A very-low-calorie ketogenic diet normalises obesity-related enhanced levels of erythropoietin compared with a low-calorie diet or bariatric surgery

IF 3.9 2区 医学 Q2 ENDOCRINOLOGY & METABOLISM
A. Fernandez-Pombo, P. M. Lorenzo, M. C. Carreira, D. Gomez-Arbelaez, A. I. Castro, D. Primo, J. Rodriguez, I. Sajoux, J. Baltar, D. de Luis, D. Bellido, A. B. Crujeiras, F. F. Casanueva
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Abstract

Purpose

Nutritional ketosis synergistically with body-weight loss induced by a very-low-calorie ketogenic diet (VLCKD) has proven to be effective in improving obesity-related pathophysiology. Recently, growing attention has been focused on the relation between erythropoietin (EPO) and obesity. Thus, this study aims to investigate whether nutritional ketosis and weight loss induced by a VLCKD modify the circulating levels of EPO in patients with obesity in comparison with the effect of low-calorie diet (LCD) or bariatric surgery (BS).

Methods

EPO levels, iron status and body composition parameters were evaluated in 72 patients with overweight or obesity and 27 normal-weight subjects at baseline and after the three different weight-reduction therapies (VLCKD, LCD and BS) in 69 patients with excess body weight. β-hydroxybutyrate levels were also measured in the VLCKD group. The follow-up was established at 2–3 months and 4–6 months.

Results

It was found that EPO levels were higher in morbid obesity and correlated with higher basal weight, fat mass (FM) and fat-free mass (FFM) in the overall sample. High baseline EPO levels were also correlated with higher impact on the course of weight loss and changes in FM and FFM induced by the three weight-loss interventions. Furthermore, the VLCKD induced a decrease in EPO levels coinciding with maximum ketosis, which was maintained over time, while statistically significant changes were not observed after LCD and BS.

Conclusion

The obesity-related increased EPO levels are restored after VLCKD intervention at the time of maximum ketosis, suggesting a potential role of the nutritional ketosis induced by the VLCKD. Baseline EPO levels could be a biomarker of response to a weight-loss therapy.

Graphical abstract

Abstract Image

与低热量饮食或减肥手术相比,极低热量生酮饮食可使与肥胖相关的红细胞生成素水平升高恢复正常
目的事实证明,极低热量生酮饮食(VLCKD)诱导的营养性酮病与体重减轻协同作用,可有效改善与肥胖相关的病理生理学。最近,人们越来越关注促红细胞生成素(EPO)与肥胖之间的关系。本研究旨在探讨营养酮病和 VLCKD 诱导的体重减轻是否会改变肥胖症患者体内 EPO 的循环水平,并与低热量饮食(LCD)或减肥手术(BS)的效果进行比较。VLCKD 组还测量了 β-羟丁酸水平。结果发现,病态肥胖症患者的 EPO 水平较高,并与总体样本中较高的基础体重、脂肪量(FM)和无脂肪量(FFM)相关。高基线 EPO 水平还与三种减肥干预措施对减肥过程以及脂肪量和无脂肪量变化的影响有关。此外,VLCKD 引发的 EPO 水平下降与最大酮病同时发生,并随着时间的推移而维持,而 LCD 和 BS 后未观察到统计学意义上的显著变化。基线 EPO 水平可能是减肥疗法反应的生物标志物。 图表摘要
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来源期刊
Journal of Endocrinological Investigation
Journal of Endocrinological Investigation 医学-内分泌学与代谢
CiteScore
8.70
自引率
7.40%
发文量
242
审稿时长
3 months
期刊介绍: The Journal of Endocrinological Investigation is a well-established, e-only endocrine journal founded 36 years ago in 1978. It is the official journal of the Italian Society of Endocrinology (SIE), established in 1964. Other Italian societies in the endocrinology and metabolism field are affiliated to the journal: Italian Society of Andrology and Sexual Medicine, Italian Society of Obesity, Italian Society of Pediatric Endocrinology and Diabetology, Clinical Endocrinologists’ Association, Thyroid Association, Endocrine Surgical Units Association, Italian Society of Pharmacology.
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