ABSTRACT
Elevated blood ketone levels (ketosis) in inpatients with diabetes can herald diabetic ketoacidosis (DKA). However, ketosis can also occur in individuals without diabetes in certain settings. It is unclear what proportion of inpatients with ketosis are in DKA and which patients are at the highest risk of DKA. This study determined that many ketone tests are performed in individuals at low risk of DKA, and a ß-hydroxybutyrate <1.0 mmol/L had a low incidence of DKA and less need for escalation in their management.
Subject(s)
Diabetic Ketoacidosis , Hospitalization , Ketones , Humans , Diabetic Ketoacidosis/blood , Diabetic Ketoacidosis/diagnosis , Ketones/blood , Male , Female , 3-Hydroxybutyric Acid/blood , Middle Aged , Inpatients , Adult , Aged , Retrospective StudiesABSTRACT
BACKGROUND: Fluorine-18 fluorodeoxyglucose (FDG) with positron emission tomography (PET) is the standard for detecting myocardial inflammation in cardiac sarcoidosis, requiring preparation with the ketogenic diet (KD) to achieve myocardial glucose suppression. Despite this, incomplete myocardial glucose suppression remains a significant issue, and strategies to reduce myocardial glucose uptake (MGU) and identify incomplete myocardial glucose suppression are required. This study sought to understand the relationship between point-of-care beta-hydroxybutyrate (BHB) and different patterns of MGU and between KD and fasting duration with MGU in patients undergoing evaluation for cardiac sarcoidosis. METHODS: We prospectively included 471 outpatients who underwent FDG-PET for cardiac sarcoidosis evaluation, followed the KD for 1 (n=100), 2 (n=29), and ≥3 days (n=342), fasted for at least 12 hours, and had BHB levels measured immediately before FDG injection. Images were classified as (1) no MGU (negative), (2) focal/multifocal (positive), (3) diffuse (nondiagnostic), or (4) nonspecific uptake (NS-MGU). RESULTS: Cardiac FDG-PET scans were interpreted as the following: 376 (79.83%) negative; 61 (12.95%) positive; 14 (2.97%) diffuse; and 20 (4.25%) NS-MGU. There was a strong negative relationship between BHB levels and MGU (P<0.0001). BHB levels increased significantly with KD duration (P<0.0001) and fasting time (P=0.0067). The combined rate of diffuse, NS-MGU, and positive scans (34%, 28%, 16%) decreased inversely with KD duration (1, 2, and ≥3 days, respectively). However, MGU was not different across different fasting times (P=0.6). Blood glucose levels were not associated with MGU (P=0.17) and only weakly associated with BHB levels (R2=0.03; P<0.001). CONCLUSIONS: We observed a strong inverse relationship between ketosis and patterns of MGU. Longer KD and fasting durations are associated with higher ketosis. However, only KD duration was associated with lower rates of MGU. Measurement of BHB levels before FDG-PET using point-of-care testing is feasible and may facilitate the management of patients referred for myocardial inflammation.
Subject(s)
Cardiomyopathies , Fluorodeoxyglucose F18 , Myocardium , Positron Emission Tomography Computed Tomography , Radiopharmaceuticals , Sarcoidosis , Humans , Male , Female , Sarcoidosis/diagnostic imaging , Sarcoidosis/metabolism , Positron Emission Tomography Computed Tomography/methods , Middle Aged , Cardiomyopathies/diagnostic imaging , Cardiomyopathies/metabolism , Prospective Studies , Myocardium/metabolism , Ketosis/metabolism , Aged , Fasting/blood , Diet, Ketogenic , Adult , Predictive Value of Tests , 3-Hydroxybutyric Acid/blood , Time Factors , Biomarkers/bloodABSTRACT
Active ghrelin (AG) is produced through the post-translational addition of n-octanoic acid to the amino residue Ser-3, making it the natural ligand for the ghrelin receptor. The synthesis of AG is contingent upon specific dietary fatty acids as substrates for the acylation process. Prior studies have demonstrated that AG infusion can lead to reduced feed intake (FI) in broiler chickens, suggesting that manipulating AG may serve as an alternative to quantitative feed restriction in broiler breeders. In this study, we evaluated the effect of dietary sodium octanoate (Octanoate) on FI, water intake (WI), BW, total ghrelin, and ß-hydroxybutyrate (BHB) concentration in two avian species. Broiler chickens and turkeys were reared as recommended by the industry. At 3 wk of age, birds were randomly assigned to a 2 × 3 factorial. The first factor included two species (chickens and turkeys), and the second included doses (0, 4, and 8 mg/mL) of Octanoate in drinking water for 30 d. Feed and WI were recorded daily, while body weight and blood samples were obtained weekly. In chickens, Octanoate doses increased ghrelin and BHB concentrations linearly, while FI and BW decreased linearly with rising Octanoate doses (P < 0.05). However, Octanoate doses did not affect ghrelin, BHB, FI, or BW in turkeys. In conclusion, our data indicate that sodium octanoate administration elicits a differential response in feed intake and body weight gain in chickens and turkeys.
