秦环龙+蔚青:生酮饮食治疗疾病的作用和机制(综述)
  • KD可诱导机体代谢(如增加脂肪酸、酮体水平和降低血糖浓度)和肠道菌群(如增加AKK菌,减少沙门氏菌)改变;
  • KD通过降低血糖、糖化血红蛋白和血清胰岛素水平,改善胰岛素敏感性,增加饱腹感和减少炎症等途径改善代谢紊乱;
  • KD也可通过提高线粒体功能和ATP生成,减少氧化应激和大脑炎症,改善运动功能和运动神经元存活等改善神经病理和生化行为;
  • KD通过降低肿瘤GPR109A的表达、mTORC1的激活和葡萄糖摄取可降低肿瘤生长,提高生存期。
主编推荐语
广西妇幼保健院营养科陈彬林
生酮饮食 (KD) 是一种高脂肪、充足蛋白质和极低碳水化合物的饮食方案,它模拟可诱导酮体生成等代谢改变的禁食状态。KD已被确立为一种成功的治疗顽固性癫痫的饮食方法,并且在过去十年中迅速引起了研究的关注,越来越多的证据表明KD对除癫痫以外的各种疾病具有治疗潜力,从肥胖到恶性肿瘤。同济大学附属第十人民医院秦环龙和蔚青作为共同通讯作者近期在Signal Transduction and Targeted Therapy发表的一篇综述总结了 KD 在不同疾病中的有效性和安全性的实验和临床证据,并讨论了可能的作用机制。有趣的是,本综述在Introduction出现了中文“病从口入”和“晋”,也许这也是中华文化自信和学术自信的一种表现。最后值得提醒的是,生酮饮食还有很多科学问题尚未得到解答,安全性也是需要考虑的问题。
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Ketogenic diet for human diseases: the underlying mechanisms and potential for clinical implementations

生酮饮食治疗人类疾病:潜在机制和临床应用的潜力

10.1038/s41392-021-00831-w

01-17, Review

Abstract & Authors:展开

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The ketogenic diet (KD) is a high-fat, adequate-protein, and very-low-carbohydrate diet regimen that mimics the metabolism of the fasting state to induce the production of ketone bodies. The KD has long been established as a remarkably successful dietary approach for the treatment of intractable epilepsy and has increasingly garnered research attention rapidly in the past decade, subject to emerging evidence of the promising therapeutic potential of the KD for various diseases, besides epilepsy, from obesity to malignancies. In this review, we summarize the experimental and/or clinical evidence of the efficacy and safety of the KD in different diseases, and discuss the possible mechanisms of action based on recent advances in understanding the influence of the KD at the cellular and molecular levels. We emphasize that the KD may function through multiple mechanisms, which remain to be further elucidated. The challenges and future directions for the clinical implementation of the KD in the treatment of a spectrum of diseases have been discussed. We suggest that, with encouraging evidence of therapeutic effects and increasing insights into the mechanisms of action, randomized controlled trials should be conducted to elucidate a foundation for the clinical use of the KD.

First Authors:
Huiyuan Zhu,Dexi Bi,Youhua Zhang,Cheng Kong

Correspondence Authors:
Qing Wei,Huanlong Qin

All Authors:
Huiyuan Zhu,Dexi Bi,Youhua Zhang,Cheng Kong,Jiahao Du,Xiawei Wu,Qing Wei,Huanlong Qin

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