Therapeutic Lub luag hauj lwm ntawm Ketogenic noj zaub mov nyob rau hauv Neurological Disorders Part 4
May 24, 2024
Kev ua xua thiab siab ntau ntawm cov tshuaj P ua rau cov hlab ntsha dilation thiab mob taub hau, uas yog cov tsos mob ntawm tus mob migraine nres [189]. Hypoglycemia yog qhia kom ncua qhov tshwm sim ntawm cortical kis kev nyuaj siab [190].
Kev mob yog lub cev tiv thaiv tus kheej ntawm lub cev tom qab raug mob lossis kis kab mob, tab sis cov lus teb ntau dhau tuaj yeem ua rau kev noj qab haus huv, tshwj xeeb tshaj yog lub hlwb ua haujlwm, uas yuav ua rau muaj teeb meem xws li kev nco poob lossis amnesia.
Txawm li cas los xij, qee qhov kev tshawb fawb qhia tau hais tias kev ua cov kauj ruam los txo qhov mob tuaj yeem pab tau kev nco thiab lub hlwb ua haujlwm. Piv txwv li, hloov koj tus cwj pwm noj mov thiab noj ntau cov zaub mov uas nplua nuj nyob rau hauv antioxidants, magnesium, zinc, thiab lwm yam minerals yuav txo tau theem ntawm o thaum txhawb lub hlwb noj qab haus huv.
Tsis tas li ntawd, kev tawm dag zog aerobic nruab nrab kuj tuaj yeem txo qhov cuam tshuam ntawm qhov mob ntawm lub hlwb. Lub sij hawm ntev nyob rau hauv qhov xwm txheej, tshwj xeeb tshaj yog nyob rau hauv cov qus, tuaj yeem txo kev ntxhov siab thiab kev ntxhov siab, uas tuaj yeem pab txo qhov tsis zoo ntawm qhov mob.
Yog li thaum qhov mob muaj peev xwm cuam tshuam rau tib neeg kev noj qab haus huv, peb tuaj yeem txo cov teebmeem no los ntawm kev ua neej nyob thiab noj zaub mov, thaum txhim kho lub hlwb thiab kev noj qab haus huv thiab tswj kev nco zoo. Nws tuaj yeem pom tias peb yuav tsum txhim kho kev nco, thiab Cistanche deserticola tuaj yeem txhim kho kev nco zoo vim Cistanche deserticola yog cov khoom siv tshuaj hauv Suav teb uas muaj ntau yam teebmeem, ib qho ntawm kev txhim kho kev nco. Kev ua tau zoo ntawm Cistanche deserticola los ntawm ntau yam khoom xyaw uas nws muaj, suav nrog tannic acid, polysaccharides, flavonoid glycosides, thiab lwm yam. Cov khoom xyaw no tuaj yeem txhawb lub hlwb kev noj qab haus huv ntau yam.
Nyem Paub txhawm rau txhim kho lub cim xeeb luv luv
Kev noj zaub mov ketosis, los ntawm kev muab lwm lub zog, ua rau cov piam thaj thiab txo qis qis, uas tuaj yeem ua rau txo qis ntawm cortical kev nyuaj siab [191].
Tsis tas li ntawd, ntau cov kev tshawb fawb hauv vitro thiab tsiaj txhu tau pom tias kev hloov pauv ntawm txoj hauv kev ntawm metabolism ntawm cov amino acids uas tau xaiv los ntawm kev nce synthesis ntawm GABA-ib qho inhibitoryneurotransmitter [52], uas sib npaug excitatory thiab inhibitory neurotransmission, anti-inflammatory teebmeem [5,8,40,142. ], nrog rau kev txhim kho cov kab mob antioxidant [12,13], nthuav tawm los ntawm ketone lub cev tuaj yeem ua rau muaj txiaj ntsig ntawm kev noj zaub mov tsawg-carbohydrate hauv migraine.Rau txhua tus neeg mob, "qhov pib mob migraine" txawv.
Qhov kev sib npaug ntawm qhov kev txhawb nqa thiab inhibition ntawm thaj chaw ntawm CNS nyob ntawm ntau yam ntawm cov qib molecular, xws li ion channel ua haujlwm, qib magnesium, thiab excitatory amino acids. Kev xav txog kev xav thiab kev tshawb fawb, txawm li cas los xij, cia peb ntseeg tias KD tuaj yeem ua tau zoo hauv kev tiv thaiv thiab kho mob migraine [192].
