Science and Technology Innovation Center, Guangzhou University of Chinese Medicine, Guangzhou, China; Sanya Hospital of Traditional Chinese Medicine, Sanya, China.
School of Basic Medical Sciences, Guangzhou University of Chinese Medicine, Guangzhou, China.
J Nutr Health Aging. 2024 Aug;28(8):100306. doi: 10.1016/j.jnha.2024.100306. Epub 2024 Jun 28.
Ketogenic diets (KD) have shown remarkable effects in many disease areas. It has been demonstrated in numerous animal experiments that KD is effective in the treatment of Alzheimer's disease (AD). But the clinical effect of treating AD is uncertain.
To systematically review the impact of KD on cognitive function in AD.
We conducted a search of three international databases-PubMed, Cochrane Library, and Embase-to retrieve RCTs on the KD intervention for AD from the inception of the databases through October 2023. Two reviewers searched and screened the literature, extracted and checked relevant data independently, and assessed the risk of bias of the included studies. The meta-analysis was carried out utilizing RevMan 5.3 software.
A total of 10 RCTS involving 691 patients with AD were included. There were 357 participants in the intervention group and 334 participants in the control group. The duration of the KD intervention ranged from a minimum of 3 months to a maximum of 15 months. Meta-analysis results showed that KD could effectively improve the mental state of the elderly (NM scale) [MD = 7.56, 95%CI (3.02, 12.10), P = 0.001], MMSE [MD = 1.25, 95%CI (0.46, 2.04), P = 0.002], and ADAS-Cog [MD = -3.43, 95%CI (-5.98, -0.88), P = 0.008]. The elevation of ketone body (β-hydroxybutyric) [MD = 118.84, 95%CI (15.20, 222.48), P = 0.02] may also lead to the elevation of triglyceride [MD = 0.19, 95%CI (0.03, 0.35), P = 0.02] and low density lipoprotein [MD = 0.31, 95%CI (0.04, 0.58), P = 0.02].
Research conducted has indicated that the KD can enhance the mental state and cognitive function of those with AD, albeit potentially leading to an elevation in blood lipid levels. In summary, the good intervention effect and safety of KD are worthy of promotion and application in clinical treatment of AD.
生酮饮食（KD）在许多疾病领域都显示出显著的效果。大量动物实验证明，KD 对阿尔茨海默病（AD）的治疗有效。但 KD 治疗 AD 的临床效果尚不确定。
系统评价 KD 对 AD 认知功能的影响。
我们检索了三个国际数据库（PubMed、Cochrane 图书馆和 Embase），从数据库成立之初到 2023 年 10 月，检索了 KD 干预 AD 的随机对照试验。两位审查员独立搜索和筛选文献，提取和核对相关数据，并评估纳入研究的偏倚风险。使用 RevMan 5.3 软件进行荟萃分析。
共纳入 10 项 RCT，涉及 691 例 AD 患者。干预组 357 例，对照组 334 例。KD 干预时间最短 3 个月，最长 15 个月。Meta 分析结果显示，KD 可有效改善老年人的精神状态（NM 量表）[MD=7.56，95%CI（3.02，12.10），P=0.001]、MMSE[MD=1.25，95%CI（0.46，2.04），P=0.002]和 ADAS-Cog[MD=-3.43，95%CI（-5.98，-0.88），P=0.008]。酮体（β-羟丁酸）升高[MD=118.84，95%CI（15.20，222.48），P=0.02]可能导致甘油三酯升高[MD=0.19，95%CI（0.03，0.35），P=0.02]和低密度脂蛋白升高[MD=0.31，95%CI（0.04，0.58），P=0.02]。
研究表明，KD 可以改善 AD 患者的精神状态和认知功能，但可能导致血脂水平升高。综上所述，KD 的良好干预效果和安全性值得在 AD 的临床治疗中推广应用。
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