Subject(s)
Animal Feed , Caprylates , Chickens , Diet , Eating , Ghrelin , Turkeys , Animals , Female , Male , 3-Hydroxybutyric Acid/blood , Animal Feed/analysis , Caprylates/administration & dosage , Chickens/physiology , Chickens/metabolism , Diet/veterinary , Dietary Supplements/analysis , Dose-Response Relationship, Drug , Eating/drug effects , Ghrelin/metabolism , Random Allocation , Turkeys/metabolismABSTRACT
This study investigates the effects of a ketogenic low-carbohydrate high-fat (LCHF) diet on body composition in healthy, young, normal-weight women. With the increasing interest in ketogenic diets for their various health benefits, this research aims to understand their impact on body composition, focusing on women who are often underrepresented in such studies. Conducting a randomized controlled feeding trial with a crossover design, this study compares a ketogenic LCHF diet to a Swedish National Food Agency (NFA)-recommended control diet over four weeks. Seventeen healthy, young, normal-weight women adhered strictly to the provided diets, with ketosis confirmed through blood ß-hydroxybutyrate concentrations. Dual-energy X-ray absorptiometry (DXA) was utilized for precise body composition measurements. To avoid bias, all statistical analyses were performed blind. The findings reveal that the ketogenic LCHF diet led to a significant reduction in both lean mass (-1.45 kg 95% CI: [-1.90;-1.00]; p < 0.001) and fat mass (-0.66 kg 95% CI: [-1.00;-0.32]; p < 0.001) compared to the control diet, despite similar energy intake and physical activity levels. This study concludes that while the ketogenic LCHF diet is effective for weight loss, it disproportionately reduces lean mass over fat mass, suggesting the need for concurrent strength training to mitigate muscle loss in women following this diet.
Subject(s)
Body Composition , Cross-Over Studies , Diet, Ketogenic , Humans , Diet, Ketogenic/methods , Female , Adult , Young Adult , Absorptiometry, Photon , Diet, Carbohydrate-Restricted/methods , 3-Hydroxybutyric Acid/blood , KetosisABSTRACT
Patients with sepsis experience metabolic and immunologic dysfunction that may be amplified by standard carbohydrate-based nutrition. A ketogenic diet (KD) may offer an immunologically advantageous alternative, although clinical evidence is limited. We conducted a single-center, open-label, randomized controlled trial to assess whether a KD could induce stable ketosis in critically ill patients with sepsis. Secondary outcomes included assessment of feasibility and safety of KD, as well as explorative analysis of clinical and immunological characteristics. Forty critically ill adults were randomized to either a ketogenic or standard high-carbohydrate diet. Stable ketosis was achieved in all KD patients, with significant increases in ß-hydroxybutyrate levels compared with controls [mean difference 1.4 milimoles per liter; 95% confidence interval (CI): 1.0 to 1.8; P < 0.001). No major adverse events or harmful metabolic side effects (acidosis, dysglycemia, or dyslipidemia) were observed. After day 4, none of the patients in the KD group required insulin treatment, whereas in the control group, insulin dependency ranged between 35% and 60% (P = 0.009). There were no differences in 30-day survival, but ventilation-free [incidence rate ratio (IRR) 1.7; 95% CI: 1.5 to 2.1; P < 0.001], vasopressor-free (IRR 1.7; 95% CI: 1.5 to 2.0; P < 0.001), dialysis-free (IRR 1.5; 95% CI: 1.3 to 1.8; P < 0.001), and intensive care unit-free days (IRR 1.7; 95% CI: 1.4 to 2.1; P < 0.001) were higher in the ketogenic group. Next-generation sequencing of CD4+/CD8+ T cells and protein analyses showed reduced immune dysregulation, with decreased gene expression of T-cell activation and signaling markers and lower pro-inflammatory cytokine secretion. This trial demonstrated the safe induction of a stable ketogenic state in sepsis, warranting larger trials to investigate potential benefits in sepsis-related organ dysfunction.
Subject(s)
Critical Illness , Diet, Ketogenic , Sepsis , Humans , Male , Sepsis/diet therapy , Sepsis/blood , Female , Middle Aged , 3-Hydroxybutyric Acid/blood , Adult , Aged , Ketosis , Treatment OutcomeABSTRACT
Stroke is a significant global burden, causing extensive morbidity and mortality. In metabolic states where glucose is limited, ketone bodies, predominantly ß-hydroxybutyrate (BHB), act as alternative fuel sources. Elevated levels of BHB have been found in the ischemic hemispheres of animal models of stroke, supporting its role in the pathophysiology of cerebral ischemia. Clinically, higher serum and urinary BHB concentrations have been associated with adverse outcomes in ischemic stroke, highlighting its potential utility as a prognostic biomarker. In both animal and cellular models, exogenous BHB administration has exhibited neuroprotective effects, reduction of infarct size, and improvement of neurological outcomes. In this review, we focus on the role of BHB before and after ischemic stroke, with an emphasis on the therapeutic potential and mechanisms of ketone administration after ischemic stroke.
