Cetyl Myristoleate를 주성분으로 하는 식물성 복합 지방산의 퇴행성 슬관절염 환자에 대한 통증 감소 효과
Effect of Cis-9-Cetylmyristoleate Containing Fatty Acids Complex Extracted from Vegetable Oils on Knee Pain in Patients with Osteoarthritis
3
조회
0
다운로드
2
인용
0
참고문헌
키워드
초록
연구배경: Cetyl myristoleate를 주성분으로 한 쇠기름 추출 복합지방산(fatt y aicd complex, FAC)이 퇴행성 슬관절염의 통증조절에 효과적이라는 보고가 있었다. 본 연구는 식물에서 cetyl myristoleate를 함유한 복합지방산을 추출하여, 이 보충제가 슬관절염 환자의 통증 감소 및 관절기능 향상에 효과적인지 알아보고자 하였다. 방법: 퇴행성 슬관절염으로 진단된 46-77세의 피험자 70명을 이중맹검 무작위 할당 방식으로 식물성 FAC군(N=34) 및위약군(N=36)에 배정하였다. 식물성 FAC군은 2정의 FAC (350 mg 중 cetyl myristoleate 12% 함유)를, 위약군은 동일 제형의 위약 2정을 각각 하루 3회 총 60일간 복용하였다. 관절통증 척도로서 visual analogue scale (VAS)과 관절기능 척도로서 Korean version of Western Ontario and McMaster’s Universities Osteoarthritis Index (KWOMAC)를 투약기간 전후로 측정하였다. 결과: 위약군 36명 중 6명(16.7%), 식물성 FAC군 34명 중 5명(14.7%)이 탈락하여 결과 분석에는 위약군 및 식물성 FAC군각각 30명, 29명이 포함되었다. 위약군에서 VAS 변화량은 평균 1.01점(6.18→5.17)으로 16.34% 감소하였다. 식물성 FAC군에서 VAS 변화량은 평균 0.76점(5.45→4.69)으로 13.94% 감소하였으나(P=0.03), 위약군보다 낮은 감소를 보였다. KWOMAC은식물성 FAC군 및 위약군에서 각각 평균 8.90점(40.83→31.93)및 8.13점(45.63→37.50) 감소하였으나, 독립표본 t-검정 결과 통계적으로 유의한 차이를 보이지 않았다(P=0.47). 결론: Cetyl myristoleate를 주성분으로 하는 식물에서 추출한복합지방산은 슬관절염 환자의 관절통증 및 관절기능 향상에있어서 위약보다 나은 효과를 보이지 않았다.
Abstract
Background: Previous study suggested that beef tallow extract including cis-9-cetylmyristoleate was a safe and effective treatment for patients with osteoarthritis. We used extract of vegetable oils containing cetyl myristoleate. This study assessed the effect of this supplementation on knee pain and function in patients with osteoarthritis. Methods: The 70 patients who manifested the symptoms and signs of osteoarthritis of knee were randomly assigned to placebo (36) and plant-fatty acids complex (FAC) group (34). Two capsules of placebo (corn starch 350 mg) and plant-FAC (12% cetyl myristoleate in 350 mg) were orally administered to placebo and plant-FAC group three times a day for 60 day, respectively. Visual analogue scale (VAS) and Korean version of Western Ontario and McMaster’s Universities Osteoarthritis Index (KWOMAC) were assessed before and after the intervention and we monitored any adverse effects. Results: The 6 of 36 patients (16.7%) in the placebo and the 5 of 34 patients (14.7%) in the plant-FAC group were missed due to low compliance. In the plant-FAC group, the VAS score was improved by mean 0.76 (P = 0.03) but the improvement was lower than that of placebo group. The KWOMAC was improved by mean 8.90 and 8.13 in the plant-FAC and placebo group, respectively. But the independent t-test showed no statistical signifi cance (P = 0.47). Conclusion: We failed to show the superiority of plant-FAC to placebo on the pain and function of patients with osteoarthritis of the knee.
