碳水化合物限制引起的低密度脂蛋白胆固醇升高对冠状动脉粥样硬化进展的影响:生酮饮食试验研究设计。

IF 1.5 4区 医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS Coronary artery disease Pub Date : 2024-11-01 Epub Date: 2024-06-13 DOI:10.1097/MCA.0000000000001395
Denise Alison R Javier, Venkat S Manubolu, Nicholas G Norwitz, April Kinninger, Jairo Aldana-Bitar, Ahmed Ghanem, Khadije Ahmad, Will D Vicuna, Hossein Hamidi, Marziyeh Bagheri, Tasneem Elsayed, Bea Villanueva, Keishi Ichikawa, Ferdinand Flores, Sajad Hamal, David Feldman, Matthew J Budoff
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引用次数: 0

摘要

背景:尽管在降低动脉粥样硬化性心血管疾病(ASCVD)的危险因素--脂蛋白胆固醇和载脂蛋白 B 的药物治疗方面进行了创新,但 ASCVD 仍是导致全球死亡的主要原因。低密度脂蛋白胆固醇(LDL-C)升高是众所周知的风险因素,也是治疗 ASCVD 的主要目标。最新研究表明,生酮饮食能有效改善大多数非 LDL-C/ 脂蛋白 B 心血管代谢风险因素。然而,生酮饮食会导致某些人的低密度脂蛋白胆固醇(LDL-C)大幅升高至 190 毫克/分升以上。有趣的是,这些人在其他方面通常都很健康。人们对限制碳水化合物的生酮饮食导致的低密度脂蛋白胆固醇水平升高对代谢健康的人动脉粥样硬化进展的影响知之甚少。本观察性研究旨在评估和描述该人群在 12 个月内冠状动脉粥样硬化的进展情况。方法:研究人员招募了 100 名相对瘦弱的人,他们采用生酮饮食,随后出现高胆固醇血症,低密度脂蛋白胆固醇(LDL-C)>190 毫克/分升,但代谢健康指标良好,研究人员对他们进行了为期 12 个月的观察。参与者接受连续冠状动脉计算机断层扫描,以评估一年内冠状动脉粥样硬化的进展情况:数据分析将在试验结束后开始,结果将随后公布:生酮饮食在医学界引起了争论和担忧,尤其是在低密度脂蛋白胆固醇(LDL-C)显著升高的人群中,有趣的是,这些人都是瘦弱而健康的。研究这部分人群 LDL-C 升高与 ASCVD 进展之间的关系,将有助于更好地了解饮食诱发高胆固醇血症的影响。
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The impact of carbohydrate restriction-induced elevations in low-density lipoprotein cholesterol on progression of coronary atherosclerosis: the ketogenic diet trial study design.

Background: Despite innovations in pharmacotherapy to lower lipoprotein cholesterol and apolipoprotein B, risk factors for atherosclerotic cardiovascular disease (ASCVD), ASCVD persists as the leading global cause of mortality. Elevations in low-density lipoprotein cholesterol (LDL-C) are a well-known risk factor and have been a main target in the treatment of ASCVD. The latest research suggests that ketogenic diets are effective at improving most non-LDL-C/apolipoprotein B cardiometabolic risk factors. However, ketogenic diets can induce large increases in LDL-C to >190 mg/dl in some individuals. Interestingly, these individuals are often otherwise lean and healthy. The influence of increased levels of LDL-C resulting from a carbohydrate-restricted ketogenic diet on the progression of atherosclerosis in otherwise metabolically healthy individuals is poorly understood. This observational study aims to assess and describe the progression of coronary atherosclerosis in this population within 12 months.

Methods: Hundred relatively lean individuals who adopted ketogenic diets and subsequently exhibited hypercholesterolemia with LDL-C to >190 mg/dl, in association with otherwise good metabolic health markers, were enrolled and observed over a period of 12 months. Participants underwent serial coronary computed tomography angiography scans to assess the progression of coronary atherosclerosis in a year.

Results: Data analysis shall begin following the conclusion of the trial with results to follow.

Conclusion: Ketogenic diets have generated debate and raised concerns within the medical community, especially in the subset exhibiting immense elevations in LDL-C, who interestingly are lean and healthy. The relationship between elevated LDL-C and ASCVD progression in this population will provide better insight into the effects of diet-induced hypercholesterolemia.

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来源期刊
Coronary artery disease
Coronary artery disease 医学-外周血管病
CiteScore
2.50
自引率
0.00%
发文量
190
审稿时长
6-12 weeks
期刊介绍: Coronary Artery Disease welcomes reports of original research with a clinical emphasis, including observational studies, clinical trials, translational research, novel imaging, pharmacology and interventional approaches as well as advances in laboratory research that contribute to the understanding of coronary artery disease. Each issue of Coronary Artery Disease is divided into four areas of focus: Original Research articles, Review in Depth articles by leading experts in the field, Editorials and Images in Coronary Artery Disease. The Editorials will comment on selected original research published in each issue of Coronary Artery Disease, as well as highlight controversies in coronary artery disease understanding and management. Submitted artcles undergo a preliminary review by the editor. Some articles may be returned to authors without further consideration. Those being considered for publication will undergo further assessment and​ peer-review by the editors and those invited to do so from a reviewer pool.
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