Subject(s)
3-Hydroxybutyric Acid , Ischemic Stroke , 3-Hydroxybutyric Acid/blood , Animals , Humans , Ischemic Stroke/metabolism , Ischemic Stroke/physiopathology , Ischemic Stroke/drug therapy , Brain Ischemia/complications , Brain Ischemia/metabolismABSTRACT
Exogenous supplementation with ketone beverages has been shown to reduce plasma glucose levels during acute nutritional ketosis. It remains to be investigated whether growth differentiation factor 15 (GDF-15)-an anorexigenic hormone-is involved in this process. The aim was to investigate the effect of a ketone ester beverage delivering ß-hydroxybutyrate (KEßHB) on plasma levels of GDF-15, as well as assess the influence of eating behaviour on it. The study was a randomised controlled trial (registered at clinicaltrials.gov as NCT03889210). Individuals were given a KEßHB beverage or placebo in a cross-over fashion. Blood samples were collected at baseline, 30, 60, 90, 120, and 150 min after ingestion. Eating behaviour was assessed using the three-factor eating questionnaire. GDF-15 levels were not significantly different (p = 0.503) after the KEßHB beverage compared with the placebo. This finding remained consistent across the cognitive restraint, emotional eating, and uncontrolled eating domains. Changes in the anorexigenic hormone GDF-15, irrespective of eating behaviour, do not appear to play a major role in the glucose-lowering effect of exogenous ketones.
Subject(s)
3-Hydroxybutyric Acid , Cross-Over Studies , Growth Differentiation Factor 15 , Ketosis , Humans , Growth Differentiation Factor 15/blood , Male , Ketosis/blood , Adult , 3-Hydroxybutyric Acid/blood , Female , Young Adult , Beverages , Blood Glucose/metabolism , Feeding BehaviorABSTRACT
The pathogenesis and diagnosis of subclinical pregnancy toxemia (SCPT) remain elusive and need further investigation in pregnant does. Therefore, the aim of our study was to describe the typical properties of hepatic venous hemodynamics by Doppler ultrasonography. A total of 70 pregnant does were classified based on the blood serum concentrations of ß-hydroxybutyric acid (ßHBA), pregnant does were categorized into control group (ßHBA concentrations <0.8 mmol/L; n = 40) and SCPT group (ßHBA concentrations >0.8 mmol/L; n = 30). DRAMISKI 4vet slim diagnostic ultrasound scanner with B, M, and Doppler (color, power, pulsing wave) modes was used for diagnosis of SCPT. Total serum cortisol level was quantitative using chemiluminescent immunoassay. Serum glucose, triglycerides, cholesterol, HDL and LDL- cholesterol and LDH- cholesterol were measured by colorimetric and kinetic methods. Liver ultrasonography of does with SCPT had been shown mild fatty infiltration with rounded margin, which was characterized by hyperechoic area. There was a significant decrease in the values of portal vein diameter (PVD), portal vein area (PVA), portal mean velocity (PMV) and portal blood flow (PBF) in SCPT does compared to control pregnant does. PVD, PVA and PBF were negatively correlated with ßHBA concentrations in does with SCPT (P < 0.05). PVD was inversely associated with serum cholesterol and triglycerides concentrations (P < 0.05). In conclusions, Doppler ultrasonography examinations of pregnant does with SCPT indicate abnormal hepatic variation. Reduced PVD, PVA, PMV and PBF together with increased ßHBA concentrations could predict SCPT in does with fair sensitivity and specificity.
Subject(s)
Hydrocortisone , Ultrasonography, Doppler , Female , Pregnancy , Hydrocortisone/blood , Ultrasonography, Doppler/veterinary , Animals , Pre-Eclampsia/blood , Pre-Eclampsia/diagnostic imaging , 3-Hydroxybutyric Acid/bloodABSTRACT
Evaluation of the metabolic profile indices allows early detection and treatment of various metabolic disorders during the transition period in ewes. This study aimed to determine the variations in the blood metabolites around lambing in Ossimi ewes. The blood metabolites were investigated in ewes with single (n = 27) and multiple (n = 9) lambs at 3- and 1-week pre-lambing and 3-week post-lambing. The plasma concentrations of glucose were higher in single-bearing ewes than those in multiple-bearing ewes (p < .05), moreover, its lowest value was measured at 1-week prepartum in both groups. Throughout the study period, the serum concentrations of non-esterified fatty acids (NEFA) were significantly increased in ewes with multiple lambs compared to ewes with single lambs (p < .05), and the highest value was found at 1-week before parturition in both groups. In addition, the serum level of beta-hydroxybutyric acid (BHBA) was higher at 3-week postpartum, and it was significantly increased in multiple-bearing ewes than that in single-bearing ones (p < .05) at 3-week pre-lambing. In both groups, the lowest values of total proteins were determined 1-week before lambing, and its concentrations, at 3- and 1-week prepartum, were higher in ewes with single lambs than those with multiple lambs (p < .05). In contrast, the serum concentrations of albumin were significantly lowered 1-week postpartum (p < .05), and without significant differences between both groups (p > .05). The serum activities of aspartate aminotransferase (AST) and gamma-glutamyltransferase (GGT) were significantly increased at 1-week after parturition in both groups (p < .05). Furthermore, the serum activities of AST were higher in multiple-bearing ewes than those in single-bearing ones at 3-week pre-lambing and 3-week post-lambing (p < .05). Variable positive and negative correlations were determined among the blood metabolites. In conclusion, physiological adaptations are associated with the fluctuation of the blood metabolites around lambing. The higher the number of foetuses the higher the metabolic variations in Ossimi ewes. Therefore, regular metabolic profiling for health monitoring may be necessary to avoid disease development during the transition period.
