Ketogenic diets, not for everyone.
Ketogenic diets, not for everyone.
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DOI：
10.1016/j.jacl.2020.10.005
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发表时间：
2021-01
影响因子：
4.4
通讯作者：
Hegele RA
中科院分区：
文献类型：
--
作者：
Goldberg IJ;Ibrahim N;Bredefeld C;Foo S;Lim V;Gutman D;Huggins LA;Hegele RA
采用低碳水化合物饮食可导致许多患者体重减轻。然而，这些现在普遍的饮食也有可能加剧高胆固醇血症。本研究的目的是显示生酮饮食对有或无基础高脂血症患者胆固醇水平的潜在有害影响。我们描述了五名患者，他们在生酮饮食中血浆胆固醇显著升高，并评估了他们是否有一个良好的描述潜在的遗传性高脂血症。五分之三的患者血液胆固醇水平异常升高至500 mg/dL以上。另外两名患者在生酮饮食中的LDL胆固醇水平增加了一倍以上。1例患者具有APOE E2/E2基因型。在两名患者中发现了更高的常见遗传多态性负担，未发现主要突变。在第四名患者中未发现潜在的遗传原因，第五名患者未进行基因检测。三名患者，包括一名最高胆固醇血症的患者，在恢复到更自由的饮食后胆固醇明显降低。1例患者拒绝改变饮食，但依折麦布治疗后LDL胆固醇降低令人满意。这些病例应作为一个警告，即高脂肪低碳水化合物饮食有可能加剧或导致高胆固醇血症患者有或没有潜在的遗传性高脂血症。
The adoption of low carbohydrate diets can lead to weight loss in many patients. However, these now widespread diets also have the potential to exacerbate hypercholesterolemia. The objective of this study is to display the potentially harmful effects of the ketogenic diet on cholesterol levels in patients with or without underlying hyperlipidemia. We describe five patients who developed marked increases in plasma cholesterol on ketogenic diets and assessed whether they had a well described underlying genetic hyperlipidemia. Three out of five patients had extraordinary increases of blood cholesterol levels to over 500 mg/dL. The other two patients more than doubled their LDL-cholesterol levels on a ketogenic diet. One patient had an APOE E2/E2 genotype. A higher burden of common genetic polymorphisms was found in two patients, with no major mutations found. No potential genetic cause was seen in a fourth patient and the fifth patient had no genetic testing. Three patients, including the one who was most hypercholesterolemic, had a marked reduction in cholesterol after reverting to a more liberal diet. One refused to change his diet but had a satisfactory LDL cholesterol reduction on ezetimibe. These cases should serve as a caution that high fat low carbohydrate diets have the potential to exacerbate or cause hypercholesterolemia in patients with or without underlying genetic hyperlipidemia.
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影响因子：
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