Department of Cardiovascular Medicine, Renji Hospital, Shanghai Jiaotong University School of Medicine, 160 Pujian Road, Pudong New Area, Shanghai, 200120, China.
Department of Cardiology, Renji Hospital Ningbo Branch, Shanghai Jiao Tong University School of Medicine, 1155 Binhai 2nd Road, Hangzhou Bay New District, Ningbo, 315336, China.
Sci Rep. 2024 Oct 1;14(1):22805. doi: 10.1038/s41598-024-73384-x.
The impact of the ketogenic diet (KD) on overall mortality and cardiovascular disease (CVD) mortality remains inconclusive.This study enrolled a total of 43,776 adults from the National Health and Nutrition Examination Survey (NHANES) conducted between 2001 and 2018 to investigate the potential association between dietary ketogenic ratio (DKR) and both all-cause mortality as well as cardiovascular disease(CVD) mortality.Three models were established, and Cox proportional hazards regression analysis was employed to examine the correlation. Furthermore, a restricted cubic spline function was utilized to assess the non-linear relationship. In addition, subgroup analysis and sensitivity analysis were performed.In the adjusted Cox proportional hazards regression model, a significant inverse association was observed between DKR and all-cause mortality (HR = 0.76, 95% CI = 0.63-0.9, P = 0.003). However, no significant association with cardiovascular mortality was found (HR = 1.13; CI = 0.79-1.6; P = 0.504). Additionally, a restricted cubic spline(RCS) analysis demonstrated a linear relationship between DKR and all-cause mortality risk. In the adult population of the United States, adherence to a KD exhibits potential in reducing all-cause mortality risk while not posing an increased threat of CVD-related fatalities.
生酮饮食（KD）对总死亡率和心血管疾病（CVD）死亡率的影响仍不确定。本研究共纳入了 2001 年至 2018 年期间进行的国家健康和营养检查调查（NHANES）中的 43776 名成年人，以调查饮食生酮比（DKR）与全因死亡率和心血管疾病（CVD）死亡率之间的潜在关联。建立了三个模型，并采用 Cox 比例风险回归分析来检查相关性。此外，还使用了限制立方样条函数来评估非线性关系。此外，还进行了亚组分析和敏感性分析。在调整后的 Cox 比例风险回归模型中，DKR 与全因死亡率之间存在显著的负相关关系（HR=0.76，95%CI=0.63-0.9，P=0.003）。然而，与心血管死亡率之间没有显著关联（HR=1.13；CI=0.79-1.6；P=0.504）。此外，限制立方样条（RCS）分析表明 DKR 与全因死亡率风险之间存在线性关系。在美国成年人中，遵循 KD 可能有助于降低全因死亡率风险，而不会增加与 CVD 相关的死亡风险。