Subject(s)
3-Hydroxybutyric Acid , Blood Glucose , Fatty Acids, Nonesterified , Animals , Female , Pregnancy , Fatty Acids, Nonesterified/blood , Blood Glucose/analysis , 3-Hydroxybutyric Acid/blood , Sheep, Domestic/blood , Postpartum Period/blood , Sheep/blood , Parturition/blood , ParityABSTRACT
OBJECTIVE: The results of this study describe the relationship between the body condition of dairy cows and selected metabolic parameters during the peri- and post-partum period with special consideration of 3 local dairy cow breed in Upper Bavaria and the Allgau. MATERIAL AND METHODS: Three local dairy cattle breeds (Swiss Brown (BV), Simmental (FL), Holstein Friesian (HF)) were examined on 68 farms in southern Germany for 7 consecutive weeks. In dry cows as well as lactating cows (5.-65. day in milk), following blood parameters were investigated: beta-hydroxybutyrate (BHB), non-esterified fatty acids (NEFA), creatinine, aspartate aminotransferase, gamma-glutamyltransferase, glutamate dehydrogenase, total protein, albumin, creatine kinase. In addition, body condition (body condition score [BCS] and back fat thickness [BFT]) were recorded. Exploratory and descriptive statistics were used for data analysis. RESULTS: Concerning the difference in condition before and after calving, the FL showed the smallest difference in RFD. For FL and BV a trend towards higher BFT values could be seen in first lactating cows. For FL and HF, the NEFA values of the later lactating cows were below those of the first lactating cows. The higher lactating cows of BV and FL had higher BHB values. The correlation between BFT and BCS showed the highest R2 (0.53) in the HF cows. BV and FL were below at 0.42 and 0.37. BCS and BFT could not be predicted by the variables NEFA, BHB and liver enzymes. BHB levels of all 3 breeds increased at weeks 2-4 post-partum. The NEFA values for all 3 breeds increased primarily in the 1st-3rd week p.p. in parallel to when the BFT p.p. decreased. NEFA values were highest when body condition declined and therefore when fat mobilization peaked. In BV and HF, there was a constant increase in GLDH when the p.p. BCS difference was there. CONCLUSION AND CLINICAL RELEVANCE: Body condition assessment (BCS at herd and animals` level, BFT at animal level) is an important tool for animal health monitoring. Due to the recognizable breed specificity, the dairy herds can be dealt with more explicitly. The aim is to optimally influence the energy balance of the cow during early lactation in order maintain the health of the animal and its organ systems.
Subject(s)
Peripartum Period , Animals , Cattle/physiology , Female , Peripartum Period/physiology , Peripartum Period/blood , Lactation/physiology , Fatty Acids, Nonesterified/blood , Body Composition/physiology , Dairying , Pregnancy , 3-Hydroxybutyric Acid/blood , Germany , Postpartum Period/physiologyABSTRACT
BACKGROUND: Serum ketone bodies increase due to dynamic changes in the lipid metabolisms of patients undergoing bariatric surgery. However, there have been few studies on the role of ketone bodies after bariatric surgery. We aimed to clarify the role of and relationship between the changes in serum ketone bodies and weight loss, as well as between those changes and the metabolic effects after laparoscopic sleeve gastrectomy (LSG). METHODS: We recruited 52 patients with severe obesity who underwent LSG. We measured acetoacetic acid (AcAc) and ß-hydroxybutyric acid (ß-OHB) at the baseline, 1 month, and 6 months after LSG. Subsequently, we compared the changes in the serum ketone bodies with weight-loss effects and various metabolic parameters. RESULTS: At 1 month after LSG, ß-OHB significantly increased (p = 0.009), then significantly decreased 6 months after LSG (p = 0.002). In addition, ß-OHB in patients without Type 2 diabetes (T2D) and metabolic dysfunction-associated steatohepatitis (MASH) was notably higher than in patients with T2D at 1 month after LSG (p < 0.001). In the early phase, both AcAc and ß-OHB mainly had strong positive correlations with changes in T2D- and MASH-related parameters. In the middle term after LSG, changes in both AcAc and ß-OHB were positively correlated with changes in lipid parameters and chronic kidney disease-related parameters. CONCLUSION: We demonstrated that the postoperative surge of ketone bodies plays a crucial function in controlling metabolic effects after LSG. These findings suggest the cause- and consequence-related roles of ketone bodies in the metabolic benefits of bariatric surgery.
