Impact of a 2-year trial of nutritional ketosis on indices of cardiovascular disease risk in patients with type 2 diabetes.
Impact of a 2-year trial of nutritional ketosis on indices of cardiovascular disease risk in patients with type 2 diabetes.
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DOI：
10.1186/s12933-020-01178-2
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发表时间：
2020-12-08
影响因子：
9.3
通讯作者：
Krauss RM
中科院分区：
文献类型：
--
作者：
Athinarayanan SJ;Hallberg SJ;McKenzie AL;Lechner K;King S;McCarter JP;Volek JS;Phinney SD;Krauss RM
我们之前曾报道，在2型糖尿病（T2 D）患者中，2年内摄入能够诱导营养性酮症的极低碳水化合物饮食（持续护理干预，CCI）可改善体重、血糖控制和心血管疾病（CVD）的多种风险因素，但低密度脂蛋白胆固醇（LDL-C）升高除外。在本研究中，我们报告了这种干预对动脉粥样硬化性心血管疾病（CVD）风险标志物的影响，重点是脂蛋白亚组分颗粒浓度以及颈动脉内膜中层厚度（CIMT）。在完成本研究2年的T2 D患者中进行分析（CCI; n = 194;常规治疗（UC）：n = 68）。在基线、1年和2年时通过离子迁移率测量脂蛋白亚组分颗粒浓度，并在基线和2年时测量CIMT。主成分分析（PCA）用于评估脂蛋白颗粒独立簇的变化。2年时，CCI导致小LDL IIIb降低23%，大LDL I增加29%，而总LDL颗粒浓度或ApoB无变化。小LDL和大LDL比例的变化反映在高比例CCI参与者（48.1%）中小LDL亚类表型B的逆转以及代表T2 D致动脉粥样硬化脂蛋白表型特征的主成分（PC）从总方差的主要成分变为次要成分。CCI组中LDL-C的增加主要归因于较大的富含胆固醇的LDL颗粒。CCI组和UC组的CIMT均无变化。在2型糖尿病患者中，2年内食用极低碳水化合物饮食伴营养性酮症降低了小LDL颗粒的水平，小LDL颗粒通常在糖尿病血脂异常中增加，并且是CVD风险升高的标志物。较大LDL颗粒浓度的相应增加导致血浆LDL-C水平升高。总LDL颗粒、ApoB和CIMT进展没有增加，提供了支持性证据，表明这种饮食干预对CVD风险没有不利影响。
We have previously reported that in patients with type 2 diabetes (T2D) consumption of a very low carbohydrate diet capable of inducing nutritional ketosis over 2 years (continuous care intervention, CCI) resulted in improved body weight, glycemic control, and multiple risk factors for cardiovascular disease (CVD) with the exception of an increase in low density lipoprotein cholesterol (LDL-C). In the present study, we report the impact of this intervention on markers of risk for atherosclerotic cardiovascular disease (CVD), with a focus on lipoprotein subfraction particle concentrations as well as carotid-artery intima-media thickness (CIMT). Analyses were performed in patients with T2D who completed 2 years of this study (CCI; n = 194; usual care (UC): n = 68). Lipoprotein subfraction particle concentrations were measured by ion mobility at baseline, 1, and 2 years and CIMT was measured at baseline and 2 years. Principal component analysis (PCA) was used to assess changes in independent clusters of lipoprotein particles. At 2 years, CCI resulted in a 23% decrease of small LDL IIIb and a 29% increase of large LDL I with no change in total LDL particle concentration or ApoB. The change in proportion of smaller and larger LDL was reflected by reversal of the small LDL subclass phenotype B in a high proportion of CCI participants (48.1%) and a shift in the principal component (PC) representing the atherogenic lipoprotein phenotype characteristic of T2D from a major to a secondary component of the total variance. The increase in LDL-C in the CCI group was mainly attributed to larger cholesterol-enriched LDL particles. CIMT showed no change in either the CCI or UC group. Consumption of a very low carbohydrate diet with nutritional ketosis for 2 years in patients with type 2 diabetes lowered levels of small LDL particles that are commonly increased in diabetic dyslipidemia and are a marker for heightened CVD risk. A corresponding increase in concentrations of larger LDL particles was responsible for higher levels of plasma LDL-C. The lack of increase in total LDL particles, ApoB, and in progression of CIMT, provide supporting evidence that this dietary intervention did not adversely affect risk of CVD.
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影响因子：
39.3
作者：
Boren, Jan;Chapman, M. John;Ginsberg, Henry N.
通讯作者：
Ginsberg, Henry N.
影响因子：
--
作者：
Davidson, W Sean;Shah, Amy S
通讯作者：
Shah, Amy S
DOI：
10.1900/rds.2013.10.191
发表时间：
2013-06-01
期刊：
The review of diabetic studies : RDS
影响因子：
--
作者：
Hamilton, Sandra J;Watts, Gerald F
通讯作者：
Watts, Gerald F
影响因子：
5.4
作者：
Lawler PR;Akinkuolie AO;Chu AY;Shah SH;Kraus WE;Craig D;Padmanabhan L;Glynn RJ;Ridker PM;Chasman DI;Mora S
通讯作者：
Mora S
DOI：
10.1161/atvbaha.112.300624
发表时间：
2013-03-01
影响因子：
8.7
作者：
Lamprea-Montealegre, Julio A.;McClelland, Robyn L.;Szklo, Moyses
通讯作者：
Szklo, Moyses