急性酮症对糖尿病前期患者血脂谱的影响：一项交叉随机对照试验的结果。
Effect of acute ketosis on lipid profile in prediabetes: findings from a cross-over randomized controlled trial.
机构信息
School of Medicine, University of Auckland, Auckland, New Zealand.
出版信息
Cardiovasc Diabetol. 2022 Jul 23;21(1):138. doi: 10.1186/s12933-022-01571-z.
BACKGROUND
Ketone monoester β-hydroxybutyrate (KEβHB) ingestion has emerged as an effective method of inducing acute ketosis. Although evidence suggests that KEβHB can offer several therapeutic benefits, whether KEβHB affects lipid profile is still unknown.
AIMS
The primary aim was to study the effect of KEβHB on plasma lipid profile in individuals with prediabetes. The secondary aim was to investigate the role of saturated fat intake in that effect.
METHODS
This study was a randomized controlled trial with cross-over design. Following an overnight fast, 18 adults (six women and 12 men) with prediabetes (diagnosed based on the American Diabetes Association criteria) ingested a single dose of KEβHB drink or placebo drink. Blood samples were collected every 30 min, from baseline to 150 min. Outcome variables included changes in total cholesterol, high-density lipoprotein (HDL) cholesterol, low-density lipoprotein (LDL) cholesterol, remnant cholesterol, triglycerides, and the triglycerides to HDL cholesterol ratio. The area under the curve (AUC) over 150 min was calculated for each outcome following ingestion of the drinks. Habitual saturated fat intake was ascertained using the EPIC-Norfolk food frequency questionnaire.
RESULTS
Significant elevation of blood β-hydroxybutyrate from 0.2 mmol/L to 3.5 mmol/L (p < 0.001) was achieved within 30 min. Acute ketosis resulted in significantly lower AUCs for remnant cholesterol (p = 0.022) and triglycerides (p = 0.022). No statistically significant differences in the AUCs for total cholesterol, HDL cholesterol, LDL cholesterol, and the triglycerides to HDL cholesterol ratio were found. The changes in remnant cholesterol and triglycerides were statistically significant in individuals with high, but not low, habitual saturated fat intake.
CONCLUSION
Acute ketosis had no untoward effect on plasma lipid profile. Moreover, it led to significantly reduced circulating levels of remnant cholesterol and triglycerides. This paves the way for investigating whether exogenous ketone supplementation reduces cardiovascular disease risk (via its actions on triglyceride-rich lipoproteins) in at-risk populations. Trial registration: ClinicalTrials.gov, NCT03889210.
背景
酮单酯 β-羟基丁酸（KEβHB）的摄入已成为诱导急性酮症的有效方法。尽管有证据表明 KEβHB 可以提供多种治疗益处，但 KEβHB 是否会影响血脂谱尚不清楚。
目的
本研究的主要目的是研究 KEβHB 对糖尿病前期个体血浆脂质谱的影响。次要目的是研究饱和脂肪摄入在这种作用中的作用。
方法
这是一项随机对照交叉试验。在禁食过夜后，18 名患有糖尿病前期（根据美国糖尿病协会标准诊断）的成年人（6 名女性和 12 名男性）分别摄入 KEβHB 饮料或安慰剂饮料。从基线到 150 分钟，每 30 分钟采集一次血样。观察指标包括总胆固醇、高密度脂蛋白（HDL）胆固醇、低密度脂蛋白（LDL）胆固醇、残粒胆固醇、甘油三酯和甘油三酯与 HDL 胆固醇比值的变化。在摄入饮料后 150 分钟内计算每个指标的曲线下面积（AUC）。采用 EPIC-Norfolk 食物频率问卷确定习惯性饱和脂肪摄入量。
结果
KEβHB 摄入后 30 分钟内血 β-羟基丁酸从 0.2mmol/L 升高至 3.5mmol/L（p<0.001）。急性酮症导致残粒胆固醇（p=0.022）和甘油三酯（p=0.022）的 AUC 显著降低。总胆固醇、HDL 胆固醇、LDL 胆固醇和甘油三酯与 HDL 胆固醇比值的 AUC 无统计学差异。在习惯性高饱和脂肪摄入者中，残粒胆固醇和甘油三酯的变化具有统计学意义，但在习惯性低饱和脂肪摄入者中无统计学意义。
结论
急性酮症对血浆脂质谱没有不良影响。此外，它导致循环中残粒胆固醇和甘油三酯水平显著降低。这为研究外源性酮补充剂是否通过对富含甘油三酯的脂蛋白的作用降低高危人群的心血管疾病风险铺平了道路。
试验注册
ClinicalTrials.gov，NCT03889210。
Zotero 插件