Subject(s)
Gastrectomy , Ketone Bodies , Laparoscopy , Obesity, Morbid , Weight Loss , Humans , Obesity, Morbid/surgery , Obesity, Morbid/blood , Ketone Bodies/blood , Female , Male , Adult , Weight Loss/physiology , Middle Aged , Diabetes Mellitus, Type 2/blood , Diabetes Mellitus, Type 2/surgery , Treatment Outcome , 3-Hydroxybutyric Acid/bloodABSTRACT
Alopecia areata (AA) is an autoimmune inflammatory disease characterized by non-scarring hair loss due to an immune response that targets hair follicles. The current treatment approach for AA involves the use of immunosuppressants and immunomodulators to reduce cytokine levels around affected hair follicles. Sodium-glucose cotransporter 2 (SGLT2) inhibitors have emerged as potential anti-inflammatory agents with diverse beneficial effects in various medical conditions. This study investigates the role of beta-hydroxybutyrate (BHB), a ketone body produced during SGLT2 inhibition, in the pathogenesis of AA. Serum BHB levels were found to be significantly elevated in patients with AA compared with healthy controls, with higher levels correlating with severity of hair loss. BHB treatment increased inflammatory cytokine production in outer root sheath (ORS) cells, mimicking the inflammatory conditions seen in AA. The results suggest that elevated BHB levels may exacerbate the inflammatory immune response in AA patients and may be associated with chronic hair loss and resistance to treatment. Serum BHB levels may serve as a potential marker of poor prognosis in patients with severe AA. Further research is needed to elucidate the precise role of BHB in the pathogenesis of AA and its implications for disease management.
Subject(s)
3-Hydroxybutyric Acid , Alopecia Areata , Inflammation , Alopecia Areata/drug therapy , Alopecia Areata/blood , Alopecia Areata/immunology , Humans , 3-Hydroxybutyric Acid/blood , Adult , Female , Male , Case-Control Studies , Cytokines/metabolism , Cytokines/blood , Hair Follicle/metabolism , Young Adult , Middle AgedABSTRACT
This study aims to investigate the relationship between metabolic parameters and the number of embryos produced in superovulated cows with high genetic characteristics in milk yield. Eighteen Holstein donors were treated with classic superovulation protocols, AI and flushing. During superovulation, decreasing doses of FSH (follicle-stimulating hormone) were administered at 12-h intervals for 4 days. Plasma insulin-like growth factor (IGF1), glucose (GLU), beta-hydroxybutyric acid (BHB), non-esterified fatty acid (NEFA), blood urea nitrogen (BUN) and total protein (TP) levels were determined by using an autoanalyzer. The mixed model analysis of variance was used for statistical analysis. As a result, plasma IGF1, BHB and BUN had significant interactions with both groups and days (p < .05). Additionally, plasma TP-days interactions were significant (p < .05). Furthermore, there was a negative correlation between the number of embryos and plasma BHB levels (p < .05). In conclusion, under appropriate environmental conditions, metabolic profile control of donors can contribute to the embryo production process and to the studies on the metabolic infrastructure.
Subject(s)
3-Hydroxybutyric Acid , Superovulation , Animals , Cattle/physiology , Female , 3-Hydroxybutyric Acid/blood , Fatty Acids, Nonesterified/blood , Follicle Stimulating Hormone/blood , Insulin-Like Growth Factor I/metabolism , Insulin-Like Growth Factor I/analysis , Blood Glucose/analysis , Blood Urea Nitrogen , Insemination, Artificial/veterinary , PregnancyABSTRACT
We aimed to unveil the underlying pathogenic mechanisms of skin cancer in relation to metabolic factors and pathway mechanisms. This study utilized the TwoSample Mendelian randomization (MR) method to investigate the causal relationship between 1400 plasma metabolites and skin cancer. The primary method employed was the inverse variance weighting (IVW). Through IVW analysis, we found 105 plasma metabolites associated with Basal Cell Carcinoma (BCC), with the highest association observed for Prolylglycine levels (OR [95% CI]: 1.1902 [1.0274, 1.3788]). For Malignant Melanoma of Skin (MSS), 68 plasma metabolites were linked, with the highest causal relationship seen for 3-Hydroxybutyrate levels (OR [95% CI]: 1.0030 [1.0013, 1.0048]). Regarding actinic keratosis (AK), and the highest association observed for Hexadecadienoate (16:2n6) levels (OR [95% CI]: 1.3302 [1.0333, 1.7125]). Glycerol to palmitoylcarnitine (16: n6) levels (OR [95% CI]: 1.3302 [1.0333, 1.125]) were found to be significant for BCC and AK. Palmitoylcarnitine (C16) had the most positive causal effect for BCC (OR [95% CI]: 1.1777 [1.0493, 1.3218]), while 5-hydroxy-2-methylpyridine sulfate levels had the highest effect for AK (OR [95% CI]: 1.1788 [1.0295, 1.3498]). And 4-guanidinobutanoate levels had the largest positive causal effect (OR [95% CI]: 1.0857 [1.0417, 1.1317]) for BCC, and X-11880 levels for MSS (OR [95% CI]: 1.0013 [1.0000, 1.0025]). The study revealed a positive association between hereditary Glycerol to palmitoylcarnitine (C16) and 5-hydroxy-2-methylpyridine sulfate levels with the risk of developing BCC and AK. Additionally, 4-guanidinobutanoate levels and X 11880 levels were found to be positively associated with the risk of BCC and MMS.
