School of Medicine, University of Auckland, Auckland, New Zealand.
School of Medicine, University of Auckland, Auckland, New Zealand.
Clin Nutr ESPEN. 2021 Jun;43:117-129. doi: 10.1016/j.clnesp.2021.03.013. Epub 2021 Mar 21.
Exogenous ketone supplementation is emerging as a nutritional intervention that beneficially affects blood glucose control. We hypothesized that varying abdominal fat phenotypes play a role in the effect of exogenously induced ketosis. The aim was to investigate whether intra-abdominal fat distribution modulates the effect of exogenous ketones on glucoregulatory peptides in new-onset prediabetes.
Eighteen individuals with new-onset prediabetes after acute pancreatitis were randomized to receive a ketone monoester supplement or placebo in a crossover fashion. All participants underwent magnetic resonance imaging on a 3T scanner to determine their abdominal fat phenotypes. They were non-exclusively categorized as low adiposity or high adiposity phenotypes based on their abdominal and ectopic fat distribution (regardless of body mass index and waist circumference). Blood samples were analyzed for glucoregulatory peptides. Total area under the curve (AUC) over 150 min was calculated for each analyte.
The total AUCs for insulin and C-peptide were significantly higher after ketone supplementation in individuals with high intra-pancreatic fat deposition, skeletal muscle fat deposition, and subcutaneous fat volume; and low visceral fat volume and intra-hepatic fat deposition. The total AUC for glucose-dependent insulinotropic peptide was significantly higher after ketone supplementation in individuals with high intra-pancreatic fat deposition, skeletal muscle fat deposition, subcutaneous fat volume, and visceral fat volume. The total AUC for glucagon-like peptide-1 was not associated with any adiposity phenotype.
Individuals with high depositions of intra-pancreatic fat, skeletal muscle fat, subcutaneous fat may not achieve favorable outcomes of blood glucose control following ketone supplementation. Abdominal fat distribution is an important factor in the pathogenesis of new-onset prediabetes and it may influence the effectiveness of nutritional strategies designed for these individuals. REGISTERED UNDER CLINICALTRIALS.
NCT03889210.
外源性酮补充剂作为一种有益的营养干预手段，正在出现，可以影响血糖控制。我们假设不同的腹部脂肪表型在体外诱导酮症的作用中发挥作用。本研究旨在探讨内脏脂肪分布是否调节外源性酮对新发糖尿病前期糖调节肽的影响。
18 例急性胰腺炎后新发糖尿病前期患者以交叉方式随机接受酮单酯补充剂或安慰剂治疗。所有参与者均接受 3T 扫描仪磁共振成像，以确定其腹部脂肪表型。根据腹部和异位脂肪分布（不考虑体重指数和腰围），他们被非排他性地分为低脂肪或高脂肪表型。分析血糖调节肽的血样。计算每个分析物 150 分钟的总曲线下面积（AUC）。
在高胰内脂肪沉积、骨骼肌脂肪沉积和皮下脂肪量的个体中，胰岛素和 C 肽的总 AUC 在酮补充后显著升高；在低内脏脂肪量和肝内脂肪沉积的个体中，葡萄糖依赖性胰岛素释放肽的总 AUC 也显著升高。在高胰内脂肪沉积、骨骼肌脂肪沉积、皮下脂肪量和内脏脂肪量的个体中，胰高血糖素样肽-1 的总 AUC 也显著升高。
在高胰内脂肪沉积、骨骼肌脂肪沉积、皮下脂肪的个体中，酮补充后血糖控制的结果可能不理想。腹部脂肪分布是新发糖尿病前期发病机制的一个重要因素，它可能影响针对这些个体的营养策略的有效性。在 CLINICALTRIALS.GOV 注册。注册号：NCT03889210。
