Hyperketonemia and ketosis increase the risk of complications in type 1 diabetes.
Hyperketonemia and ketosis increase the risk of complications in type 1 diabetes.
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DOI：
10.1016/j.freeradbiomed.2016.03.020
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发表时间：
2016-06
影响因子：
7.4
通讯作者：
Jain SK
中科院分区：
文献类型：
--
作者：
Kanikarla-Marie P;Jain SK
促进酮产生的饮食越来越多地用于治疗多种神经系统疾病。在大多数情况下，酮的升高被认为是有利的，因为它们提供能量并能有效满足身体的能量需求。尽管酮有很多好处，但循环中酮浓度高于正常水平往往会通过激活导致细胞损伤的有害途径而引发各种病理并发症。最近的文献表明，循环酮水平升高与氧化应激之间可能存在联系，将高酮血症与无数疾病联系起来。酮体是由肝脏中脂肪酸氧化产生的，作为替代能源，通常发生在葡萄糖限制条件下。生酮和酮解的调节在决定血液中酮浓度方面起着重要作用。高酮血症是一种血液中乙酰乙酸 (AA)、3-β-羟基丁酸 (BHB) 和丙酮水平升高的病症。一些生理和病理触发因素，例如禁食、生酮饮食和糖尿病，会导致循环酮的积累和升高。研究发现，与酮水平正常的糖尿病患者相比，酮水平升高的糖尿病患者的大脑、肾脏、肝脏和微血管系统的并发症增加。本综述总结了高酮血症和酮症酸中毒导致氧化还原失衡增加，从而增加患者发病和死亡风险的机制。
Diets that boost ketone production are increasingly used for treating several neurological disorders. Elevation in ketones in most cases is considered favorable, as they provide energy and are efficient in fueling the body’s energy needs. Despite all the benefits from ketones, the above normal elevation in the concentration of ketones in the circulation tend to illicit various pathological complications by activating injurious pathways leading to cellular damage. Recent literature demonstrates a plausible link between elevated levels of circulating ketones and oxidative stress, linking hyperketonemia to innumerable morbid conditions. Ketone bodies are produced by the oxidation of fatty acids in the liver as a source of alternative energy that generally occurs in glucose limiting conditions. Regulation of ketogenesis and ketolysis plays an important role in dictating ketone concentrations in the blood. Hyperketonemia is a condition with elevated blood levels of acetoacetate (AA), 3-β-hydroxybutyrate (BHB), and acetone. Several physiological and pathological triggers, such as fasting, ketogenic diet, and diabetes cause an accumulation and elevation of circulating ketones. Complications of the brain, kidney, liver, and microvasculature were found to be elevated in diabetic patients who had elevated ketones compared to those diabetics with normal ketone levels. This review summarizes the mechanisms by which hyperketonemia and ketoacidosis cause an increase in redox imbalance and thereby increasing the risk of morbidity and mortality in patients.