Subject(s)
Carcinoma, Basal Cell , Mendelian Randomization Analysis , Skin Neoplasms , Humans , Skin Neoplasms/blood , Skin Neoplasms/genetics , Skin Neoplasms/epidemiology , Carcinoma, Basal Cell/blood , Carcinoma, Basal Cell/genetics , Carcinoma, Basal Cell/epidemiology , Melanoma/blood , Melanoma/genetics , Melanoma/epidemiology , Keratosis, Actinic/blood , Keratosis, Actinic/genetics , 3-Hydroxybutyric Acid/blood , Genetic Predisposition to Disease , Melanoma, Cutaneous MalignantABSTRACT
AIM: To examine the effects of the thiazolidinedione (TZD) pioglitazone on reducing ketone bodies in non-obese patients with T2DM treated with the sodium-glucose cotransporter-2 (SGLT2) inhibitor canagliflozin. METHODS: Crossover trials with two periods, each treatment period lasting 4 weeks, with a 4-week washout period, were conducted. Participants were randomly assigned in a 1:1 ratio to receive pioglitazone combined with canagliflozin (PIOG + CANA group) versus canagliflozin monotherapy (CANA group). The primary outcome was change (Δ) in ß-hydroxybutyric acid (ß-HBA) before and after the CANA or PIOG + CANA treatments. The secondary outcomes were Δchanges in serum acetoacetate and acetone, the rate of conversion into urinary ketones, and Δchanges in factors related to SGLT2 inhibitor-induced ketone body production including non-esterified fatty acids (NEFAs), glucagon, glucagon to insulin ratio, and noradrenaline (NA). Analyses were performed in accordance with the intention-to-treat principle. RESULTS: Twenty-five patients with a mean age of 49 ± 7.97 years and a body mass index of 25.35 ± 2.22 kg/m2 were included. One patient discontinued the study during the washout period. Analyses revealed a significant increase in the levels of serum ketone bodies and an elevation in the rate of conversion into urinary ketones after both interventions. However, differernces in levels of ketone bodies (except for acetoacetate) in the PIOG + CANA group were significantly smaller than in the CANA group (219.84 ± 80.21 µmol/L vs. 317.69 ± 83.07 µmol/L, p < 0.001 in ß-HBA; 8.98 ± 4.17 µmol/L vs. 12.29 ± 5.27 µmol/L, p = 0.018 in acetone). NEFA, glucagon, glucagon to insulin ratio, and NA were also significantly increased after both CANA and PIOG + CANA treatments; while only NEFAs demonstrated a significant difference between the two groups. Correlation analyses revealed a significant association between the difference in Δchanges in serum NEFA levels with the differences in Δchanges in ketones of ß-HBA and acetoacetate. CONCLUSION: Supplementation of pioglitazone could alleviate canagliflozin-induced ketone bodies. This benefit may be closely associated with decreased substrate NEFAs rather than other factors including glucagon, fasting insulin and NA.
Subject(s)
Canagliflozin , Cross-Over Studies , Diabetes Mellitus, Type 2 , Drug Therapy, Combination , Hypoglycemic Agents , Ketone Bodies , Pioglitazone , Sodium-Glucose Transporter 2 Inhibitors , Humans , Sodium-Glucose Transporter 2 Inhibitors/therapeutic use , Male , Diabetes Mellitus, Type 2/drug therapy , Diabetes Mellitus, Type 2/blood , Middle Aged , Ketone Bodies/blood , Female , Pioglitazone/therapeutic use , Canagliflozin/therapeutic use , Hypoglycemic Agents/therapeutic use , 3-Hydroxybutyric Acid/blood , Acetoacetates/blood , Insulin/blood , Adult , Glucagon/blood , Thiazolidinediones/therapeutic use , Fatty Acids, Nonesterified/blood , Blood Glucose/drug effects , Blood Glucose/metabolismABSTRACT
AIMS: Cardiac energy metabolism is perturbed in ischaemic heart failure and is characterized by a shift from mitochondrial oxidative metabolism to glycolysis. Notably, the failing heart relies more on ketones for energy than a healthy heart, an adaptive mechanism that improves the energy-starved status of the failing heart. However, whether this can be implemented therapeutically remains unknown. Therefore, our aim was to determine if increasing ketone delivery to the heart via a ketogenic diet can improve the outcomes of heart failure. METHODS AND RESULTS: C57BL/6J male mice underwent either a sham surgery or permanent left anterior descending coronary artery ligation surgery to induce heart failure. After 2 weeks, mice were then treated with either a control diet or a ketogenic diet for 3 weeks. Transthoracic echocardiography was then carried out to assess in vivo cardiac function and structure. Finally, isolated working hearts from these mice were perfused with appropriately 3H or 14C labelled glucose (5â mM), palmitate (0.8â mM), and ß-hydroxybutyrate (ß-OHB) (0.6â mM) to assess mitochondrial oxidative metabolism and glycolysis. Mice with heart failure exhibited a 56% drop in ejection fraction, which was not improved with a ketogenic diet feeding. Interestingly, mice fed a ketogenic diet had marked decreases in cardiac glucose oxidation rates. Despite increasing blood ketone levels, cardiac ketone oxidation rates did not increase, probably due to a decreased expression of key ketone oxidation enzymes. Furthermore, in mice on the ketogenic diet, no increase in overall cardiac energy production was observed, and instead, there was a shift to an increased reliance on fatty acid oxidation as a source of cardiac energy production. This resulted in a decrease in cardiac efficiency in heart failure mice fed a ketogenic diet. CONCLUSION: We conclude that the ketogenic diet does not improve heart function in failing hearts, due to ketogenic diet-induced excessive fatty acid oxidation in the ischaemic heart and a decrease in insulin-stimulated glucose oxidation.
