Bae Jaehyun, Kim Young-Eun, Jung Keum Ji, Jee Sun Ha, Lee Byung-Wan
Division of Endocrinology and Metabolism, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.
Division of Endocrinology and Metabolism, Department of Internal Medicine, Hallym University Kangnam Sacred Heart Hospital, College of Medicine, Hallym University, Seoul, Korea.
Nutr Diabetes. 2025 Apr 16;15(1):16. doi: 10.1038/s41387-025-00364-z.
Ketogenic conditions have gained attention due to their favorable metabolic prognoses. We aimed to investigate the association between blood levels of beta-hydroxybutyrate (βHB), the most abundant form of ketone body, and type 2 diabetes (T2D) incidence in patients with impaired fasting glucose (IFG).
We randomly selected 500 patients with IFG from the prospective Korean Cancer Prevention Study II biobank. Blood levels of βHB were measured from the stored samples, and the diagnostic data from the Korean National Health Insurance Service were used to determine the probability of T2D-free survival. A multivariable Cox regression analysis was performed to assess the association between blood βHB levels and the incidence of new-onset T2D.
A total of 453 patients with IFG were included, and 105 (23%) developed T2D during a mean follow-up period of 10.9 years. Higher blood βHB levels in patients with IFG were associated with improved T2D-free survival, although it was not statistically significant (log-rank test, p = 0.058). In multivariable Cox regression models, βHB levels showed a tendency toward a lower risk of T2D, but it was not statistically significant (HR 0.70; 95% CI 0.47-1.04; p = 0.07).
In patients with IFG, the blood βHB level showed a tendency to be associated with the risk of new-onset T2D; however, this tendency was not statistically significant.
生酮状态因其良好的代谢预后而受到关注。我们旨在研究酮体最丰富的形式——β-羟基丁酸（βHB）的血液水平与空腹血糖受损（IFG）患者2型糖尿病（T2D）发病率之间的关联。
我们从韩国前瞻性癌症预防研究II生物样本库中随机选取了500例IFG患者。从储存样本中测量βHB的血液水平，并使用韩国国民健康保险服务的诊断数据来确定无T2D生存的概率。进行多变量Cox回归分析以评估血液βHB水平与新发T2D发病率之间的关联。
共纳入453例IFG患者，在平均10.9年的随访期内，105例（23%）发生了T2D。IFG患者较高的血液βHB水平与改善的无T2D生存相关，尽管无统计学意义（对数秩检验，p = 0.058）。在多变量Cox回归模型中，βHB水平显示出T2D风险较低的趋势，但无统计学意义（风险比0.70；95%置信区间0.47 - 1.04；p = 0.07）。
在IFG患者中，血液βHB水平显示出与新发T2D风险相关的趋势；然而，这种趋势无统计学意义。
