliferator and fatty acids”, Mol Endocrinol, Vol. 6, No. 10, pp. 1634-1641 (1992).
119.Gebel T., Arand M., Oesch F., “Induction of the peroxisome proliferator activated receptor by fenofibrate in rat liver”, FEBS Lett, Vol. 309, No. 1, pp. 37-40 (1992).
120.Berger J., Moller D. E., “The mechanisms of action of PPARs”, Annu Rev Med, Vol. 53, pp. 409-435 (2002).
121.Glass C. K., Ogawa S., “Combinatorial roles of nuclear receptors in inflammation and immunity”, Nat Rev Immunol, Vol. 6, No. 1, pp. 44-55 (2006).
122.Desvergne B., Wahli W., “Peroxisome proliferator-activated receptors: Nuclear control of metabolism”, Endocr Rev, Vol. 20, No. 5, pp. 649-688 (1999).
123.Han S. H., Quon M. J., Koh K. K., “Beneficial vascular and metabolic effects of peroxisome proliferator-activated receptor-alpha activators”, Hypertension, Vol. 46, No. 5, pp. 1086-1092 (2005).
124.Kliewer S. A., Forman B. M., Blumberg B., Ong E. S., Borgmeyer U., Mangelsdorf D. J., Umesono K., Evans R. M., “Differential expression and activation of a family of murine peroxisome proliferator-activated receptors”, Proc Natl Acad Sci U S A, Vol. 91, No. 15, pp. 7355-7359 (1994).
125.Braissant O., Foufelle F., Scotto C., Dauca M., Wahli W., “Differential expression of peroxisome proliferator-activated receptors (PPARs): Tissue distribution of PPAR-alpha, -beta, and -gamma in the adult rat”, Endocrinology, Vol. 137, No. 1, pp. 354-366 (1996).
126.Muscat G. E., Dressel U., “Cardiovascular disease and PPARdelta: Targeting the risk factors”, Curr Opin Investig Drugs, Vol. 6, No. 9, pp. 887-894 (2005).
127.Tontonoz P., Hu E., Spiegelman B. M., “Stimulation of adipogenesis in fibroblasts by PPAR gamma 2, a lipid-activated transcription factor”, Cell, Vol. 79, No. 7, pp. 1147-1156 (1994).
128.Schiffrin E. L., “Peroxisome proliferator-activated receptors and cardiovascular remodeling”, Am J Physiol Heart Circ Physiol, Vol. 288, No. 3, pp. H1037-1043 (2005).
129.Olefsky J. M., Saltiel A. R., “PPAR gamma and the treatment of insulin resistance”, Trends Endocrinol Metab, Vol. 11, No. 9, pp. 362-368 (2000).
130.Issemar I., Green S., “Activation of a member of the hormone receptor superfamily by peroxisome proliferators”, Nature, Vol. 346, pp. 645 (1991).
131.Jonathan B., Jorge P., “Peroxisome proliferator-activated receptors as transcriptional nodal points and therapeutic targets”, Circulation, Vol. 115, pp. 518-533 (2007).
132.Issemann I., Prince R. A., Tugwood J. D., Green S., “The retinoid x receptor enhances the function of the peroxisome proliferator activated receptor”, Biochimie, Vol. 75, No. 3-4, pp. 251-256 (1993).
133.Shulman A. I., Mangelsdorf D. J., “Retinoid x receptor heterodimers in the metabolic syndrome”, N Engl J Med, Vol. 353, No. 6, pp. 604-615 (2005).
134.Leibovitz E., Schiffrin E. L., “PPAR activation: A new target for the treatment of hypertension”, J Cardiovasc Pharmacol, Vol. 50, No. 2, pp. 120-125 (2007).
135.Lee C. H., Chawla A., Urbiztondo N., Liao D., Boisvert W. A., Evans R. M., Curtiss L. K., “Transcriptional repression of atherogenic inflammation: Modulation by PPARdelta”, Science, Vol. 302, No. 5644, pp. 453-457 (2003).
136.Blanquart C., Mansouri R., Paumelle R., Fruchart J. C., Staels B., Glineur C., “The protein kinase c signaling pathway regulates a molecular switch between transactivation and transrepression activity of the peroxisome proliferator-activated receptor alpha”, Mol Endocrinol, Vol. 18, No. 8, pp. 1906-1918 (2004).
137.Perissi V., Aggarwal A., Glass C. K., Rose D. W., Rosenfeld M. G., “A corepressor/coactivator exchange complex required for transcriptional activation by nuclear receptors and other regulated transcription factors”, Cell, Vol. 116, No. 4, pp. 511-526 (2004).