Subject(s)
Diet, Ketogenic , Disease Models, Animal , Energy Metabolism , Glucose , Glycolysis , Heart Failure , Mice, Inbred C57BL , Mitochondria, Heart , Myocardial Ischemia , Myocardium , Oxidation-Reduction , Ventricular Function, Left , Animals , Heart Failure/diet therapy , Heart Failure/metabolism , Heart Failure/physiopathology , Male , Mitochondria, Heart/metabolism , Glucose/metabolism , Myocardial Ischemia/diet therapy , Myocardial Ischemia/metabolism , Myocardial Ischemia/physiopathology , Myocardium/metabolism , Stroke Volume , Isolated Heart Preparation , 3-Hydroxybutyric Acid/blood , 3-Hydroxybutyric Acid/metabolismABSTRACT
This study investigated the physiological characteristics and carcass performance associated with residual methane emissions (RME), and the effects of bull differences on CH4-related traits in Japanese Black cattle. Enteric methane (CH4) emissions from 156 Japanese Black cattle (111 heifers and 45 steers) were measured during early fattening using the sniffer method. Various physiological parameters were investigated to clarify the physiological traits between the high, middle, and low RME groups. CH4-related traits were examined to determine whether bull differences affected progeny CH4 emissions. Ruminal butyrate and NH3 concentrations were significantly higher in the high-RME group than in the low-RME group, whereas the propionate content was significantly higher in the low-RME group. Blood urea nitrogen, ß-hydroxybutyric acid, and insulin concentrations were significantly higher, and blood amino acids were lower in the high-RME group than in the other groups. No significant differences were observed in the carcass traits and beef fat composition between RME groups. CH4-related traits were significantly different among bull herds. Our results show that CH4-related traits are heritable, wherein bull differences affect progeny CH4 production capability, and that the above-mentioned rumen fermentations and blood metabolites could be used to evaluate enteric methanogenesis in Japanese Black cattle.
Subject(s)
Butyrates , Methane , Rumen , Animals , Methane/metabolism , Cattle/metabolism , Cattle/physiology , Male , Rumen/metabolism , Female , Butyrates/metabolism , Ammonia/metabolism , Ammonia/blood , Ammonia/analysis , Fermentation , 3-Hydroxybutyric Acid/blood , Propionates/metabolism , Blood Urea Nitrogen , Insulin/blood , Insulin/metabolismABSTRACT
BACKGROUND: In observational and experimental studies, diabetes has been reported as a protective factor for aortic dissection. 3-Hydroxybutyrate, a key constituent of ketone bodies, has been found to favor improvements in cardiovascular disease. However, whether the protective effect of diabetes on aortic dissection is mediated by 3-hydroxybutyrate is unclear. We aimed to investigate the causal effects of diabetes on the risk of aortic dissection and the mediating role of 3-hydroxybutyrate in them through two-step Mendelian randomization. MATERIALS AND METHODS: We performed a two-step Mendelian randomization to investigate the causal connections between diabetes, 3-hydroxybutyrate, and aortic dissection and calculate the mediating effect of 3-hydroxybutyrate. Publicly accessible data for Type 1 diabetes, Type 2 diabetes, dissection of aorta and 3-hydroxybutyrate were obtained from genome-wide association studies. The association between Type 1 diabetes and dissection of aorta, the association between Type 2 diabetes and dissection of aorta, and mediation effect of 3-hydroxybutyrate were carried out separately. RESULTS: The IVW method showed that Type 1 diabetes was negatively associated with the risk of aortic dissection (OR 0.912, 95% CI 0.836-0.995), The weighted median, simple mode and weighted mode method showed consistent results. The mediated proportion of 3-hydroxybutyrate on the relationship between Type 1 diabetes and dissection of aorta was 24.80% (95% CI 5.12-44.47%). The IVW method showed that Type 2 diabetes was negatively associated with the risk of aortic dissection (OR 0.763, 95% CI 0.607-0.960), The weighted median, simple mode and weighted mode method showed consistent results. 3-Hydroxybutyrate does not have causal mediation effect on the relationship between Type 2 diabetes and dissection of aorta. CONCLUSION: Mendelian randomization study revealed diabetes as a protective factor for dissection of aorta. The protective effect of type 1 diabetes on aortic dissection was partially mediated by 3-hydroxybutyrate, but type 2 diabetes was not 3-hydroxybutyrate mediated.
