生酮饮食可减少卵巢或子宫内膜癌女性的中心性肥胖和血清胰岛素。
A Ketogenic Diet Reduces Central Obesity and Serum Insulin in Women with Ovarian or Endometrial Cancer.
机构信息
Departments of Nutrition Sciences, University of Alabama at Birmingham, Birmingham, AL.
Departments of Health Behavior, University of Alabama at Birmingham, Birmingham, AL.
出版信息
J Nutr. 2018 Aug 1;148(8):1253-1260. doi: 10.1093/jn/nxy119.
BACKGROUND
The glycolytic nature of cancer cells presents a potential treatment target that may be addressed by a ketogenic diet (KD).
OBJECTIVE
We hypothesized that a KD would improve body composition and lower serum insulin and insulin-like growth factor-I (IGF-I) in women with ovarian or endometrial cancer.
METHODS
In this randomized controlled trial, women with ovarian or endometrial cancer [age: ≥19 y; body mass index (kg/m2): ≥18.5] were randomly assigned to a KD (70:25:5 energy from fat, protein, and carbohydrate) or the American Cancer Society diet (ACS; high-fiber, low-fat). Body composition (DXA) and fasting serum insulin, IGF-I, and β-hydroxybutyrate were obtained at baseline and at 12 wk; urinary ketones were also measured throughout the intervention. We assessed differences between the diets with ANCOVA and independent t tests. We used correlation analyses to estimate associations between changes in serum analytes and body composition.
RESULTS
After 12 wk, the KD (compared with ACS) group had lower adjusted total (35.3 compared with 38.0 kg, P < 0.05) and android (3.0 compared with 3.3 kg, P < 0.05) fat mass. Percentage of change in visceral fat was greater in the KD group (compared with the ACS group; -21.2% compared with -4.6%, P < 0.05). Adjusted total lean mass did not differ between the groups. The KD (compared with ACS) group had lower adjusted fasting serum insulin (7.6 compared with 11.2 µU/mL, P < 0.01). There was a significant inverse association between the changes in serum β-hydroxybutyrate and IGF-I concentrations (r = -0.57; P < 0.0001).
CONCLUSIONS
In women with ovarian or endometrial cancer, a KD results in selective loss of fat mass and retention of lean mass. Visceral fat mass and fasting serum insulin also are reduced by the KD, perhaps owing to enhanced insulin sensitivity. Elevated serum β-hydroxybutyrate may reflect a metabolic environment inhospitable to cancer proliferation. This trial was registered at www.clinicaltrials.gov as NCT03171506.
背景
癌细胞的糖酵解特性为治疗提供了一个潜在的靶点，而生酮饮食（KD）可能可以针对这一靶点进行治疗。
目的
我们假设 KD 可以改善身体成分并降低卵巢癌或子宫内膜癌女性的血清胰岛素和胰岛素样生长因子-I（IGF-I）水平。
方法
在这项随机对照试验中，患有卵巢癌或子宫内膜癌的女性（年龄：≥19 岁；体重指数（kg/m2）：≥18.5）被随机分配到生酮饮食（KD；脂肪、蛋白质和碳水化合物的能量分别为 70%、25%和 5%）或美国癌症协会饮食（ACS；高纤维、低脂肪）组。在基线和 12 周时，通过 DXA 获得身体成分和空腹血清胰岛素、IGF-I 和 β-羟丁酸；在整个干预过程中还测量了尿酮体。我们使用协方差分析和独立 t 检验评估两种饮食之间的差异。我们使用相关分析来估计血清分析物和身体成分变化之间的关联。
结果
12 周后，KD 组（与 ACS 组相比）的总脂肪量（35.3 公斤比 38.0 公斤，P<0.05）和腹型脂肪量（3.0 公斤比 3.3 公斤，P<0.05）较低。KD 组的内脏脂肪百分比变化更大（与 ACS 组相比；-21.2%比-4.6%，P<0.05）。两组的总瘦体重无差异。KD 组（与 ACS 组相比）的空腹血清胰岛素水平较低（7.6 微单位/毫升比 11.2 微单位/毫升，P<0.01）。血清 β-羟丁酸和 IGF-I 浓度的变化呈显著负相关（r=-0.57；P<0.0001）。
结论
在患有卵巢癌或子宫内膜癌的女性中，KD 可导致脂肪量选择性减少，瘦体重保持不变。KD 还可降低内脏脂肪量和空腹血清胰岛素水平，这可能归因于胰岛素敏感性增强。升高的血清 β-羟丁酸可能反映了不利于癌症增殖的代谢环境。该试验在 www.clinicaltrials.gov 上注册，编号为 NCT03171506。
Zotero 插件