背景:轻度神经认知障碍(NCD),正式称为轻度认知障碍,通常是阿尔茨海默病(AD)发展之前的临床阶段,最普遍的主要非传染性疾病,和其他痴呆症的原因。葡萄糖是人脑代谢的主要能量来源,轻度NCD患者的葡萄糖摄取减少,AD,其他非传染性疾病。不像葡萄糖,在轻度NCD和AD患者中,酮的摄取仍然正常,提示使用酮体可以弥补轻度NCD和AD患者的葡萄糖能量缺乏。
目的:本系统综述的目的是总结外源性酮的疗效和安全性,包括中链甘油三酯(MCT),轻度NCD和AD患者认知功能的研究.
方法:Embase,MEDLINE,MEDLINE正在进行中,PubMed提前打印,Cochrane中央控制试验登记册,欧洲PMC数据库从成立到2022年4月进行了搜索。研究报告了轻度NCD和AD患者外生酮的随机对照试验的认知功能疗效和安全性结果。
方法:数据由1名评审员提取,并由第二名评审员检查。使用Cochrane偏差风险工具评估偏差风险,版本2。
方法:本综述确定了13项研究MCT或椰子油对轻度NCD或AD患者的疗效和安全性的个体试验。由于研究的异质性,使用了叙事合成。
结论:总体而言,在认知能力的多个方面观察到与外源性酮相关的改善,尽管纳入研究之间的巨大异质性使得很难从目前的文献中得出确切的结论。尽管一些研究调查了载脂蛋白Eε4等位基因状态对治疗效果的影响,目前的数据不足以断定是否存在这种影响。
背景:PROSPERO注册号.CRD4202236664。
BACKGROUND: Mild neurocognitive disorder (NCD), formally known as mild cognitive impairment, is usually the clinical stage preceding the development of Alzheimer\'s disease (AD), the most prevalent major NCD, and other causes of dementia. Glucose is a major source of energy for human brain metabolism and the uptake of glucose is reduced in patients with mild NCD, AD, and other NCDs. Unlike glucose, the uptake of ketones remains normal in people with mild NCD and AD, suggesting that the use of ketone bodies may compensate for glucose energy deficiency in patients with mild NCD and AD.
OBJECTIVE: The aim of this systematic review was to summarize the efficacy and safety of exogenic ketones, including medium chain triglycerides (MCTs), on cognitive function in patients with mild NCD and AD.
METHODS: The Embase, MEDLINE, MEDLINE In-Process, PubMed Ahead-of-Print, Cochrane Central Register of Controlled Trials, Europe PMC databases were searched from inception to April 2022. Studies reporting cognitive function efficacy and safety outcomes from randomized controlled trials of exogenic ketones in patients with mild NCD and AD were included.
METHODS: Data were extracted by 1 reviewer and checked by a second reviewer. Risk of bias was assessed using the Cochrane risk of bias tool, version 2.
METHODS: This review identified 13 individual trials investigating the efficacy and safety of MCT or coconut oil for patients with mild NCD or with AD. Because of the heterogeneity of the studies, a narrative synthesis was used.
CONCLUSIONS: Overall, improvements associated with exogenic ketones were observed in multiple aspects of cognitive abilities, although the large heterogeneity between the included studies makes it difficult to draw firm conclusions from the current literature. Although some studies investigated the impact of the apolipoprotein E ε4 allele status on treatment efficacy, the current data are insufficient to conclude whether such an effect is present.
BACKGROUND: PROSPERO registration No. CRD42022336664.