Advanced Medical & Dental Institute, SAINS@BERTAM, Universiti Sains Malaysia, 13200 Kepala Batas, Pulau Pinang, Malaysia.
Advanced Medical & Dental Institute, SAINS@BERTAM, Universiti Sains Malaysia, 13200 Kepala Batas, Pulau Pinang, Malaysia; Center for Population Health, Dept. Social and Preventive Medicine, Faculty of Medicine, University Malaya, 50603 Kuala Lumpur, Malaysia.
Obes Res Clin Pract. 2021 Jan-Feb;15(1):10-18. doi: 10.1016/j.orcp.2020.12.001. Epub 2020 Dec 25.
Obesity is a serious chronic disease and a public health concern in both developing and developed countries. Managing obesity has been a great challenge for both health care professionals and patients alike. Among the various diet programs aimed at promoting weight loss, the ketogenic diet, a diet high in fat and low in carbohydrates, has been at the forefront recently and its mechanism in weight loss is much debated. Activation of Sirtuin 1 or SIRT1 is able to circumvent various diseases, including metabolic syndrome and obesity and is thought to be a potentially reliable treatment target for both of them. Augmentation of SIRT1 may be carried out using dietary means such as nicotinamide adenine dinucleotide (NAD) supplementation and/or ketogenic diet. Although ketogenic diet may augment SIRT1 activation in people affected by obesity, recent studies have indicated that the relationship between SIRT1 and ketogenesis is unpredictable. The exact circumstances and mechanisms of SIRT1, NAD and ketogenesis in the clinical setting as an intervention tool in managing obesity remained uncertain. Although several recent literatures have documented significant weight-loss following ketogenic diet interventions, there were limitations with regards to duration of trial, choice and the number of trial subjects. Studies investigating the safety of ketogenic diet in the long term, beyond 46 weeks and related mechanism and pathways are still lacking and the sustainability of this diet remains to be determined. This review explores the recent progress on ketogenic diet and its relationships with SIRT1 as a tool in managing obesity and relevant clinical implications.
肥胖是一种严重的慢性疾病，是发展中国家和发达国家共同面临的公共卫生问题。管理肥胖一直是医疗保健专业人员和患者共同面临的巨大挑战。在旨在促进减肥的各种饮食计划中，高脂肪、低碳水化合物的生酮饮食最近处于前沿地位，其减肥机制备受争议。Sirtuin 1 或 SIRT1 的激活能够规避包括代谢综合征和肥胖在内的各种疾病，被认为是这两种疾病的潜在可靠治疗靶点。SIRT1 的增强可以通过饮食手段来实现，例如烟酰胺腺嘌呤二核苷酸（NAD）补充和/或生酮饮食。虽然生酮饮食可能会增加肥胖人群中 SIRT1 的激活，但最近的研究表明，SIRT1 和酮生成之间的关系是不可预测的。SIRT1、NAD 和酮生成在临床环境中作为管理肥胖的干预工具的确切情况和机制仍不确定。尽管最近的一些文献记录了生酮饮食干预后体重显著减轻，但试验的持续时间、选择和试验对象的数量存在局限性。关于生酮饮食在 46 周以上的长期安全性、相关机制和途径的研究仍然缺乏，这种饮食的可持续性仍有待确定。本综述探讨了生酮饮食的最新进展及其作为管理肥胖的工具与 SIRT1 的关系以及相关的临床意义。
