Department of Endocrinology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Hubei Provincial Clinical Research Center for Diabetes and Metabolic Disorders, Wuhan, China.
Front Endocrinol (Lausanne). 2021 Nov 2;12:753039. doi: 10.3389/fendo.2021.753039. eCollection 2021.
While the prevalence of cardio-metabolic diseases (CMDs) has become a worldwide epidemic, much attention is paid to managing CMDs effectively. A ketogenic diet (KD) constitutes a high-fat and low-carbohydrate diet with appropriate protein content and calories. KD has drawn the interests of clinicians and scientists regarding its application in the management of metabolic diseases and related disorders; thus, the current review aimed to examine the evidences surrounding KD and the CMDs to draw the clinical implications. Overall, KD appears to play a significant role in the therapy of various CMDs, which is manifested by the effects of KDs on cardio-metabolic outcomes. KD therapy is generally promising in obesity, heart failure, and hypertension, though different voices still exist. In diabetes and dyslipidemia, the performance of KD remains controversial. As for cardiovascular complications of metabolic diseases, current evidence suggests that KD is generally protective to obese related cardiovascular disease (CVD), while remaining contradictory to diabetes and other metabolic disorder related CVDs. Various factors might account for the controversies, including genetic background, duration of therapy, food composition, quality, and sources of KDs. Therefore, it's crucial to perform more rigorous researches to focus on clinical safety and appropriate treatment duration and plan of KDs.
虽然心脏代谢疾病 (CMD) 的流行已成为全球性的流行病,但人们对有效管理 CMD 给予了极大的关注。生酮饮食 (KD) 是一种高脂肪、低碳水化合物、适量蛋白质和卡路里的饮食。KD 引起了临床医生和科学家的兴趣,因为它可以应用于代谢疾病和相关疾病的管理;因此,本综述旨在检查围绕 KD 和 CMD 的证据,以得出临床意义。总的来说,KD 似乎在各种 CMD 的治疗中发挥了重要作用,这表现在 KDs 对心脏代谢结果的影响上。KD 疗法在肥胖、心力衰竭和高血压方面的效果显著,但仍存在不同的声音。在糖尿病和血脂异常方面,KD 的疗效仍存在争议。对于代谢疾病的心血管并发症,目前的证据表明,KD 对肥胖相关心血管疾病 (CVD) 一般具有保护作用,但对糖尿病和其他代谢紊乱相关 CVD 则存在矛盾。各种因素可能导致这些争议,包括遗传背景、治疗持续时间、KD 的食物成分、质量和来源。因此,有必要进行更严格的研究,重点关注 KD 的临床安全性以及适当的治疗持续时间和方案。