Exercise Metabolism and Inflammation Laboratory, University of British Columbia Okanagan, Kelowna, BC, Canada.
Department of Kinesiology, McMaster University, Hamilton, ON, Canada.
J Clin Endocrinol Metab. 2021 Mar 25;106(4):e1738-e1754. doi: 10.1210/clinem/dgaa925.
Postprandial hyperglycemia increases systemic inflammation and is a risk factor for cardiovascular disease. A ketone monoester (KME) drink containing β-hydroxybutyrate (β-OHB) rapidly lowers plasma glucose, which may be a strategy protecting against postprandial hyperglycemia.
We hypothesized that KME would attenuate 2-hour postprandial glucose, lower systemic inflammation, and improve vascular function in adults with obesity.
In a randomized crossover design, 14 participants with obesity (age = 56 ± 12 years; body mass index = 32.8 ± 7.7 kg/m2) consumed KME (12 g β-OHB) or placebo 15 minutes prior to each meal for 14 days with all meals provided and matched between conditions. Postprandial glycemia was assessed by continuous glucose monitoring. Vascular function and inflammation were assessed before and after treatment periods.
Postprandial glucose was 8.0% lower in KME versus placebo (g = 0.735; P = 0.011) and 24-hour average glucose reduced by 7.8% (g = 0.686; P = 0.0001). Brachial artery flow-mediated dilation increased from 6.2 ± 1.5% to 8.9 ± 3.3% in KME (g = 1.05; P = 0.0004) with no changes in placebo (condition × time interaction, P = 0.004). There were no changes in plasma cytokines; however, lipopolysaccharide-stimulated monocyte caspase-1 activation was lower following KME supplementation versus placebo (stimulation × condition × time interaction; P = 0.004). The KME supplement was well tolerated by participants and adherence to the supplementation regimen was very high.
In adults with obesity, 14 days of premeal KME supplementation improves glucose control, enhances vascular function, and may reduce cellular inflammation. KME supplementation may be a viable, nonpharmacological approach to improving and protecting vascular health in people with heightened cardiometabolic risk.
餐后高血糖会增加全身炎症反应，是心血管疾病的危险因素。一种含有β-羟基丁酸（β-OHB）的酮单酯（KME）饮料能迅速降低血糖，可能是预防餐后高血糖的一种策略。
我们假设 KME 可降低肥胖成年人 2 小时餐后血糖，降低全身炎症反应，并改善血管功能。
在一项随机交叉设计中，14 名肥胖成年人（年龄=56±12 岁；体重指数=32.8±7.7kg/m2）在 14 天内每餐 15 分钟前分别摄入 KME（12gβ-OHB）或安慰剂，所有膳食均提供并在两种条件下匹配。通过连续血糖监测评估餐后血糖。在治疗前后评估血管功能和炎症。
与安慰剂相比，KME 使餐后血糖降低 8.0%（g=0.735；P=0.011），24 小时平均血糖降低 7.8%（g=0.686；P=0.0001）。肱动脉血流介导的扩张从 KME 时的 6.2±1.5%增加到 8.9±3.3%（g=1.05；P=0.0004），而安慰剂组没有变化（条件×时间交互作用，P=0.004）。血浆细胞因子没有变化；然而，与安慰剂相比，KME 补充后脂多糖刺激的单核细胞半胱氨酸天冬氨酸蛋白酶-1 活性降低（刺激×条件×时间交互作用；P=0.004）。KME 补充剂被参与者很好地耐受，对补充剂方案的依从性非常高。
在肥胖成年人中，14 天的餐前 KME 补充可改善血糖控制，增强血管功能，并可能降低细胞炎症。KME 补充可能是改善和保护代谢风险增加人群血管健康的一种可行的非药物方法。
