含性激素、激活mTORC1信号途径……揭开乳制品致痘机制!

2022-01-25 丛博士 丛博士护肤课堂

饮食是导致长痘一个重要因素。包括牛奶及乳制品、甜食、巧克力、某些水果等都会导致长痘。今天重点介绍一下乳制品导致长痘的原因。

饮食是导致长痘一个重要因素。包括牛奶及乳制品、甜食、巧克力、某些水果等都会导致长痘。今天重点介绍一下乳制品导致长痘的原因。
 
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一、西方饮食与痤疮

研究发现:
以高血糖碳水化合物和牛奶为特征的西式饮食是诱发或加重寻常痤疮的主要因素。所谓西方饮食,指的是高糖、高脂、高乳制品等西方饮食习惯。研究发现,在以素食为主的一些原始部落的年轻人中不长痤疮。
实际上我们中国人的饮食习惯与西方已经相差无几了,所以也有学者把“寻常痤疮”列为现代文明病之一。迄今为止,乳制品被证实是所有饮食因素中与长痘关系最密切的!
牛奶可视为一种内分泌信号,可以提高IGF-1(胰岛素样生长因子-1)的血清水平和mTORC1的活性,从而促进生长和合成代谢。西式饮食增强的mTORC1/S6K1信号传导可以解释寻常痤疮与体重指数(body mass index, BMI)增加和胰岛素抵抗的关系。有证据表明,饮食干预可重新调整偏离正常的p53/mTORC1信号传导。
 
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二、牛奶中含有多种激素

研究发现,牛奶中包括所有种类的类固醇生殖激素,包括IGF-1、雄激素前体和雌孕激素。值得特别注意的是,许多激素是5α-双氢睾酮的前体,在体内还原为双氢睾酮而直接导致长痘。下面是饮食导致长痘的示意图。大家可以看到,乳制品可以通过乳制品摄入和乳制品激素两个方面导致皮脂溢出和粉刺形成。
 
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来源:参考文献1

三、通过IGF-mTORC1信号途径

乳制品,尤其是其所含的乳清蛋白和酪蛋白,是IGF-1的强有力的刺激因素。乳制品摄入后大量IGF-1生成,通过IGF-mTORC1信号途径,导致皮脂生成增多、毛囊漏斗部角化,从而导致粉刺及痘痘形成(见上图)。乳蛋白来源支链氨基酸(BCAA)可直接激活mTORC1,从而促进细胞合成代谢、皮脂生成和皮脂腺细胞存活。
 
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四、所有乳制品都会导致长痘吗?

目前研究发现,没有证据证明酸奶或奶酪与痤疮的发病有直接相关性。因此,理论上是可以吃酸奶和奶酪的。然而,市场上卖的酸奶多半为添加有糖、乳清蛋白、果粒等的风味酸奶。所以,只有没有添加剂的纯酸奶才没有致痘作用。那些味道很好的风味酸奶,还是少吃为妙。(见下图)
 
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只有纯酸奶可以吃
 

五、案例

国际著名时尚杂志Vogue在2018年报道了一个停止食用乳制品后痤疮自行消退的案例:
 
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再看一下我主译的《痤疮 病因与实用治疗》中的案例:
 
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小 结

1 大量科学研究证实了乳制品导致长痘的事实。两方面因素使得每天喝牛奶的朋友会长痘。一方面是,动物体内的生殖激素通过牛奶传递到人体内,这些激素可以直接促发长痘。另一方面,乳制品(尤其是乳清蛋白和酪蛋白),可以刺激大量IGF-1生成,并通过IGF-mTORC1信号途径,导致皮脂生成增多、毛囊漏斗部角化,从而导致粉刺及痘痘形成。
 
2 在没有其他因素的情况下,停止摄入乳制品极有可能使痘痘大量减少。
 
参考文献
1 丛林,尹志强主译. 痤疮 病因与实用治疗[M]. 北京:人民卫生出版社, 2019.07.
2 丛林. Plewig-Kligman痤疮与玫瑰痤疮 第4版[M]. 北京:北京大学医学出版社, 2021.01

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    2022-03-10 医者仁者
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    2022-01-31 ms5000001035087752

    学习了

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    2022-01-31 ms5000001035087752

    学习学习

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    2022-01-26 雕雕
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