Angela G Juby, Professor of Medicine, Division of Geriatrics, Department of Medicine, 1-198 Clinical Sciences Building, 11350 83 Avenue, Edmonton, T6G 2P4, Canada, Tel: 1 780 492 6233, Fax: 1 780 492 2874, Email:
J Prev Alzheimers Dis. 2021;8(1):19-28. doi: 10.14283/jpad.2020.53.
Objectives, Design, Setting: The ketogenic effect of medium chain triglyceride (MCT) oil offers potential for Alzheimer's disease prevention and treatment. Limited literature suggests a linear B-hyroxybutyrate (BHB) response to increasing MCT doses. This pharmacokinetic study evaluates factors affecting BHB response in three subject groups.
Healthy subjects without cognitive deficits <65years, similarly healthy subjects >=65years, and those with Alzheimer's Disease were assessed.
Different doses (0g,14g, 28g, 42g) of MCT oil (99.3% C8:0) were administered, followed by fasting during the study period.
BHB measured by finger prick sampling hourly for 5 hours after ingestion. Each subject attended four different days for each ascending dose. Data was also collected on body composition, BMI, waist/hip ratio, grip strength, gait speed, nutrient content of pre-study breakfast and side effects.
Twenty-five participants: eight healthy; average age of 44yr (25-61), nine healthy; 79yr (65-90) and eight with AD; 78.6yr (57-86) respectively. Compiled data showed the expected linear dose response relationship. No group differences, with baseline corrected area under the blood vs. time curve (r2=0.98) and maximum concentrations (r2=0.97). However, there was notable individual variability in maximum BHB response (42g dose: 0.4 -2.1mM), and time to reach maximum BHB response both, within and between individuals. Variability was unrelated to age, sex, sarcopenic or AD status. Visceral fat, BMI, waist/hip ratio and pretest meal CHO and protein content all affected the BHB response (p<0.001).
There was a large inter-individual variability, with phenotype effects identified. This highlights challenges in interpreting clinical responses to MCT intake.
目的、设计、设置:中链甘油三酯(MCT)油的生酮作用为预防和治疗阿尔茨海默病提供了潜力。有限的文献表明,MCT 剂量增加会导致线性 B-羟丁酸(BHB)反应。这项药代动力学研究评估了影响三组受试者 BHB 反应的因素。
无认知缺陷的健康受试者<65 岁,同样健康的 65 岁及以上受试者,以及阿尔茨海默病患者。
给予不同剂量(0g、14g、28g、42g)的 MCT 油(99.3% C8:0),然后在研究期间禁食。
摄入后 5 小时内每小时通过手指刺破采样测量 BHB。每位受试者在每个递增剂量下分别进行四天不同的试验。还收集了身体成分、BMI、腰围/臀围比、握力、步态速度、研究前早餐的营养成分和副作用的数据。
25 名参与者:8 名健康,平均年龄 44 岁(25-61 岁),9 名健康,79 岁(65-90 岁),8 名患有 AD,78.6 岁(57-86 岁)。综合数据显示出预期的线性剂量反应关系。没有组间差异,基础校正后的血药浓度-时间曲线下面积(r2=0.98)和最大浓度(r2=0.97)。然而,在最大 BHB 反应(42g 剂量:0.4-2.1mM)和达到最大 BHB 反应的时间方面,个体内和个体间均存在显著的个体变异性。这种变异性与年龄、性别、肌肉减少症或 AD 状态无关。内脏脂肪、BMI、腰围/臀围比以及试验前的膳食 CHO 和蛋白质含量均影响 BHB 反应(p<0.001)。
个体间存在很大的变异性,并确定了表型效应。这凸显了解释 MCT 摄入对临床反应的挑战。