METHODS: A comprehensive search was conducted on three electronic databases, including PubMed/Medline, Web of Science, and Scopus until December 2022. The inclusion criteria were studies that described any changes in GM after consuming KD in neurological patients. Full text of studies such as clinical trials and cohorts were added. The quality assessment of cohort studies was conducted using the Newcastle-Ottawa Quality Assessment Scale and for the clinical trials using the Cochrane Collaboration tool. The search, screening, and data extraction were performed by two researchers independently.
RESULTS: Thirteen studies examining the effects of the KD on the GM in neurological patients were included. Studies have shown that KD improves clinical outcomes by reducing disease severity and recurrence rates. An increase in Proteobacteria phylum, Escherichia, Bacteroides, Prevotella, Faecalibacterium, Lachnospira, Agaricus, and Mrakia genera and a reduction in Firmicutes, and Actinobacteria phyla, Eubacterium, Cronobacter, Saccharomyces, Claviceps, Akkermansia and Dialister genera were reported after KD. Studies showed a reduction in concentrations of fecal short-chain fatty acids and branched-chain fatty acids and an increase in beta Hydroxybutyrate, trimethylamine N-oxide, and N-acetylserotonin levels after KD.
CONCLUSIONS: The KD prescribed in neurological patients has effectively altered the GM composition and GM-derived metabolites.
方法:对三个电子数据库进行了全面搜索,包括PubMed/Medline,WebofScience,和Scopus,直到2022年12月。纳入标准是描述神经系统患者服用KD后GM变化的研究。增加了临床试验和队列等研究的全文。使用纽卡斯尔-渥太华质量评估量表进行队列研究的质量评估,并使用Cochrane协作工具进行临床试验。搜索,筛选,和数据提取由两名研究人员独立进行。
结果:纳入了13项研究,研究了KD对神经系统患者GM的影响。研究表明,KD通过降低疾病严重程度和复发率来改善临床结果。变形杆菌门的增加,埃希氏菌,拟杆菌,普雷沃氏菌,粪杆菌,落叶螺旋体,蘑菇,和Mrakia属以及Firmicutes的减少,和放线菌门,真细菌,Cronobacter,酵母菌,Claviceps,KD后报告了Akkermansia和Dialister属。研究表明,粪便短链脂肪酸和支链脂肪酸的浓度降低,β-羟基丁酸增加,三甲胺N-氧化物,和KD后的N-乙酰5-羟色胺水平。
结论:在神经科患者中规定的KD有效地改变了GM组成和GM衍生的代谢产物。