The role and benefits of ketogenic diet in modulating inflammation in multiple sclerosis: A systematic review and meta-analysis.

IF 4.3 3区医学 Q1 MEDICINE, GENERAL & INTERNAL

Dm Disease-A-Month Pub Date : 2025-10-08 DOI:10.1016/j.disamonth.2025.102013

Nalla Jaipal Reddy, Neo Zhong Yi Benjamin, Pannala Harsha Reddy, Andy Thai, Hamza Muntasir Al Rawashdeh, Chiranjeevee Saravanan, Priyadarshi Prajjwal, Yogesh Tekuru, Pugazhendi Inban, Jobby John

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引用次数: 0

Abstract

Background: The ketogenic diet, known for its anti-inflammatory and neuroprotective effects, has gained attention as a potential therapeutic approach for modulating inflammation and improving clinical outcomes in Multiple Sclerosis patients.

Objectives: To systematically evaluate and synthesize clinical and preclinical evidence on the ketogenic diet's role in modulating inflammation in Multiple Sclerosis patients and quantitatively assess its effects on inflammation.

Results: The meta-analysis revealed significant effects of the KD on inflammatory markers in MS patients. At 3 months, Leptin levels decreased significantly (mean difference: -2.63 ng/mL, 95 % CI: -3.03 to -2.24, p < 0.00001), and Adiponectin levels increased (mean difference: -1.78 mcg/mL, 95 % CI: -2.26 to -1.29, p < 0.00001). At 6 months, Leptin again decreased (mean difference: -2.18 ng/mL, 95 % CI: -2.92 to -1.43, p < 0.00001), and Adiponectin increased (mean difference: -1.65 mcg/mL, 95 % CI: -1.93 to -1.36, p < 0.00001). However, Neurofilament Light Chain (NfL) showed no significant change (mean difference: -0.10, 95 % CI: -0.61 to 0.40, p > 0.05), suggesting stable neurodegeneration biomarkers. The overall results suggest that the ketogenic diet reduces Leptin, increases Adiponectin, but does not worsen neurodegeneration, highlighting its anti-inflammatory effects.

Conclusion: The ketogenic diet shows promise in improving inflammation, fatigue, depression, and quality of life in MS patients. While neurodegenerative biomarkers like NfL remain stable, deeper ketosis may enhance neuroprotection. Further long-term studies are needed to confirm these effects.

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生酮饮食在多发性硬化症中调节炎症的作用和益处：一项系统综述和荟萃分析。

背景：生酮饮食以其抗炎和神经保护作用而闻名，作为一种调节炎症和改善多发性硬化症患者临床结果的潜在治疗方法而受到关注。目的：系统评价和综合生酮饮食对多发性硬化症患者炎症调节作用的临床和临床前证据，定量评价生酮饮食对炎症的影响。结果：荟萃分析显示KD对MS患者炎症标志物有显著影响。3个月时，瘦素水平显著下降（平均差异：-2.63 ng/mL, 95% CI: -3.03至-2.24,p < 0.00001），脂联素水平升高（平均差异：-1.78 mcg/mL, 95% CI: -2.26至-1.29,p < 0.00001）。6个月时，瘦素再次下降（平均差值：-2.18 ng/mL, 95% CI: -2.92至-1.43,p < 0.00001），脂联素增加（平均差值：-1.65 mcg/mL, 95% CI: -1.93至-1.36,p < 0.00001）。然而，神经丝轻链（NfL）无显著变化（平均差异：-0.10,95% CI: -0.61 ~ 0.40, p < 0.05），提示神经退行性变生物标志物稳定。总体结果表明，生酮饮食减少瘦素，增加脂联素，但不会加重神经变性，突出其抗炎作用。结论：生酮饮食有望改善多发性硬化症患者的炎症、疲劳、抑郁和生活质量。虽然神经退行性生物标志物如NfL保持稳定，但更深的酮症可能增强神经保护。需要进一步的长期研究来证实这些影响。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Dm Disease-A-Month 医学-医学：内科

CiteScore

5.70

自引率

2.50%

发文量

140

审稿时长

>12 weeks

期刊介绍： Designed for primary care physicians, each issue of Disease-a-Month presents an in-depth review of a single topic. In this way, the publication can cover all aspects of the topic - pathophysiology, clinical features of the disease or condition, diagnostic techniques, therapeutic approaches, and prognosis.