背景:生酮饮食(KD)在许多疾病领域显示出显着的效果。在许多动物实验中已证明KD可有效治疗阿尔茨海默病(AD)。但治疗AD的临床疗效尚不确定。
目的:系统评价KD对AD认知功能的影响。
方法:我们搜索了三个国际数据库-PubMed,科克伦图书馆,和Embase-从数据库开始到2023年10月检索ADKD干预的RCT。两名审稿人搜索并筛选了文献,独立提取和检查相关数据,并评估纳入研究的偏倚风险。Meta分析采用RevMan5.3软件进行。
结果:共纳入10例RCTS,涉及691例AD患者。干预组有357名参与者,对照组有334名参与者。KD干预的持续时间从最少3个月到最多15个月不等。Meta分析结果显示,KD能有效改善老年人的心理状态(NM量表)[MD=7.56,95CI(3.02,12.10),P=0.001],MMSE[MD=1.25,95CI(0.46,2.04),P=0.002],和ADAS-Cog[MD=-3.43,95CI(-5.98,-0.88),P=0.008]。酮体(β-羟基丁酸)的升高[MD=118.84,95CI(15.20,222.48),P=0.02]也可能导致甘油三酯的升高[MD=0.19,95CI(0.03,0.35),P=0.02]和低密度脂蛋白[MD=0.31,95CI(0.04,0.58),P=0.02]。
结论:进行的研究表明,KD可以增强AD患者的精神状态和认知功能,尽管可能导致血脂水平升高。总之,KD具有良好的干预效果和安全性,值得在AD临床治疗中推广应用。
BACKGROUND: Ketogenic diets (KD) have shown remarkable effects in many disease areas. It has been demonstrated in numerous animal experiments that KD is effective in the treatment of Alzheimer\'s disease (AD). But the clinical effect of treating AD is uncertain.
OBJECTIVE: To systematically review the impact of KD on cognitive function in AD.
METHODS: We conducted a search of three international databases-PubMed, Cochrane Library, and Embase-to retrieve RCTs on the KD intervention for AD from the inception of the databases through October 2023. Two reviewers searched and screened the literature, extracted and checked relevant data independently, and assessed the risk of bias of the included studies. The meta-analysis was carried out utilizing RevMan 5.3 software.
RESULTS: A total of 10 RCTS involving 691 patients with AD were included. There were 357 participants in the intervention group and 334 participants in the control group. The duration of the KD intervention ranged from a minimum of 3 months to a maximum of 15 months. Meta-analysis results showed that KD could effectively improve the mental state of the elderly (NM scale) [MD = 7.56, 95%CI (3.02, 12.10), P = 0.001], MMSE [MD = 1.25, 95%CI (0.46, 2.04), P = 0.002], and ADAS-Cog [MD = -3.43, 95%CI (-5.98, -0.88), P = 0.008]. The elevation of ketone body (β-hydroxybutyric) [MD = 118.84, 95%CI (15.20, 222.48), P = 0.02] may also lead to the elevation of triglyceride [MD = 0.19, 95%CI (0.03, 0.35), P = 0.02] and low density lipoprotein [MD = 0.31, 95%CI (0.04, 0.58), P = 0.02].
CONCLUSIONS: Research conducted has indicated that the KD can enhance the mental state and cognitive function of those with AD, albeit potentially leading to an elevation in blood lipid levels. In summary, the good intervention effect and safety of KD are worthy of promotion and application in clinical treatment of AD.