Subject(s)
3-Hydroxybutyric Acid , Aortic Aneurysm , Aortic Dissection , Diabetes Mellitus, Type 1 , Diabetes Mellitus, Type 2 , Genetic Predisposition to Disease , Genome-Wide Association Study , Mendelian Randomization Analysis , Humans , Aortic Dissection/genetics , Aortic Dissection/epidemiology , Aortic Dissection/etiology , 3-Hydroxybutyric Acid/blood , Diabetes Mellitus, Type 2/genetics , Diabetes Mellitus, Type 2/diagnosis , Diabetes Mellitus, Type 2/epidemiology , Risk Factors , Aortic Aneurysm/genetics , Aortic Aneurysm/epidemiology , Aortic Aneurysm/etiology , Diabetes Mellitus, Type 1/genetics , Diabetes Mellitus, Type 1/diagnosis , Diabetes Mellitus, Type 1/epidemiology , Risk Assessment , Protective Factors , Phenotype , Biomarkers/blood , Mediation AnalysisABSTRACT
A dysregulated inflammatory response contributes to the occurrence of disorders in cows during the transition period from pregnancy to lactation. However, a detailed characterization of clinically healthy cows that exhibit an enhanced inflammatory response during this critical period remains incomplete. In this experiment, a total of 99 individual transition dairy cows and 109 observations (18 cows monitored in 2 consecutive lactations), submitted to similar transition management were involved to evaluate the relationship between elevated an inflammatory response and metabolic and oxidative status, as well as transition outcomes. Blood was taken at -7, 3, 6, 9, and 21 DIM, and concentrations of metabolic parameters (glucose, ß-hydroxybutyric acid, nonesterified fatty acids [NEFA], insulin, IGF-1, and fructosamine) were analyzed. Additionally, oxidative parameters (proportion of oxidized glutathione to total glutathione in red blood cells, the activity of glutathione peroxidase [GPx] and superoxide dismutase, concentrations of malondialdehyde, and oxygen radical absorbance capacity) and acute phase proteins (APP) including haptoglobin (Hp), serum amyloid A (SAA) and albumin-to-globulin ratio (A:G) were determined in the blood at 21 DIM. The 3 APP parameters were used to group clinically healthy cows into 2 categories through k-medoids clustering (i.e., a group showing an acute phase response, APR; n = 39) and a group not showing such a response (i.e., non-APR; n = 50). Diseased cases (n = 20) were handled in a separate group. Lower SAA and Hp concentrations as well as higher A:G were observed in the non-APR group, although for Hp, differences were observed from the APR group and not from the diseased group. Only 1 of the 5 oxidative parameters differed between the groups, with the non-APR group exhibiting lower GPx activity compared with the diseased group. The non-APR group showed the highest IGF-1 levels among the 3 groups and and lower NEFA concentrations compared with the diseased groups. Cows in the diseased group also showed reduced dry matter intake and milk yield compared with clinically healthy cows, regardless of their inflammatory status. Moreover, the APR group exhibited temporarily lower activity levels compared with the non-APR group. These findings highlight that cows with a lower inflammatory status after 21 DIM exhibited better metabolic health characteristics and productive performance, as well as activity levels. Nevertheless, the detrimental effects of a higher inflammatory status in the absence of clinical symptoms are still relatively limited.
Subject(s)
Inflammation , Lactation , Animals , Female , Cattle , Inflammation/veterinary , Inflammation/blood , Fatty Acids, Nonesterified/blood , Reproduction , Pregnancy , Oxidative Stress , 3-Hydroxybutyric Acid/bloodABSTRACT
Studies suggest that ketogenic diets (KD) may improve memory in mouse models of aging and Alzheimer's disease (AD). This study determined whether a continuous or intermittent KD (IKD) enhanced cognitive behavior in the TgF344-AD rat model of AD. At 6 months-old, TgF344-AD and wild-type (WT) littermates were placed on a control (CD), KD, or IKD (morning CD and afternoon KD) provided as two meals per day for 2 or 6 months. Cognitive and motor behavior and circulating ß-hydroxybutyrate (BHB), AD biomarkers and blood lipids were assessed. Animals on a KD diet had elevated circulating BHB, with IKD levels intermediate to CD and KD. TgF344-AD rats displayed impaired spatial learning memory in the Barnes maze at 8 and 12 months of age and impaired motor coordination at 12 months of age. Neither KD nor IKD improved performance compared to CD. At 12 months of age, TgF344-AD animals had elevated blood lipids. IKD reduced lipids to WT levels with KD further reducing cholesterol below WT levels. This study shows that at 8 or 12 months of age, KD or IKD intervention did not improve measures of cognitive or motor behavior in TgF344-AD rats; however, both IKD and KD positively impacted circulating lipids.