138.Takano H., Komuro I., “Peroxisome proliferator-activated receptor gamma and cardiovascular diseases”, Circ J, Vol. 73, No. 2, pp. 214-220 (2009).
139.Andrews T. C., Whitney E. J., Green G., Kalenian R., Personius B. E., “Effect of gemfibrozil +/- niacin +/- cholestyramine on endothelial function in patients with serum low-density lipoprotein cholesterol levels <160 mg/dl and high-density lipoprotein cholesterol levels <40 mg/dl”, Am J Cardiol, Vol. 80, No. 7, pp. 831-835 (1997).
140.Jonkers I. J., de Man F. H., van der Laarse A., Frolich M., Gevers Leuven J. A., Kamper A. M., Blauw G. J., Smelt A. H., “Bezafibrate reduces heart rate and blood pressure in patients with hypertriglyceridemia”, J Hypertens, Vol. 19, No. 4, pp. 749-755 (2001).
141.The BIP Study Group, “Secondary prevention by raising HDL cholesterol and reducing triglycerides in patients with coronary artery disease: The bezafibrate infarction prevention (BIP) study”, Circulation, Vol. 102, No. 1, pp. 21-27 (2000).
142.Keech A., Simes R. J., Barter P., Best J., Scott R., Taskinen M. R., Forder P., Pillai A., Davis T., Glasziou P., Drury P., Kesaniemi Y. A., Sullivan D., Hunt D., Colman P., d''Emden M., Whiting M., Ehnholm C., Laakso M., “Effects of long-term fenofibrate therapy on cardiovascular events in 9795 people with type 2 diabetes mellitus (the FIELD study): Randomised controlled trial”, Lancet, Vol. 366, No. 9500, pp. 1849-1861 (2005).
143.Goldenberg I., Goldbourt U., Boyko V., Behar S., Reicher-Reiss H., “Relation between on-treatment increments in serum high-density lipoprotein cholesterol levels and cardiac mortality in patients with coronary heart disease (from the bezafibrate infarction prevention trial)”, Am J Cardiol, Vol. 97, No. 4, pp. 466-471 (2006).
144.Haim M., Benderly M., Boyko V., Goldenberg I., Tanne D., Battler A., Goldbourt U., Behar S., “Decrease in triglyceride level by bezafibrate is related to reduction of recurrent coronary events: A bezafibrate infarction prevention substudy”, Coron Artery Dis, Vol. 17, No. 5, pp. 455-461 (2006).
145.Shaish A., Harari A., Hananshvili L., Cohen H., Bitzur R., Luvish T., Ulman E., Golan M., Ben-Amotz A., Gavish D., Rotstein Z., Harats D., “9-cis beta-carotene-rich powder of the alga dunaliella bardawil increases plasma HDL-cholesterol in fibrate-treated patients”, Atherosclerosis, Vol. 189, No. 1, pp. 215-221 (2006).
146.Dormandy J. A., Charbonnel B., Eckland D. J., Erdmann E., Massi-Benedetti M., Moules I. K., Skene A. M., Tan M. H., Lefebvre P. J., Murray G. D., Standl E., Wilcox R. G., Wilhelmsen L., Betteridge J., Birkeland K., Golay A., Heine R. J., Koranyi L., Laakso M., Mokan M., Norkus A., Pirags V., Podar T., Scheen A., Scherbaum W., Schernthaner G., Schmitz O., Skrha J., Smith U., Taton J., “Secondary prevention of macrovascular events in patients with type 2 diabetes in the proactive study (prospective pioglitazone clinical trial in macrovascular events): A randomised controlled trial”, Lancet, Vol. 366, No. 9493, pp. 1279-1289 (2005).
147.Wang T. D., Chen W. J., Lin J. W., Chen M. F., Lee Y. T., “Effects of rosiglitazone on endothelial function, C-reactive protein, and components of the metabolic syndrome in nondiabetic patients with the metabolic syndrome”, Am J Cardiol, Vol. 93, No. 3, pp. 362-365 (2004).
148.Sourij H., Zweiker R., Wascher T. C., “Effects of pioglitazone on endothelial function, insulin sensitivity, and glucose control in subjects with coronary artery disease and new-onset type 2 diabetes”, Diabetes Care, Vol. 29, No. 5, pp. 1039-1045 (2006).
