生酮饮食治疗 2 型糖尿病的效果：近期研究的系统评价和荟萃分析。

The effects of the ketogenic diet for the management of type 2 diabetes mellitus: A systematic review and meta-analysis of recent studies.

机构信息

School of Biological Sciences, Faculty of Science, The University of Hong Kong, Hong Kong SAR, China.

School of Biological Sciences, Faculty of Science, The University of Hong Kong, Hong Kong SAR, China; Department of Nursing and Allied Health, School of Health Sciences, Swinburne University of Technology, Hawthorn, VIC, Australia.

出版信息

Diabetes Metab Syndr. 2023 Dec;17(12):102905. doi: 10.1016/j.dsx.2023.102905. Epub 2023 Nov 15.

DOI:10.1016/j.dsx.2023.102905

PMID:38006799

Abstract

OBJECTIVE

To systematically review the effects of the ketogenic diet on glycaemic control, body weight, cardiovascular risk factors, and liver and kidney function in patients with type 2 diabetes.

METHODS

PubMed, MEDLINE, Embase, Cochrane Library and CINAHL were searched for randomised controlled trials published between 2001 and 2021 that compared the ketogenic diet to a control diet for effects on glycaemic control, body weight, cardiovascular risk factors, liver and renal function markers in adults with type 2 diabetes for >14 days. Meta-analyses using fixed or random effects models were conducted.

RESULTS

Nineteen reports from 11 randomised controlled trials were included. Compared to the control, the ketogenic diet showed no significant difference in changes in glycaemic control or body weight, but greater increases in HDL (standardised mean difference 0.19; 95%CI 0.02-0.37; I = 0 %; moderate-quality evidence) and greater reductions in triglycerides (standardised mean difference -0.41; 95%CI -0.64 to -0.18; I = 0 %; low-quality evidence).

CONCLUSIONS

The ketogenic diet may improve lipid profiles but showed no additional benefits for glycaemic control or weight loss compared to control diets in type 2 diabetes patients over two years.

摘要

目的

系统评价生酮饮食对 2 型糖尿病患者血糖控制、体重、心血管风险因素以及肝肾功能的影响。

方法

检索 2001 年至 2021 年间发表的随机对照试验，比较生酮饮食与对照饮食对 2 型糖尿病成人>14 天血糖控制、体重、心血管风险因素、肝功能和肾功能标志物的影响。使用固定或随机效应模型进行荟萃分析。

结果

纳入了 11 项随机对照试验的 19 份报告。与对照组相比，生酮饮食在血糖控制或体重变化方面没有显著差异，但 HDL 升高（标准化均数差 0.19；95%CI 0.02-0.37；I²=0%；中等质量证据），甘油三酯降低（标准化均数差 -0.41；95%CI -0.64 至 -0.18；I²=0%；低质量证据）。