致力於傳播正確醫學觀念，以期突破媒體的壟斷
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前幾篇講到咖啡的文章，我們探討了保肝、癌症、骨質舒鬆症等等，今天又要講到咖啡和糖尿病的關係了。
這裡有一篇新聞：喝咖啡糖尿病風險降11%，裡面說美國最新研究發現，咖啡攝取量高的成人，罹患糖尿病的機率較低，增加咖啡攝取量能降低約11%罹患第二型糖尿病的風險。此處下載原文。
Changes in Coffee Intake and Subsequent Risk of Type 2 Diabetes Bhupathira by arguskao
不只這篇文章，這裡也有一篇美國JAMA的醫學報告。芬蘭國立衛生研究，針對6974名男性和7655名女性進行研究，這些受試者都是三十五歲到六十四歲的健康男女。追蹤調查的結果發現，「咖啡的飲用量和罹患第二型糖尿病呈現負相關。
英國的醫學期刊《刺絡針（Lancet）》也刊載過一篇研究論文，裡面指出：「一天喝七杯以上咖啡的人，罹患糖尿病的機率比一天喝不到兩杯的人機率低。
下一篇咖啡中的綠原酸
看到肥胖會得癌症這個標題，大家一定嚇一跳吧，我也是看到這篇新聞：女重度肥胖，手術防子宮內膜癌。新聞提到美國加州大學聖地牙哥分校團隊發表於《婦科腫瘤學》的研究指出，BMI值大於40的女性，罹患子宮內膜癌的比例是BMI值25女性的8倍；研究人員分析逾740萬名女性的就醫紀錄後發現，若接受「胃繞道」、「袖狀胃切除」、「胃束帶」等減重手術，可降低罹患子宮內膜癌比例逾7成，若患者在手術後能控制飲食及保持運動習慣，罹癌風險更可減少達81%。
但是千萬不要隨便相信新聞標題，不然就會犯了某位醫師犯的錯喲。附註：感冒到底應不應該吃藥。
我們附上該篇英文報告，看來是真有這麼回事。
Researchers at the University of California, San Diego School of Medicine and Moores Cancer Center report that bariatric surgery resulting in dramatic weight loss in formerly severely obese women reduces the risk of endometrial (uterine) cancer by 71 percent and as much as 81 percent if normal weight is maintained after surgery.
Published in the April issue of Gynecologic Oncology, the official publication of the Society of Gynecologic Oncology, the findings indicate obesity may be a modifiable risk factor for endometrial cancer, and bariatric surgery a viable option for eligible patients. They are based on a retrospective cohort study of 7,431,858 patients in the University HealthSystem Consortium database, which contains information from contributing academic medical centers in the United States and affiliated hospitals. Of this total, 103,797 patients had a history of bariatric surgery and 44,345 had a diagnosis of uterine malignancy.
Obesity is a widespread public health problem in the United States, with an estimated two-thirds of the U.S. adult population considered to be overweight or obese. The condition is strongly linked to a host of health risks, among them heart disease, diabetes and cancer, in particular endometrial cancer.
“Estimating from various studies that looked at increasing BMI and endometrial cancer risk, a woman with a Body Mass Index (BMI) of 40 would have approximately eight times greater risk of endometrial cancer than someone with a BMI of 25,” said first author Kristy Ward, MD, the senior gynecologic oncology fellow in the Department of Reproductive Medicine at UC San Diego School of Medicine. “This risk likely continues to go up as BMI goes up.”
Bariatric surgery is often the last resort for obese patients after all other non-surgical weight loss efforts have failed. To qualify, patients must be an acceptable surgical risk and be defined as either severely obese with a BMI of 40 or greater or have a BMI of 35 or greater with at least one related condition: diabetes, obstructive sleep apnea, obesity-related cardiomyopathy or heart muscle disease or severe joint disease.
Typically, bariatric surgery involves reducing the size of the stomach using a constrictive gastric band, removing a portion of the stomach or resecting and re-routing the small intestines to a small stomach pouch. In all cases, the surgery must be followed by lifestyle changes to ensure long-term weight loss success.
A number of biological mechanisms link obesity to endometrial cancer. Excessive adipose or fat tissue, for example, raises circulating levels of estrogen, which is associated with tumor creation and metastasis. Obesity also causes chronic inflammation, boosting insulin resistance and increased estrogen levels.
“The majority of endometrial cancers are estrogen-driven,” said Ward. “In a normal menstruating woman, two hormones control the endometrium (inner lining of the uterus). Estrogen builds up the endometrium and progesterone stabilizes it. A woman with excess adipose tissue has an increased level of estrogen because the fat tissue converts steroid hormones into a form of estrogen.
“So there is too much estrogen, causing the endometrium to build up, but not enough progesterone to stabilize it. The endometrium continues to grow and can undergo changes into abnormal tissue, leading to cancer.”
Bariatric surgery has been shown to reduce the impact of these factors: hormone levels become normal; inflammation decreases; insulin resistance drops; weight loss allows for increased physical activity and improved overall health.
“The obesity epidemic is a complicated problem,” she said. “Further work is needed to define the role of bariatric surgery in cancer care and prevention, but we know that women with endometrial cancer are more likely to die of cardiovascular causes than they are of endometrial cancer. It’s clear that patients who are overweight and obese should be counseled about weight loss, and referral to a bariatric program should be considered in patients who meet criteria.”
Co-authors include Angelica M. Roncancio, University of Texas School of Public Health; Nina R. Shah, Mitzie-Ann Davis, Cheryl C. Saenz, Michael T. McHale and Steven C. Plaxe, all of UC San Diego Moores Cancer Center.
下一篇咖啡對於降低肝癌的報告
吃西藥傷胃，所以最好配個胃藥？你以為吃藥…真的只是吃藥嗎？小心「＜暗＞”鈉”不住」反傷腎！而胃痛到底該吃胃乳還是胃散？感冒藥一定要吃完嗎？久咳不癒，又該看哪一科？長期咳嗽該如何對症下藥？燙傷要在家緊急處理，可以冰敷、擦牙膏、小護士、或塗醬油嗎？鎖定這集健康同學會，告訴你是不是所有大病小病都非”藥”不可！
主 持 人：隋安德、張雅芳
來 賓：
保健室主任 潘懷宗 藥理學博士
值班醫師 王健宇 家庭醫學科
值班藥師 高啟峰
５年９班代表 洪素卿 資深醫藥記者
６年６班代表 劉芯彤 東森財經新聞台主播
６年２班代表 黃敬平 資深媒體人
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