Storoschuk Kristi L, Wood Thomas R, Stubbs Brianna J
School of Kinesiology and Health Studies, Queen's University, Kingston, ON, Canada.
Department of Pediatrics, University of Washington, Washington, WA, United States.
Front Physiol. 2023 Jun 28;14:1202186. doi: 10.3389/fphys.2023.1202186. eCollection 2023.
Ketone bodies such as beta-hydroxybutyrate (BHB) have pleiotropic functional benefits as fuel and signaling metabolites and may have multiple clinical applications. An alternative to inducing ketosis by dietary modification is intravenous delivery of exogenous sources of ketones. It is unknown whether there is a strong relationship between BHB infusion rate and blood BHB concentrations in the published literature; this information is vital for clinical studies investigating therapeutic effects of ketosis. This systematic review aimed to aggregate available data and address this gap. The PubMed and EMBASE databases were searched, and data were extracted from 23 manuscripts where BHB was infused and maximum and/or steady state BHB levels assessed. Infusion rate was adjusted when racemic BHB was infused but only D-BHB was measured. Using a random effects meta-regression, strong linear relationships between BHB infusion rate and maximal (y = 0.060 + 0.870x, = 87.2%, < 0.0001) and steady state (y = -0.022 + 0.849x, = 86.9%, < 0.0001) blood BHB concentrations were found. Sensitivity analysis found this relationship was stronger when studies in non-healthy populations were excluded (y = 0.059 + 0.831x, = 96.3%, < 0.0001). There is a strong relationship between BHB infusion rate and blood BHB concentrations; the regressions described here can be used by clinicians or researchers to determine ketone delivery required for a target blood concentration.
β-羟基丁酸（BHB）等酮体作为燃料和信号代谢物具有多效性功能益处，可能有多种临床应用。通过饮食调整诱导酮症的一种替代方法是静脉输注外源性酮。在已发表的文献中，BHB输注速率与血液BHB浓度之间是否存在强关联尚不清楚；该信息对于研究酮症治疗效果的临床研究至关重要。本系统评价旨在汇总现有数据并填补这一空白。检索了PubMed和EMBASE数据库，并从23篇输注BHB并评估最大和/或稳态BHB水平的手稿中提取数据。输注外消旋BHB时调整输注速率，但仅测量D-BHB。使用随机效应元回归，发现BHB输注速率与最大血液BHB浓度（y = 0.060 + 0.870x，R² = 87.2%，P < 0.0001）和稳态血液BHB浓度（y = -0.022 + 0.849x，R² = 86.9%，P < 0.0001）之间存在强线性关系。敏感性分析发现，排除非健康人群的研究后，这种关系更强（y = 0.059 + 0.831x，R² = 96.3%，P < 0.0001）。BHB输注速率与血液BHB浓度之间存在强关联；临床医生或研究人员可使用此处描述的回归来确定目标血液浓度所需的酮输送量。