참고문헌 (23)
- Felson DT, "Clinical practice. Osteoarthritis of the knee", N Engl J Med, 354, pp.841~848 (2006)
- McAlindon TE, "Knee pain and disability in the community", Br J Rheumatol, 31, pp.189~192 (1992)
- 문우남, "무릎통증을 호소하는 여자에서의 방사선적 골관절염의 빈도", 대한류마티스학회지, 10(1), pp.2~15 (2003), 대한류마티스학회
- Schurman DJ, "Osteoarthritis: current treatment and future prospects for surgical, medical, and biologic intervention", Clin Orthop Relat Res, 427, pp.183~189 (2004)
- Griffin MR, "Nonsteroidal anti-inflammatory drug use and increased risk for peptic ulcer disease in elderly persons", Ann Intern Med, 114, pp.257~263 (1991)
- Fries JF, "The relative toxicity of nonsteroidal antiinflammatory drugs", Arthritis Rheum, 34, pp.1353~1360 (1991)
- Pelletier JP, "Most recent developments in strategies to reduce the progression of structural changes in osteoarthritis: today and tomorrow", Arthritis Res Ther, 8, pp.206~ (2006)
- Farahat MN, "Cytokine expression in synovial membranes of patients with rheumatoid arthritis and osteoarthritis", Ann Rheum Dis, 52, pp.870~875 (1993)
- Benito MJ, "Synovial tissue infl ammation in early and late osteoarthritis", Ann Rheum Dis, 64, pp.1263~1267 (2005)
- Ameye LG, "Osteoarthritis and nutrition. From nutraceuticals to functional foods: a systematic review of scientific evidence", Arthritis Res Ther, 8, pp.127~ (2006)
- Joo-Han Oh, "The Efficacy and Safety of Beef Tallow Extract Including Cis-9-cetylmyristoleate in Patients with Osteoarthritis- As an Adjuvant Pharmacological Treatment -", Journal of Food Science and Nutrition, 10(3), pp.285~289 (2005), 한국식품영양과학회
- Peat G, "Clinical classification criteria for knee osteoarthritis: performance in the general population and primary care", Ann Rheum Dis, 65, pp.1363~1367 (2006)
- Treadwell MJ, "Using quality improvement strategies to enhance pediatric pain assessment", Int J Qual Health Care, 14, pp.39~47 (2002)
- Bellamy N, "The WOMAC knee and hip osteoarthritis indices: development, validation, globalization and influence on the development of the AUSCAN hand osteoarthritis indices", Clin Exp Rheumatol, 23, pp.148~153 (2005)
- Bae SC, "Crosscultural adaptation and validation of Korean Western Ontario and McMaster Universities (WOMAC) and lequesne osteoarthritis indices for clinical research", Osteoarthritis Cartilage, 9, pp.746~750 (2001)
- Calder PC, "Fatty acids and lymphocyte functions", Br J Nutr, 87, pp.31~48 (2002)
- Kremer JM, "Effects of high-dose fish oil on rheumatoid arthritis aft er stopping nonsteroidal antiinfl ammatory drugs. Clinical and immune correlates", Arthritis Rheum, 38, pp.1107~1114 (1995)
- Revell PA, "The synovial membrane in osteoarthritis: a histological study including the characterisation of the cellular infiltrate present in inflammatory osteoarthritis using monoclonal antibodies", Ann Rheum Dis, 47, pp.300~307 (1988)
- Diehl HW, "Cetyl myristoleate isolated from Swiss albino mice: an apparent protective agent against adjuvant arthritis in rats", J Pharm Sci, 83, pp.296~299 (1994)
- Hunter KW Jr, "Synthesis of cetyl myristoleate and evaluation of its therapeutic efficacy in a murine model of collagen-induced arthritis", Pharmacol Res, 47, pp.43~47 (2003)
- Hesslink R Jr, "Cetylated fatty acids improve knee function in patients with osteoarthritis", J Rheumatol, 29, pp.1708~1712 (2002)
- Kraemer WJ, "Effects of treatment with a cetylated fatty acid topical cream on static postural stability and plantar pressure distribution in patients with knee osteoarthritis", J Strength Cond Res, 19, pp.115~121 (2005)
- Morelli V, "Alternative therapies for traditional disease states: osteoarthritis", Am Fam Physician, 67, pp.339~344 (2003)