中链甘油三酯可诱导轻度酮症，并可能改善阿尔茨海默病患者的认知功能。一项对人体研究的系统评价和荟萃分析。
Medium Chain Triglycerides induce mild ketosis and may improve cognition in Alzheimer's disease. A systematic review and meta-analysis of human studies.
机构信息
Laboratory of Clinical Investigation, Intramural Research Program, National Institute on Aging, National Institutes of Health, Baltimore, USA.
Department of Neuroscience, Johns Hopkins University School of Medicine, Baltimore, USA.
出版信息
Ageing Res Rev. 2020 Mar;58:101001. doi: 10.1016/j.arr.2019.101001. Epub 2019 Dec 20.
INTRODUCTION/AIM: The brain in Alzheimer's disease shows glucose hypometabolism but may utilize ketones for energy production. Ketone levels can potentially be boosted through oral intake of Medium Chain Triglycerides (MCTs). The aim of this meta-analysis is to investigate the effect of MCTs on peripheral ketone levels and cognitive performance in patients with mild cognitive impairment and Alzheimer's disease.
METHODS
Medline, Scopus and Web of Science were searched for literature up to March 1, 2019. Meta-analyses were performed by implementing continuous random-effects models and outcomes were reported as weighted Mean Differences (MDs) or Standardized Mean Differences (SMDs).
RESULTS
Twelve records (422 participants) were included. Meta-analysis of RCTs showed that, compared with placebo, MCTs elevated beta-hydroxybutyrate [MD = 0.355; 95 % CI (0.286, 0.424), I = 0 %], showed a trend towards cognitive improvement on ADAS-Cog [MD = -0.539; 95% CI (-1.239, -0.161), I = 0 %], and significantly improved cognition on a combined measure (ADAS-Cog with MMSE) [SMD = -0.289; 95 % CI (-0.551, -0.027), I = 0 %].
CONCLUSIONS
In this meta-analysis, we demonstrated that MCTs can induce mild ketosis and may improve cognition in patients with mild cognitive impairment and Alzheimer's disease. However, risk of bias of existing studies necessitates future trials.
简介/目的：阿尔茨海默病患者的大脑表现出葡萄糖代谢低下，但可能利用酮体作为能量来源。通过口服中链甘油三酯（MCT）可以潜在地提高酮体水平。本荟萃分析的目的是研究 MCT 对轻度认知障碍和阿尔茨海默病患者外周酮体水平和认知表现的影响。
方法
截至 2019 年 3 月 1 日，通过 Medline、Scopus 和 Web of Science 搜索文献。通过实施连续随机效应模型进行荟萃分析，结果以加权均数差（MD）或标准化均数差（SMD）报告。
结果
共纳入 12 项记录（422 名参与者）。随机对照试验的荟萃分析表明，与安慰剂相比，MCT 可升高β-羟丁酸[MD = 0.355；95%CI（0.286，0.424），I = 0%]，ADAS-Cog 认知改善呈趋势[MD = -0.539；95%CI（-1.239，-0.161），I = 0%]，并显著改善综合测量（ADAS-Cog 与 MMSE）的认知[SMD = -0.289；95%CI（-0.551，-0.027），I = 0%]。
结论
在这项荟萃分析中，我们证明 MCT 可以诱导轻度酮症，并可能改善轻度认知障碍和阿尔茨海默病患者的认知功能。然而，现有研究的偏倚风险需要进一步的试验。
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