149.Nakamura T., Matsuda T., Kawagoe Y., Ogawa H., Takahashi Y., Sekizuka K., Koide H., “Effect of pioglitazone on carotid intima-media thickness and arterial stiffness in type 2 diabetic nephropathy patients”, Metabolism, Vol. 53, No. 10, pp. 1382-1386 (2004).
150.Sidhu J. S., Kaposzta Z., Markus H. S., Kaski J. C., “Effect of rosiglitazone on common carotid intima-media thickness progression in coronary artery disease patients without diabetes mellitus”, Arterioscler Thromb Vasc Biol, Vol. 24, No. 5, pp. 930-934 (2004).
151.Bakris G. L., Ruilope L. M., McMorn S. O., Weston W. M., Heise M. A., Freed M. I., Porter L. E., “Rosiglitazone reduces microalbuminuria and blood pressure independently of glycemia in type 2 diabetes patients with microalbuminuria”, J Hypertens, Vol. 24, No. 10, pp. 2047-2055 (2006).
152.Nissen S. E., Wolski K., “Effect of rosiglitazone on the risk of myocardial infarction and death from cardiovascular causes”, N Engl J Med, Vol. 356, No. 24, pp. 2457-2471 (2007).
153.Sotiropoulos K., Clermont A., Yasuda Y., Rask-Madsen C., Mastumoto M., Takahashi J., Della Vecchia K., Kondo T., Aiello L., King G., “Adipose-specific effect of rosiglitazone on vascular permeability and protein kinase c activation: Novel mechanism for PPAR {gamma} agonist''s effects on edema and weight gain”, FASEB J, Vol. 20, No. 8, pp. 1203-1205 (2006).
154.Lohray B. B., Lohray V. B., Bajji A. C., Kalchar S., Poondra R. R., Padakanti S., Chakrabarti R., Vikramadithyan R. K., Misra P., Juluri S., Mamidi N. V., Rajagopalan R., “(-)3-[4-[2-(phenoxazin-10-yl) ethoxy]phenyl]-2-ethoxypropanoic acid [(-)drf 2725]: A dual PPAR agonist with potent antihyperglycemic and lipid modulating activity”, J Med Chem, Vol. 44, No. 16, pp. 2675-2678 (2001).
155.Etgen G. J., Oldham B. A., Johnson W. T., Broderick C. L., Montrose C. R., Brozinick J. T., Misener E. A., Bean J. S., Bensch W. R., Brooks D. A., Shuker A. J., Rito C. J., McCarthy J. R., Ardecky R. J., Tyhonas J. S., Dana S. L., Bilakovics J. M., Paterniti J. R., Jr., Ogilvie K. M., Liu S., Kauffman R. F., “A tailored therapy for the metabolic syndrome: The dual peroxisome proliferator-activated receptor-alpha/gamma agonist LY465608 ameliorates insulin resistance and diabetic hyperglycemia while improving cardiovascular risk factors in preclinical models”, Diabetes, Vol. 51, No. 4, pp. 1083-1087 (2002).
156.Mamnoor P. K., Hegde P., Datla S. R., Damarla R. K., Rajagopalan R., Chakrabarti R., “Antihypertensive effect of ragaglitazar: A novel PPARalpha and gamma dual activator”, Pharmacol Res, Vol. 54, No. 2, pp. 129-135 (2006).
157.Nissen S. E., Wolski K., Topol E. J., “Effect of muraglitazar on death and major adverse cardiovascular events in patients with type 2 diabetes mellitus”, JAMA, Vol. 294, No. 20, pp. 2581-2586 (2005).
158.De Ciuceis C., Amiri F., Iglarz M., Cohn J. S., Touyz R. M., Schiffrin E. L., “Synergistic vascular protective effects of combined low doses of PPARalpha and PPARgamma activators in angiotensin ii-induced hypertension in rats”, Br J Pharmacol, Vol. 151, No. 1, pp. 45-53 (2007).
159.Benkirane K., Viel E. C., Amiri F., Schiffrin E. L., “Peroxisome proliferator-activated receptor gamma regulates angiotensin ii-stimulated phosphatidylinositol 3-kinase and mitogen-activated protein kinase in blood vessels in vivo”, Hypertension, Vol. 47, No. 1, pp. 102-108 (2006).
160.Piccinni C., Motola D., Marchesini G., Poluzzi E., “Assessing the association of pioglitazone use and bladder cancer through drug adverse event reporting”, Diabetes care, Vol. 34, No. 6, pp. 1369-1371 (2011).
