生酮疗法对神经退行性疾病的疗效(综述)
创作:szx 审核:szx 03月17日
  • 纳入17项对照试验(干预至少4周,涉及979名受试者),总结生酮疗法对神经退行性疾病的疗效;
  • 涉及的适应症包括:轻度认知障碍(n=6)、多发性硬化(n=4)、阿尔兹海默症(n=5)、帕金森病(n=1)、帕金森病继发轻度认知障碍(n=1);
  • 采用的干预手段包括:生酮饮食(n=9)、中链甘油三酯(n=7)、禁食(n=1);
  • 生酮疗法的疗效因疾病类型、严重程度、干预手段、评估结局而异。
  • 相比于生酮饮食,补充外源性生酮剂的可行性及依从性更高。
主编推荐语
szx
Advances in Nutrition上发表的一篇系统性综述,对17项对照试验(共涉及近1000名神经退行性疾病患者)的数据进行总结:生酮疗法(包括生酮饮食、中链甘油三酯、禁食)对神经退行性疾病的疗效因多种因素而异,而考虑到可行性、依从性等方面,补充外源性生酮剂优于生酮饮食。
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The Efficacy of Ketogenic Therapies in the Clinical Management of People with Neurodegenerative Disease: A Systematic Review

生酮疗法在神经退行性疾病患者临床管理中的疗效:一项系统性综述

10.1093/advances/nmaa180

02-23, Review

Abstract & Authors:展开

Abstract:收起
Ketone bodies have potential disease-modifying activity that represent a novel therapeutic approach for neurodegenerative diseases (NDD). The aim of this systematic review was to summarize and evaluate the evidence for the application of ketogenic therapies (dietary or exogenous ketogenic agents) for NDD and provide recommendations for future research. Eight databases were electronically searched for articles reporting on controlled trials (≥4 wk duration) that induced ketosis or elevated serum ketone concentrations in people with NDD. Of 4498 records identified, 17 articles met the inclusion criteria with a total of 979 participants including studies on mild cognitive impairment (MCI; n = 6), multiple sclerosis (n = 4), Alzheimer's disease (n = 5), Parkinson's disease (n = 1), and MCI secondary to Parkinson's disease (n = 1). Of 17 studies, 7 were randomized double-blind placebo-controlled trials. Most studies used dietary interventions (n = 9), followed by medium-chain triglycerides (n = 7) and a fasting protocol (n = 1). Generally, trials were 6 wk in duration and assessed cognition as the primary outcome. Studies were heterogeneous in type and severity of NDD, interventions used, and outcomes assessed. Overall, 3/17 studies carried a low risk of bias. Based on available evidence, exogenous ketogenic agents may be more feasible than dietary interventions in NDD from a compliance and adherence perspective; more research is required to confirm this. Recommendations for future research include improving exogenous formulations to reduce adverse effects, exploring interindividual factors affecting response-to-treatment, and establishing a “minimum required dose” for clinically meaningful improvements in disease-specific symptoms, such as cognition or motor function.

First Authors:
Lauren S Dewsbury

Correspondence Authors:
Chai K Lim,Genevieve Z Steiner

All Authors:
Lauren S Dewsbury,Chai K Lim,Genevieve Z Steiner

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