■阿尔茨海默病(AD)的患病率正在增加,但对其认知障碍的有效治疗仍然非常有限。这项研究调查了通过饮食操纵产生酮体对早期AD引起的轻度认知障碍患者记忆的影响,并探讨了潜在的作用机制。
■我们进行了12周,平行组,生酮饮食的受控可行性试验,改良的阿特金斯饮食(MAD),与患有归因于AD的认知障碍的患者的对照饮食相比。我们进行了神经心理学评估,包括记忆测试,并在基线和干预12周后收集血液样本。我们对血浆样品进行非靶向脂质组学和靶向代谢组学分析以检测随时间的变化。
■共筛选了839个人,得到38名随机参与者,其中20人被分配接受MAD,18人被分配接受对照饮食。由于减员,对于主要终点,MAD组中只有13个和对照组中的9个进行了评估,两名参与者达到酮症水平,用于定义MAD依从性标准。与对照组相比,MAD组的记忆综合评分从基线的平均变化为1.37(95%CI:-0.87,4.90)分。干预对基线MAD变化的影响大小中等(Cohen'sD=0.57,95%CI:-0.67,1.33)。在15名参与者中(9名MAD,六个对照)评估脂质组学和代谢组学-脂质组学和代谢组学,从基线到12周,13种代谢物和10种脂质显示出显着变化,包括三酰基甘油(标签,50:5、52:5和52:6),鞘磷脂(SM,44:3、46:0、46:3和48:1),乙酰乙酸酯,脂肪酰基肉碱,甘油-3-磷酸,和羟基脂肪酸。
■在基线和第6周之间磨耗最大。在第6周保留的所有参与者完成研究。尽管按照先验定义的标准,遵守率很低,脂质组学和代谢组学分析显示,在随机化后12周时,MAD和对照参与者之间的循环脂质和代谢物相对于基线有显著变化,MAD参与者表现得更多,尽管不重要,提高记忆力。
UNASSIGNED: Alzheimer\'s disease (AD) is increasing in prevalence, but effective treatments for its cognitive impairment remain severely limited. This study investigates the impact of ketone body production through dietary manipulation on memory in persons with mild cognitive impairment due to early AD and explores potential mechanisms of action.
UNASSIGNED: We conducted a 12-week, parallel-group, controlled feasibility trial of a
ketogenic diet, the modified Atkins diet (MAD), compared to a control diet in patients with cognitive impairments attributed to AD. We administered neuropsychological assessments, including memory tests, and collected blood samples at baseline and after 12 weeks of intervention. We performed untargeted lipidomic and targeted metabolomic analyses on plasma samples to detect changes over time.
UNASSIGNED: A total of 839 individuals were screened to yield 38 randomized participants, with 20 assigned to receive MAD and 18 assigned to receive a control diet. Due to attrition, only 13 in the MAD arm and nine in the control arm were assessed for the primary endpoint, with two participants meeting ketosis levels used to define MAD adherence criteria. The average change from baseline in the Memory Composite Score was 1.37 (95% CI: -0.87, 4.90) points higher in the MAD group compared to the control group. The effect size of the intervention on baseline MAD change was moderate (Cohen\'s D = 0.57, 95% CI: -0.67, 1.33). In the 15 participants (nine MAD, six control) assessed for lipidomic and metabolomic-lipidomics and metabolomics, 13 metabolites and 10 lipids showed significant changes from baseline to 12 weeks, including triacylglycerols (TAGs, 50:5, 52:5, and 52:6), sphingomyelins (SM, 44:3, 46:0, 46:3, and 48:1), acetoacetate, fatty acylcarnitines, glycerol-3-phosphate, and hydroxy fatty acids.
UNASSIGNED: Attrition was greatest between baseline and week 6. All participants retained at week 6 completed the study. Despite low rates of adherence by criteria defined a priori, lipidomic and metabolomic analyses indicate significant changes from baseline in circulating lipids and metabolites between MAD and control participants at 12-week postrandomization, and MAD participants showed greater, albeit nonsignificant, improvement in memory.