161.Gadang V., Gilbert W., Hettiararchchy N., Horax R., Katwa L., Devareddy L., “Dietary bitter melon seed increases peroxisome proliferator-activated receptor-gamma gene expression in adipose tissue, down-regulates the nuclear factor-kappab expression, and alleviates the symptoms associated with metabolic syndrome”, J Med Food, Vol. 14, No. 1-2, pp. 86-93 (2011).
162.Wu W. H., Lin B. Y., Kuo Y. H., Huang C. J., “Triglycerides constituted of short and medium chain fatty acids and dicarboxylic acids in Momordica charantia, as well as capric acid, inhibit PGE 2 production in Raw264.7 macrophages”, Food Chemistry , pp. 1-6 (2009).
163.Miura T., Itoh Y., Iwamoto N., Kato M., Ishida T., “Suppressive activity of the fruit of Momordica charantia with exercise on blood glucose in type 2 diabetic mice”, Biol Pharm Bull, Vol. 27, No. 2, pp. 248-250 (2004).
164.蔡崇煌、陳靖棻、蔡新聲、黃青真、林澤銘，「降血糖藥物分類：Diabetes M」，澄清醫護管理雜誌，第7卷，第1期，第42-51頁(2011)。
165.American Diabetes Association, “Diagnosis and classification of diabetes mellitus”, Diabetes Care, Vol. 33 Suppl 1, pp. S62-69 (2010).
166.Nathan D. M., Buse J. B., Davidson M. B., Ferrannini E., Holman R. R., Sherwin R., Zinman B., “Medical management of hyperglycemia in type 2 diabetes: A consensus algorithm for the initiation and adjustment of therapy: A consensus statement of the american diabetes association and the european association for the study of diabetes”, Diabetes Care, Vol. 32, No. 1, pp. 193-203 (2009).
167.Ooi C. P., Yassin Z., Hamid T. A., “Momordica charantia for type 2 diabetes mellitus”, Cochrane Database Syst Rev, No. 2, pp. CD007845 (2010).
168.Dixit V. P., Khanna P., Bhargava S. K., “Effects of Momordica charantia L. Fruit extract on the testicular function of dog”, Planta Med, Vol. 34, No. 3, pp. 280-286 (1978).
169.Inayat ur R., Malik S. A., Bashir M., Khan R., Iqbal M., “Serum sialic acid changes in non-insulin-dependant diabetes mellitus (NIDDM) patients following bitter melon (Momordica charantia) and rosiglitazone (avandia) treatment”, Int J Phytother Phytopharmacol, Vol. 16, No. 5, pp. 401-405 (2009).
170.Leatherdale B. A., Panesar R. K., Singh G., Atkins T. W., Bailey C. J., Bignell A. H., “Improvement in glucose tolerance due to Momordica charantia (karela)”, Br Med J (Clin Res Ed), Vol. 282, No. 6279, pp. 1823-1824 (1981).
171.Welihinda J., Karunanayake E. H., Sheriff M. H., Jayasinghe K. S., “Effect of Momordica charantia on the glucose tolerance in maturity onset diabetes”, J Ethnopharmacol, Vol. 17, No. 3, pp. 277-282 (1986).
172.Grover J., Gupta S., “Hypoglycemic activity of seeds of Momordica charantia”, Eur J Pharmacol, Vol. 183, pp. 1026-1027 (1990).
173.Ahmad N., Hassan M. R., Halder H., Bennoor K. S., “Effect of Momordica charantia (karolla) extracts on fasting and postprandial serum glucose levels in NIDDM patients”, Bangladesh Med Res Counc Bull, Vol. 25, No. 1, pp. 11-13 (1999).
174.Rosales R., Fernando R., “An inquiry to the hypoglycemic action of Momordica charantia among type 2 diabetes patients”, Philipp J Intern Med, Vol. 7, No. 8, pp. 213-216 (2001).
175.John A. J., Cherian R., Subhash H. S., Cherian A. M., “Evaluation of the efficacy of bitter gourd (Momordica charantia) as an oral hypoglycemic agent--a randomized controlled clinical trial”, Indian J Physiol Pharmacol, Vol. 47, No. 3, pp. 363-365 (2003).
176.Kasbia G. S., Arnason J. T., Imbeault P., “No effect of acute, single dose oral administration of Momordica charantia Linn., on glycemia, energy expenditure and appetite: A pilot study in non-diabetic overweight men”, J Ethnopharmacol, Vol. 126, No. 1, pp. 127-133 (2009).
