定位极低碳水化合物生酮饮食的作用靶点
创作:周旸 审核:周旸 2019年05月23日
  • 纳入52名适合做减肥手术的重度肥胖患者,连续25天食用极低碳水化合物生酮饮食(VLCKD);
  • 干预后,患者的BMI、空腹血糖、胰岛素血症和血脂参数均显著下降,肱动脉血流介导的舒张功能无显著变化,严重的肝脂肪变性患者的数量明显减少;
  • 患者体内的溶酶体酸性脂肪酶(LAL)在干预后活性增加,但与健康人群无显著差别;
  • VLCKD增加了重度肥胖患者的LAL活性,减少了循环脂蛋白分泌,上述作用可归功于膳食中极低的碳水化合物和较多的蛋白质。
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周旸
溶酶体酸脂肪酶活性过低与非酒精性脂肪性肝病等代谢疾病相关。《Journal of Clinical Medicine》近期发表研究,发现极低碳水化合物生酮的饮食可提高重度肥胖患者的溶酶体酸脂肪酶活性,降低血脂参数,具有改善肥胖患者健康指标的作用。该结果对阐释膳食干预的分子机制具有参考价值。
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Lysosomal Acid Lipase as a Molecular Target of the Very Low Carbohydrate Ketogenic Diet in Morbidly Obese Patients: The Potential Effects on Liver Steatosis and Cardiovascular Risk Factors

病态肥胖患者中,溶酶体酸脂肪酶作为极低碳水化合物生酮饮食的分子靶点:对肝脂肪变性和心血管风险因素的潜在影响

10.3390/jcm8050621

2019-05-07, Article

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A very low carbohydrate ketogenic diet (VLCKD) is an emerging technique to induce a significant, well-tolerated, and rapid loss of body weight in morbidly obese patients. The low activity of lysosomal acid lipase (LAL) could be involved in the pathogenesis of non-alcoholic fatty liver disease (NAFLD), which is a common feature in morbidly obese patients. Fifty-two obese patients suitable for a bariatric surgery intervention underwent a 25-day-long VLCKD. The biochemical markers of glucose and lipid metabolism, and flow-mediated dilation (FMD) of the brachial artery were measured before and after VLCKD. LAL activity was measured using the dried blood spot technique in 20 obese patients and in a control group of 20 healthy, normal-weight subjects. After VLCKD, we observed a significant reduction in body mass index, fasting glucose, insulinemia, and lipid profile parameters. No significant variation in FMD was observed. The number of patients with severe liver steatosis significantly decreased. LAL activity significantly increased, although the levels were not significantly different as compared to the control group. In conclusion, VLCKD induces the activity of LAL in morbidly obese subjects and reduces the secretion of all circulating lipoproteins. These effects could be attributed to the peculiar composition of the diet, which is particularly poor in carbohydrates and relatively rich in proteins.

First Authors:
Stefano Ministrini

Correspondence Authors:
Stefano Ministrini

All Authors:
Stefano Ministrini,Lucia Calzini,Elisa Nulli Migliola,Maria Anastasia Ricci,Anna Rita Roscini,Donatella Siepi,Giulia Tozzi,Giulia Daviddi,Eva-Edvige Martorelli,Maria Teresa Paganelli,Graziana Lupattelli

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