生酮饮食对人体胰岛素样生长因子（IGF）-1 的影响：系统回顾和荟萃分析。

IF 12.5 1区医学 Q1 CELL BIOLOGY

Ageing Research Reviews Pub Date : 2024-10-11 DOI:10.1016/j.arr.2024.102531

Gayathiri Rajakumar , Maria Lastra Cagigas , Tian Wang , Angela Y. Pan , Tiana Pelaia , Stephen J. Fuller , Luigi Fontana

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引用次数: 0

摘要

背景：胰岛素样生长因子（IGF）-1在衰老和癌症生物学中发挥作用，已知禁食会降低成人血清中的IGF-1水平。然而，自由生酮饮食（KD）对 IGF-1 水平的影响仍不清楚：根据 PRISMA 指南，我们通过系统检索 Ovid、PubMed、Scopus 和 CENTRAL 图书馆，对截至 2023 年 6 月的人体试验进行了荟萃分析。符合条件的研究为任何健康状况的成人开具了酮病处方，确认了酮病，并测量了血清 IGF-1。涉及规定禁食或能量限制的方案被排除在外。纵向计算KD组干预前后测量值的平均差（MD）和95%置信区间（CI）：在12篇符合纳入标准的出版物中，共有522人参与，其中236人被分配到KD组。干预持续时间为 1-20 周不等。十项试验的汇总结果显示，干预后血清 IGF-1 水平显著降低（MD：-24.9ng/mL [95% CI -31.7 to -18.1]；P2=27%，P=0.19）。KDs还与空腹胰岛素（MD：-2.57 mU/L [95% CI -4.41 to -0.74]，p=0.006）和血糖（MD：-7.30mg/dL [95% CI -11.62 to -2.98]，p=0.0009）的显著下降有关，尽管异质性很明显。对研究设计、性别、膳食持续时间和肿瘤状况进行的亚组分析显示没有明显差异：结论：开食性酮症酸中毒（脂肪含量大于 55%）可有效诱导酮症，使血清 IGF-1 降低 20%，空腹血糖降低 6%，胰岛素降低 29%。临床上，IGF-1的显著降低无需规定禁食或严格限制卡路里摄入量即可实现。我们有必要进一步研究 KDs 对衰老生物标志物和癌症管理的影响。

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Effect of ketogenic diets on insulin-like growth factor (IGF)-1 in humans: A systematic review and meta-analysis

Background

Insulin-like growth factor (IGF)-1 plays a role in aging and cancer biology, with fasting known to reduce serum IGF-1 levels in human adults. However, the impact of ad libitum ketogenic diets (KDs) on IGF-1 levels remains unclear.

Methods

Adhering to PRISMA guidelines, we conducted a meta-analysis of human trials by systematically searching Ovid, PubMed, Scopus, and CENTRAL Libraries until June 2023. Eligible studies prescribed KDs to adults of any health status, confirmed ketosis, and measured serum IGF-1. Protocols involving prescribed fasting or energy restriction were excluded. Mean differences (MD) and 95 % confidence intervals (CIs) were calculated longitudinally between pre- and post-intervention measurements for the KD groups.

Results

Among twelve publications meeting the inclusion criteria, 522 individuals participated, with 236 completing KDs. The intervention duration ranged from 1 to 20 weeks. Pooled results from ten trials showed a significant reduction in serum IGF-1 levels post-intervention (MD: −24.9 ng/mL [95 % CI −31.7 to −18.1]; p<0.0001) with low heterogeneity across studies (I²=27 %, p=0.19). KDs were also associated with significantly decreased fasting insulin (MD: −2.57 mU/L [95 % CI −4.41 to −0.74], p=0.006) and glucose (MD: −7.30 mg/dL [95 % CI −11.62 to −2.98], p=0.0009), although heterogeneity was significant. Subgroup analyses on study design, gender, dietary duration, and oncological status revealed no significant differences.

Conclusion

Ad libitum KDs (>55 % fat) effectively induce ketosis and can lower serum IGF-1 by 20 %, fasting glucose by 6 % and insulin by 29 %. This clinically notable reduction in IGF-1 can be attained without the need for a prescribed fasting or severe calorie restriction regimen. Further investigation is warranted to explore the impact of KDs on ageing biomarkers and cancer management.

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来源期刊

Ageing Research Reviews 医学-老年医学

CiteScore

19.80

自引率

2.30%

发文量

216

审稿时长

55 days

期刊介绍： With the rise in average human life expectancy, the impact of ageing and age-related diseases on our society has become increasingly significant. Ageing research is now a focal point for numerous laboratories, encompassing leaders in genetics, molecular and cellular biology, biochemistry, and behavior. Ageing Research Reviews (ARR) serves as a cornerstone in this field, addressing emerging trends. ARR aims to fill a substantial gap by providing critical reviews and viewpoints on evolving discoveries concerning the mechanisms of ageing and age-related diseases. The rapid progress in understanding the mechanisms controlling cellular proliferation, differentiation, and survival is unveiling new insights into the regulation of ageing. From telomerase to stem cells, and from energy to oxyradical metabolism, we are witnessing an exciting era in the multidisciplinary field of ageing research. The journal explores the cellular and molecular foundations of interventions that extend lifespan, such as caloric restriction. It identifies the underpinnings of manipulations that extend lifespan, shedding light on novel approaches for preventing age-related diseases. ARR publishes articles on focused topics selected from the expansive field of ageing research, with a particular emphasis on the cellular and molecular mechanisms of the aging process. This includes age-related diseases like cancer, cardiovascular disease, diabetes, and neurodegenerative disorders. The journal also covers applications of basic ageing research to lifespan extension and disease prevention, offering a comprehensive platform for advancing our understanding of this critical field.