177.Monograph, “Momordica charantia (bitter melon) ”, Altern Med Rev, Vol. 12, No. 4, pp. 360-363 (2007).
178.Zhang M., Hettiarachchy N. S., Horax R., Chen P., Over K. F., “Effect of maturity stages and drying methods on the retention of selected nutrients and phytochemicals in bitter melon (Momordica charantia) leaf”, J Food Sci, Vol. 74, No. 6, pp. C441-448 (2009).
179.謝婉郁，「山苦瓜改善血糖血脂代謝異常之效應探討」，碩士論文，國立臺灣大學微生物與生化學研究所，臺北(2005)。
180.Geil P., Shane-McWhorter L., “Dietary supplements in the management of diabetes: Potential risks and benefits”, J Am Diet Assoc, Vol. 108, No. 4 Suppl 1, pp. S59-65 (2008).
181.Raman A., Lau C., “Anti-diabetic properties and phytochemistry of Momordica charantia L. (cucurbitaceae)”, Phytomedicine, Vol. 2, No. 4, pp. 349-362 (1996).
182.Tennekoon K. H., Jeevathayaparan S., Angunawala P., Karunanayake E. H., Jayasinghe K. S., “Effect of Momordica charantia on key hepatic enzymes”, J Ethnopharmacol, Vol. 44, No. 2, pp. 93-97 (1994).
183.Nadkarni N., D''Cruz S., Sachdev A., “Hematemesis due to bitter melon (Momordica charantia) extract-induced gastric ulcerations”, Indian J Gastroenterol, Vol. 29, No. 1, pp. 37-38 (2010).
184.Alam S., Asad M., Asdaq S. M., Prasad V. S., “Antiulcer activity of methanolic extract of Momordica charantia L. In rats”, J Ethnopharmacol, Vol. 123, No. 3, pp. 464-469 (2009).
185.Hulin A., Wavelet M., Desbordes J., “Intoxication aigue par Momordica charantia. A propos de deux eas”, Medecine d’Affrique Noir, Vol. 35, pp. 671-674 (1988).
186.Isomaa B., Almgren P., Tuomi T., Forsen B., Lahti K., Nissen M., Taskinen M. R., Groop L., “Cardiovascular morbidity and mortality associated with the metabolic syndrome”, Diabetes Care, Vol. 24, No. 4, pp. 683-689 (2001).
187.Kylin E., “Studien über das hypertonie-hyperglykämie-hyperurikämiesyndrom”, Zentralbl Inn Med, Vol. 81, pp. 105-127 (1923).
188.Reaven G. M., “Role of insulin resistance in human disease”, Diabetes, Vol. 37, No. 12, pp. 1595-1607 (1988).
189.Kaplan N. M., “The deadly quartet: Upper body obesity, glucose intolerance, hypertriglyceridemia, and hypertension”, Arch intern Med, Vol. 149, pp. 1541-1520 (1989).
190.Alberti K. G., Zimmet P. Z., “Definition, diagnosis and classification of diabetes mellitus and its complications. Part 1: Diagnosis and classification of diabetes mellitus provisional report of a WHO consultation”, Diabe med, Vol. 15, No. 7, pp. 539-553 (1998).
191.Grundy S. M., Brewer H. B., Jr., Cleeman J. I., Smith S. C., Jr., Lenfant C., “Definition of metabolic syndrome: Report of the national heart, lung, and blood institute/american heart association conference on scientific issues related to definition”, Arterioscler Thromb Vasc Biol, Vol. 24, No. 2, pp. e13-18 (2004).
192.Grundy S. M., Cleeman J. I., Daniels S. R., Donato K. A., Eckel R. H., Franklin B. A., Gordon D. J., Krauss R. M., Savage P. J., Smith S. C., Jr., Spertus J. A., Costa F., “Diagnosis and management of the metabolic syndrome: An american heart association/national heart, lung, and blood institute scientific statement”, Circulation, Vol. 112, No. 17, pp. 2735-2752 (2005).
193.Tan C. E., Ma S., Wai D., Chew S. K., Tai E. S., “Can we apply the national cholesterol education program adult treatment panel definition of the metabolic syndrome to asians?”, Diabetes Care, Vol. 27, No. 5, pp. 1182-1186 (2004).
194.Gami A., Witt B., Howard D., Erwin P., Gami L., Somers V., Montori V., “Metabolic syndrome and risk of incident cardiovascular events and death a systematic review and meta-analysis of longitudinal studies”, J Am Coll Cardiol, Vol. 49, No. 4, pp. 403-414 (2007).
