Unit of Reproductive Endocrinology, 1st Department of Obstetrics and Gynecology, Medical School, Aristotle University of Thessaloniki, GR-54124 Thessaloniki, Greece.
Unit of Immunonutrition and Clinical Nutrition, Department of Rheumatology and Clinical Immunology, Faculty of Medicine, School of Health Sciences, University of Thessaly, Biopolis, GR-41110 Larissa, Greece.
Nutrients. 2023 Oct 16;15(20):4383. doi: 10.3390/nu15204383.
In glucose-deprived conditions, ketone bodies are produced by the liver mitochondria, through the catabolism of fatty acids, and are used peripherally, as an alternative energy source. Ketones are produced in the body under normal conditions, including during pregnancy and the neonatal period, when following a ketogenic diet (KD), fasting, or exercising. Additionally, ketone synthesis is also augmented under pathological conditions, including cases of diabetic ketoacidosis (DKA), alcoholism, and several metabolic disorders. Nonetheless, diet is the main regulator of total body ketone concentrations. The KDs are mimicking the fasting state, altering the default metabolism towards the use of ketones as the primary fuel source. Recently, KD has gained recognition as a medical nutrition therapy for a plethora of metabolic conditions, including obesity and diabetes mellitus (DM). The present review aims to discuss the role of ketones, KDs, ketonemia, and ketonuria in DM, presenting all the available new evidence in a comprehensive manner.
在葡萄糖缺乏的情况下，肝脏线粒体通过脂肪酸的分解代谢产生酮体，并在周围组织中被用作替代能源。在正常情况下，包括怀孕期间和新生儿期，当进行生酮饮食（KD）、禁食或运动时，酮体也会在体内产生。此外，在一些病理情况下，如糖尿病酮症酸中毒（DKA）、酒精中毒和几种代谢紊乱，酮体的合成也会增加。然而，饮食是调节全身酮体浓度的主要因素。KD 模拟禁食状态，将默认代谢改变为使用酮体作为主要燃料来源。最近，KD 已被认可为治疗肥胖和糖尿病（DM）等多种代谢疾病的医学营养疗法。本综述旨在讨论酮体、KD、酮血症和酮尿在 DM 中的作用，全面呈现所有现有新证据。
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