Clinical Trial Center, Hallym University Hospital, Anyang 14066, Korea.
College of Pharmacy, Ajou University, Suwon 16499, Korea.
Nutrients. 2020 Jul 6;12(7):2005. doi: 10.3390/nu12072005.
The aim of this meta-analysis was to explore the efficacy of a ketogenic diet in metabolic control in patients with overweight or obesity and with or without type 2 diabetes. Embase, PubMed, and Cochrane Library were searched for randomized controlled trials that enrolled patients with overweight or obesity on a ketogenic diet for metabolic control. Fourteen studies were included in meta-analysis. The effects of ketogenic diets on glycemic control were greater for diabetic patients relative to those of low-fat diets, indicated by lower glycated hemoglobin (SMD, -0.62; < 0.001) and homeostatic model assessment index (SMD, -0.29; = 0.02), while comparable effects were observed for nondiabetic patients. Ketogenic diets led to substantial weight reduction (SMD, -0.46; = 0.04) irrespective of patients' diabetes status at baseline and improved lipid profiles in terms of lower triglyceride (SMD, -0.45; = 0.01) and greater high-density lipoprotein (SMD, 0.31; = 0.005) for diabetic patients. Other risk markers showed no substantial between-group difference post intervention. Our study findings confirmed that ketogenic diets were more effective in improving metabolic parameters associated with glycemic, weight, and lipid controls in patients with overweight or obesity, especially those with preexisting diabetes, as compared to low-fat diets. This effect may contribute to improvements in metabolic dysfunction-related morbidity and mortality in these patient populations.
本荟萃分析的目的是探讨生酮饮食在超重或肥胖且患有或不患有 2 型糖尿病的患者代谢控制中的疗效。在 Embase、PubMed 和 Cochrane Library 中搜索了纳入超重或肥胖患者的生酮饮食代谢控制的随机对照试验。有 14 项研究纳入荟萃分析。与低脂饮食相比，生酮饮食对糖尿病患者的血糖控制效果更大，糖化血红蛋白（SMD，-0.62；<0.001）和稳态模型评估指数（SMD，-0.29；=0.02）更低，而对非糖尿病患者的效果则相当。生酮饮食导致体重显著减轻（SMD，-0.46；=0.04），无论患者基线时的糖尿病状况如何，并改善了血脂谱，降低了甘油三酯（SMD，-0.45；=0.01）和增加了高密度脂蛋白（SMD，0.31；=0.005），对于糖尿病患者而言。其他风险标志物在干预后没有显示出组间的实质性差异。我们的研究结果证实，与低脂饮食相比，生酮饮食在改善与血糖、体重和血脂控制相关的代谢参数方面对超重或肥胖患者，尤其是那些患有糖尿病前期的患者更有效。这种效果可能有助于改善这些患者群体中与代谢功能障碍相关的发病率和死亡率。