195.國民健康局，「代謝症候群防治策略」 http://www.bhp.doh.gov.tw:8080/BHP/fileviewer?id=355578，(2004)。
196.國民健康局，「成人(20歲以上)代謝症候群之判定標準(2006台灣) 」http://www.bhp.doh.gov.tw/bhpnet/portal/them_show.aspx?subject=200712250023&class=2&no=200712250123，(2006)。
197.Ford E. S., “Rarer than a blue moon: The use of a diagnostic code for the metabolic syndrome in the U.S.”, Diabetes Care, Vol. 28, No. 7, pp. 1808-1809 (2005).
198.Kahn R., “Metabolic syndrome: Is it a syndrome? Does it matter?”, Circulation, Vol. 115, No. 13, pp. 1806-1810; discussion 1811 (2007).
199.Grundy S. M., “Does the metabolic syndrome exist?”, Diabetes Care, Vol. 29, No. 7, pp. 1689-1692; discussion 1693-1686 (2006).
200.Reaven G. M., “The individual components of the metabolic syndrome: Is there a raison d''etre?”, J Am Coll Nutr, Vol. 26, No. 3, pp. 191-195 (2007).
201.Blaha M., Elasy T., A, “Clinical use of the metabolic syndrome: Why the confusion?”, Clin Diabetis, Vol. 24, pp. 125-131 (2006).
202.蔡崇煌、林正介、林高德，「代謝症候群之診斷及處置」，台灣家醫研究， 第6卷，第2期，第53-65頁(2008)。
203.蔡崇煌、黃素雲，「代謝症候群－臨床醫師的共同課題」，台灣醫界雜誌，第53卷，第2期，第21-24頁(2010)。
204.Balkau B., Charles M. A., “Comment on the provisional report from the WHO consultation. European group for the study of insulin resistance (EGIR)”, Diabet Med, Vol. 16, No. 5, pp. 442-443 (1999).
205.Alberti K. G., Zimmet P., Shaw J., “The metabolic syndrome--a new worldwide definition”, Lancet, Vol. 366, No. 9491, pp. 1059-1062 (2005).
206.Vague J., “Sexual differentiation. A factor affecting the forms of obesity”, Presse Med, Vol. 30, pp. 339-340 (1947).
207.Vague J., “The degree of masculine differentiation of obesities: A factor determining predisposition to diabetes, atherosclerosis, gout, and uric calculous disease”, Am J Clin Nutr, Vol. 4, No. 1, pp. 20-34 (1956).
208.Bloomgarden Z. T., “Definitions of the insulin resistance syndrome: The 1st world congress on the insulin resistance syndrome”, Diabetes Care, Vol. 27, No. 3, pp. 824-830 (2004).
209.Ruderman N. B., D C., Pi-Sunyer X., Schneider S., “The metabolically obese, normal-weight individual revisited ”, Diabetes, Vol. 47, pp. 699-714 (1998).
210.McNeill A. M., Rosamond W. D., Girman C. J., Golden S. H., Schmidt M. I., East H. E., Ballantyne C. M., Heiss G., “The metabolic syndrome and 11-year risk of incident cardiovascular disease in the atherosclerosis risk in communities study”, Diabetes Care, Vol. 28, No. 2, pp. 385-390 (2005).
211.Rexrode K. M., Carey V. J., Hennekens C. H., Walters E. E., Colditz G. A., Stampfer M. J., Willett W. C., Manson J. E., “Abdominal adiposity and coronary heart disease in women”, JAMA, Vol. 280, No. 21, pp. 1843-1848 (1998).
212.Sarwar N., Danesh J., Eiriksdottir G., Sigurdsson G., Wareham N., Bingham S., Boekholdt S. M., Khaw K. T., Gudnason V., “Triglycerides and the risk of coronary heart disease: 10,158 incident cases among 262,525 participants in 29 western prospective studies”, Circulation, Vol. 115, No. 4, pp. 450-458 (2007).
213.Otvos J. D., Jeyarajah E. J., Cromwell W. C., “Measurement issues related to lipoprotein heterogeneity”, Am J Cardiol, Vol. 90, No. 8A, pp. 22i-29i (2002).
214.Jeppesen J., Hansen T. W., Rasmussen S., Ibsen H., Torp-Pedersen C., Madsbad S., “Insulin resistance, the metabolic syndrome, and risk of incident cardiovascular disease: A population-based study”, J Am Coll Cardiol, Vol. 49, No. 21, pp. 2112-2119 (2007).
