生酮饮食对肥胖患者营养参数的影响：系统评价和荟萃分析。

UNLABELLED: The effect of a ketogenic diet (KD) on biochemical parameters and nutritional status has been the subject of debate over the years, as several randomized clinical trials (RCTs) obtained different results. METHOD: A systematic review and random-effects meta-analysis of RCTs comparing KD with a balanced diet was performed by means of a search of PubMed, Cochrane Library, Scopus, and Web of Science. Trials where the method for measuring the response variables was unclear, those that considered pathologies other than chronic non-communicable diseases and those with participants receiving pharmacological treatment for obesity were excluded from the comparison. RESULTS: Of the studies included in the meta-analysis, no statistically significant standardized mean differences were observed for body mass index (BMI) ( = -0.457, = 0.359), total cholesterol, COL-T ( = 0.230, = 0.591), high-density lipoprotein, HDL ( = -0.028, = 0.934), low-density lipoprotein, LDL ( = 0.528, = 0.173), or triglycerides, TG ( = -0.283, = 0.222), with high values of heterogeneity. The percentage of women included in the studies is a significant moderating variable in terms of BMI ratio ( = -6.68, < 0.001) and TG ( = -2.27, = 0.023). CONCLUSION: A KD shows no more benefits on nutritional parameters than a balanced diet, and adverse effects of being on the diet are sometimes reported.

未加说明：多年来，生酮饮食（KD）对生化参数和营养状况的影响一直存在争议，因为几项随机临床试验（RCT）得出了不同的结果。

方法：通过对 PubMed、Cochrane 图书馆、Scopus 和 Web of Science 进行搜索，对比较 KD 与均衡饮食的 RCT 进行了系统评价和随机效应荟萃分析。排除了那些测量响应变量的方法不明确、考虑的是慢性非传染性疾病以外的病理、以及那些接受肥胖药物治疗的参与者的试验，不参与比较。

结果：在荟萃分析中纳入的研究中，体重指数（BMI）（ = -0.457， = 0.359）、总胆固醇、COL-T（ = 0.230， = 0.591）、高密度脂蛋白、HDL（ = -0.028， = 0.934）、低密度脂蛋白、LDL（ = 0.528， = 0.173）或甘油三酯、TG（ = -0.283， = 0.222）均未观察到统计学上显著的标准化均数差异，异质性值较高。研究中纳入的女性比例是 BMI 比值（ = -6.68， < 0.001）和 TG（ = -2.27， = 0.023）的一个显著调节变量。

结论：KD 在营养参数方面并没有比均衡饮食带来更多的益处，而且有时会报告饮食的不良反应。