Biology Department, Boston College, Chestnut Hill, MA 02467 USA.
Nutr Metab (Lond). 2015 Mar 11;12:12. doi: 10.1186/s12986-015-0009-2. eCollection 2015.
Metabolic therapy using ketogenic diets (KD) is emerging as an alternative or complementary approach to the current standard of care for brain cancer management. This therapeutic strategy targets the aerobic fermentation of glucose (Warburg effect), which is the common metabolic malady of most cancers including brain tumors. The KD targets tumor energy metabolism by lowering blood glucose and elevating blood ketones (β-hydroxybutyrate). Brain tumor cells, unlike normal brain cells, cannot use ketone bodies effectively for energy when glucose becomes limiting. Although plasma levels of glucose and ketone bodies have been used separately to predict the therapeutic success of metabolic therapy, daily glucose levels can fluctuate widely in brain cancer patients. This can create difficulty in linking changes in blood glucose and ketones to efficacy of metabolic therapy.
A program was developed (Glucose Ketone Index Calculator, GKIC) that tracks the ratio of blood glucose to ketones as a single value. We have termed this ratio the Glucose Ketone Index (GKI).
The GKIC was used to compute the GKI for data published on blood glucose and ketone levels in humans and mice with brain tumors. The results showed a clear relationship between the GKI and therapeutic efficacy using ketogenic diets and calorie restriction.
The GKIC is a simple tool that can help monitor the efficacy of metabolic therapy in preclinical animal models and in clinical trials for malignant brain cancer and possibly other cancers that express aerobic fermentation.
使用生酮饮食（KD）进行代谢治疗正在成为治疗脑癌的现行标准治疗方法的替代或补充方法。这种治疗策略针对的是葡萄糖的有氧发酵（Warburg 效应），这是包括脑肿瘤在内的大多数癌症的常见代谢异常。KD 通过降低血糖和提高血液酮体（β-羟基丁酸）来靶向肿瘤能量代谢。与正常脑细胞不同，当葡萄糖受到限制时，脑肿瘤细胞无法有效地将酮体用作能量。尽管血浆葡萄糖和酮体水平已被分别用于预测代谢治疗的疗效，但脑癌患者的血糖水平可能会广泛波动。这可能会导致将血糖和酮体的变化与代谢治疗的疗效联系起来变得困难。
开发了一个程序（血糖酮指数计算器，GKIC），该程序可将血糖与酮体的比值作为单个值进行跟踪。我们将该比值称为血糖酮指数（GKI）。
使用 GKIC 计算了人类和患有脑肿瘤的小鼠的血糖和酮体水平发表的数据的 GKI。结果表明，GKI 与使用生酮饮食和热量限制的治疗疗效之间存在明显关系。
GKIC 是一种简单的工具，可以帮助监测恶性脑癌的临床前动物模型和临床试验以及可能表达有氧发酵的其他癌症的代谢治疗的疗效。