215.Kullo I. J., Cassidy A. E., Peyser P. A., Turner S. T., Sheedy P. F., 2nd, Bielak L. F., “Association between metabolic syndrome and subclinical coronary atherosclerosis in asymptomatic adults”, Am J Cardiol, Vol. 94, No. 12, pp. 1554-1558 (2004).
216.Santos R. D., Nasir K., Tufail K., Meneghelo R. S., Carvalho J. A., Blumenthal R. S., “Metabolic syndrome is associated with coronary artery calcium in asymptomatic white brazilian men considered low-risk by framingham risk score”, Prev Cardiol, Vol. 10, No. 3, pp. 141-146 (2007).
217.Diabetes Epidemiology: Collaborative analysis Of Diagnostic Criteria in Europe (DECODE) Study Group, “Does diagnosis of the metabolic syndrome detect further men at high risk of cardiovascular death beyond those identified by a conventional cardiovascular risk score? The decode study”, Eur J Cardiovasc Prev Rehabil, Vol. 14, No. 2, pp. 192-199 (2007).
218.蔡崇煌、李孟智、黃素雲、楊明和、王素美、林高德，「代謝症候群在生物心理社會模式之考量」，澄清醫護管理雜誌，第3卷，第8-16頁(2007)。
219.Tsai C. H., Li T. C., Lin C. C., Tsay H. S., “Factor analysis of modifiable cardiovascular risk factors and prevalence of metabolic syndrome in adult Taiwanese”, Endocrine, Vol. 40, No. 2, pp. 256-264 (2011).
220.Kahn R., Buse J., Ferrannini E., Stern M., “The metabolic syndrome: Time for a critical appraisal: Joint statement from the american diabetes association and the european association for the study of diabetes”, Diabetes Care, Vol. 28, No. 9, pp. 2289-2304 (2005).
221.Johnson L. W., Weinstock R. S., “The metabolic syndrome: Concepts and controversy”, Mayo Clin Proc, Vol. 81, No. 12, pp. 1615-1620 (2006).
222.蔡崇煌、黃青真、蔡新聲，「心臟血管危險變項之探究式因素分析」，澄清醫護管理雜誌，第7卷，第3期，第30-40頁(2011)。
223.Hanley A. J., Karter A. J., Festa A., D''Agostino R., Jr., Wagenknecht L. E., Savage P., Tracy R. P., Saad M. F., Haffner S., “Factor analysis of metabolic syndrome using directly measured insulin sensitivity: The insulin resistance atherosclerosis study”, Diabetes, Vol. 51, No. 8, pp. 2642-2647 (2002).
224.Shen B. J., Todaro J. F., Niaura R., McCaffery J. M., Zhang J., Spiro A., 3rd, Ward K. D., “Are metabolic risk factors one unified syndrome? Modeling the structure of the metabolic syndrome x”, Am J Epidemiol, Vol. 157, No. 8, pp. 701-711 (2003).
225.Chuang S. Y., Chen C. H., Chou P., “Hypertension and the insulin-related metabolic syndrome: Factor analysis in 17,539 Taiwanese”, Acta Cardiologica Sinica, Vol. 20, No. 4, pp. 229-236 (2004).
226.Liou T. L., Lin M. W., Hsiao L. C., Tsai T. T., Chan W. L., Ho L. T., Hwu C. M., “Is hyperuricemia another facet of the metabolic syndrome?”, J Chin Med Assoc, Vol. 69, No. 3, pp. 104-109 (2006).
227.Lawlor D. A., Ebrahim S., May M., Davey Smith G., “(mis)use of factor analysis in the study of insulin resistance syndrome”, Am J Epidemiol, Vol. 159, No. 11, pp. 1013-1018 (2004).
228.Chen C. H., Lin K. C., Tsai S. T., Chou P., “Different association of hypertension and insulin-related metabolic syndrome between men and women in 8437 nondiabetic chinese”, Am J Hypertens, Vol. 13, No. 7, pp. 846-853 (2000).
229.Resnick H. E., Jones K., Ruotolo G., Jain A. K., Henderson J., Lu W., Howard B. V., “Insulin resistance, the metabolic syndrome, and risk of incident cardiovascular disease in nondiabetic american indians: The strong heart study”, Diabetes Care, Vol. 26, No. 3, pp. 861-867 (2003).
