Glucose and Lipid Homeostasis and Inflammation in Humans Following an Isocaloric Ketogenic Diet
Glucose and Lipid Homeostasis and Inflammation in Humans Following an Isocaloric Ketogenic Diet
复制标题
DOI：
10.1002/oby.22468
复制
发表时间：
2019-06-01
期刊：
影响因子：
6.9
通讯作者：
Leibel, Rudolph L.
中科院分区：
文献类型：
--
作者：
Rosenbaum, Michael;Hall, Kevin D.;Leibel, Rudolph L.
目的本研究的目的是测量从基线饮食（BD）过渡到等热量生酮饮食（KD）后血糖、血脂和炎症参数的变化。方法对17名男性（BMI：25-35 kg/m2）在4周BD（15%蛋白质、50%碳水化合物、35%脂肪）和4周等热量KD（15%蛋白质、5%碳水化合物、80%脂肪）期间的葡萄糖稳态、脂质稳态和炎症进行研究。在与BD（对照餐[CM]）和KD（生酮餐）组成相匹配的混合餐试验后评估餐后反应。结果糖尿病肾病组空腹酮体、甘油、游离脂肪酸、胰高血糖素、脂联素、抑胃肽、总胆固醇、低密度脂蛋白胆固醇、C反应蛋白均显著升高。空腹胰岛素、C肽、甘油三酯和成纤维细胞生长因子21显著降低。在KD期间，两种试验餐的葡萄糖曲线下面积均显著较高，并且仅CM的胰岛素曲线下面积显著较高。葡萄糖稳态分析表明，KD胰岛素敏感性下降，在CM，但增加生酮餐。胰岛素介导的抗脂解作用在KD上降低，与膳食类型无关。结论：转换为KD与胆固醇和炎症标志物升高、甘油三酯降低和胰岛素介导的抗脂解作用降低相关。葡萄糖稳态参数具有饮食依赖性和试验餐依赖性。
Objective The objective of this study was to measure changes in glucose, lipid, and inflammation parameters after transitioning from a baseline diet (BD) to an isocaloric ketogenic diet (KD). Methods Glucose homeostasis, lipid homeostasis, and inflammation were studied in 17 men (BMI: 25-35 kg/m(2)) during 4 weeks of a BD (15% protein, 50% carbohydrate, 35% fat) followed by 4 weeks of an isocaloric KD (15% protein, 5% carbohydrate, 80% fat). Postprandial responses were assessed following mixed-meal tests matched to compositions of the BD (control meal [CM]) and KD (ketogenic meal). Results Fasting ketones, glycerol, free fatty acids, glucagon, adiponectin, gastric inhibitory peptide, total and low-density lipoprotein cholesterol, and C-reactive protein were significantly increased on the KD. Fasting insulin, C-peptides, triglycerides, and fibroblast growth factor 21 were significantly decreased. During the KD, the glucose area under the curve was significantly higher with both test meals, and the insulin area under the curve was significantly higher only for the CM. Analyses of glucose homeostasis suggested that the KD insulin sensitivity decreased during the CM but increased during the ketogenic meal. Insulin-mediated antilipolysis was decreased on the KD regardless of meal type. Conclusions Switching to the KD was associated with increased cholesterol and inflammatory markers, decreased triglycerides, and decreased insulin-mediated antilipolysis. Glucose homeostasis parameters were diet dependent and test meal dependent.