230.Meigs J. B., “The metabolic syndrome”, BMJ, Vol. 327, No. 7406, pp. 61-62 (2003).
231.Braunstein J. B., Cheng A., Fakhry C., Nass C. M., Vigilance C., Blumenthal R. S., “ABCs of cardiovascular disease risk management”, Cardiol Rev, Vol. 9, No. 2, pp. 96-105 (2001).
232.陳嬿如、黃麗卿，「胰島素敏感性及抗性之測定方法」，基層醫學，第20卷，第10期，第253-259頁(2005)。
233.莊其穆，「臨床醫師如何執行第一期臨床試驗」，台灣醫界，第54卷，第4期，第201-210頁(2011)。
234.Patel J. C., Dhirawani M. K., Doshi J. C., “"Karella" in the treatment of diabetes mellitus”, Indian J Med Sci, Vol. 22, No. 1, pp. 30-32 (1968).
235.Shah P. B., “Intention-to-treat and per-protocol analysis”, CMAJ : Canadian Medical Association journal = journal de l''Association medicale canadienne, Vol. 183, No. 6, pp. 696; author reply 696 (2011).
236.Polit D. F., Gillespie B. M., “Intention-to-treat in randomized controlled trials: Recommendations for a total trial strategy”, Res Nurs Health, Vol. 33, No. 4, pp. 355-368 (2010).
237.Montori V. M., Guyatt G. H., “Intention-to-treat principle”, CMAJ, Vol. 165, No. 10, pp. 1339-1341 (2001).
238.Littell R. C., Stroup W. W., Freund R. J., “SAS system for linear models”, SAS Institute, Cary, NC, (2002).
239.Rubin D. B., “Inference and missing data”, Biometrika, Vol. 63, No. 3, pp. 581 (1976).
240.Shih C. C., Lin C. H., Lin W. L., Wu J. B., “Momordica charantia extract on insulin resistance and the skeletal muscle GLUT4 protein in fructose-fed rats”, J Ethnopharmacol, Vol. 123, No. 1, pp. 82-90 (2009).
241.Wang Z. Q., Zhang X. H., Yu Y., Poulev A., Ribnicky D., Floyd Z. E., Cefalu W. T., “Bioactives from bitter melon enhance insulin signaling and modulate acyl carnitine content in skeletal muscle in high-fat diet-fed mice”, J Nutr Biochem, Vol. 22, No. 11, pp. 1064-1073 (2011).
242.Yin J., Zhang H., Ye J.,“Traditional chinese medicine in treatment of metabolic syndrome”, Endocr Metab Immune Disord Drug Targets, Vol. 8, No. 2, pp. 99-111 (2008).
243.Chan L. L., Chen Q., Go A. G., Lam E. K., Li E. T., “Reduced adiposity in bitter melon (Momordica charantia)-fed rats is associated with increased lipid oxidative enzyme activities and uncoupling protein expression”, J Nutr, Vol. 135, No. 11, pp. 2517-2523 (2005).
244.Chen Q., Li E. T., “Reduced adiposity in bitter melon (Momordica charantia) fed rats is associated with lower tissue triglyceride and higher plasma catecholamines”, Br J Nutr, Vol. 93, No. 5, pp. 747-754 (2005).
245.Martinez M. N., Emfinger C. H., Overton M. H., Hill S., Ramaswamy T. S., Cappel D. A., Wu K., Fazio S., McDonald W. H., Hachey D. L., Tabb D. L., Stafford J. M., “Obesity and altered glucose metabolism impact HDL composition in cetp transgenic mice: A role for ovarian hormones”, J Lipid Res, (2012).
246.Nicholls S. J., Brewer H. B., Kastelein J. J., Krueger K. A., Wang M. D., Shao M., Hu B., McErlean E., Nissen S. E., “Effects of the CETP inhibitor evacetrapib administered as monotherapy or in combination with statins on HDL and LDL cholesterol: A randomized controlled trial”, JAMA, Vol. 306, No. 19, pp. 2099-2109 (2011).
247.Surwit R. S., Kuhn C. M., Cochrane C., McCubbin J. A., Feinglos M. N., “Diet-induced type ii diabetes in c57bl/6j mice”, Diabetes, Vol. 37, No. 9, pp. 1163-1167 (1988).
248.Saha S., New L. S., Ho H. K., Chui W. K., Chan E. C., “Investigation of the role of the thiazolidinedione ring of troglitazone in inducing hepatotoxicity”, Toxicol Lett, Vol. 192, No. 2, pp. 141-149 (2010).