4.3.2. Cov ntaub ntawv kho mob
Txog niaj hnub no, kev sim tshuaj kho mob los ntawm di Lorenzo li al. [193] (Table 2) tau qhia tias Kev Noj Qab Haus Huv Tsawg Carbohydrate Ketogenic (VLCKD) muaj txiaj ntsig zoo hauv kev txo cov mob migraine. Tom qab ntawd tus naj npawb ntawm cov mob migraine poob qis los ntawm -3.02 thaum siv VLCKD piv nrog cov khoom noj uas tsis yog-ketogenic tsawg heev. Txawm li cas los xij, exogenous kev tswj hwm ntawm ketone lub cev tsis tau txhim kho tus neeg mob tus mob [194].
4.4. Alzheimer's Disease
4.4.1. Etiopathogenesis thiab lub luag haujlwm muaj peev xwm ntawm Ketogenic noj zaub mov
Feem ntau hais lus, lo lus dementia piav txog qhov txo qis ntawm kev txawj ntse mus rau qib uas ua rau nws tsis tuaj yeem ua haujlwm txhua hnub. Cov feem ntau ntawm dementia, tshwj xeeb tshaj yog nyob rau hauv cov neeg laus, yog Alzheimer's kab mob (lub luag hauj lwm rau ze li ob feem peb ntawm dementia mob nyob rau hauv cov neeg muaj hnub nyoog 65 xyoos) [195]. Qhov kev pheej hmoo ntawm tus kab mob no nce nrog lub hnub nyoog ntawm tus neeg mob [196].
Cov kws tshaj lij kwv yees tias cov neeg mob Alzheimer's kab mob yuav maj mam nce ntxiv rau xyoo tom ntej [197]. Kev txiav txim siab qhov pib ntawm cov kev hloov pauv uas ua rau muaj tus kab mob no yog qhov nyuaj heev.
Qhov teeb meem no ua rau muaj kev puas tsuaj tag nrho ntawm kev txawj ntse. Nws pom zoo cuam tshuam rau kev nco, kev nkag siab txog cov teeb meem tsis yooj yim, kev paub lus zoo, thiab muaj peev xwm tsom mus rau kev mloog [195]. Cov tsos mob nyob rau hauv feem ntau pib nrog me me lub sij hawm luv luv nco, nrog rau kev nco tsis ntev los no [197].Nyob rau hauv kev nkag siab txog cov ntsiab lus ntawm tus kab mob no, nws yog ib qho tseem ceeb los txiav txim siab txog qhov muaj feem cuam tshuam.
Kev muaj hnub nyoog nce ntxiv, kev raug mob taub hau loj, mob hlab ntsha hauv lub hlwb, nicotinism, lossis kev nyuaj siab yuav cuam tshuam rau tus nqi ntawm kev loj hlob ntawm tus kab mob [195]. Tsis tas li ntawd, cov tshuaj geneticfactors zoo li ua lub luag haujlwm tseem ceeb hauv kev loj hlob ntawm tus kab mob.Cov txheej txheem pathological hauv qab Alzheimer's tus kab mob yog cov deposition ntawm txawv txav neuronal plaques thiab neurofibrillary tangles [198].
Plaques txhais tau tias asmicrochanges nyob rau hauv neurons uas koom nrog ib tug tseem ceeb ntawm A nyob ib puag ncig los ntawm pab pawg ntawm enlargedaxons. Beta-amyloid, nyob rau hauv physiological mob, muab los ntawm amyloid precursorprotein (APP). APP faib feem ntau los ntawm alpha thiab beta-secretase. Raws li qhov tshwm sim ntawm cov txheej txheem no, cov khoom me me ntawm qhov tsis muaj mob A tshwm sim. Nyob rau hauv cov ntaub ntawv ntawm pathological hloov, APP yog splitby gamma thiab beta-secretase.
Raws li qhov tshwm sim ntawm cov txheej txheem no, A (42 peptides) yog tsim.Nws tsub zuj zuj thiab tom qab sib sau ua ke ua rau saum toj no-hais txog kev hloov pauv pathological. Beta-amyloid feem ntau tso rau hauv cov hlab ntsha thiab cov teeb meem grey ntawm lub hlwb.
Hauv cov txheej txheem piav qhia, cov caj ces tseem ceeb ua lub luag haujlwm tseem ceeb, lub luag haujlwm rau cov txheej txheem hais txog APP kev puas tsuaj yog nyob ntawm chromosome 21, uas yog qhov tseem ceeb txuas hauv tsev neeg etiology ntawm Alzheimer's disease [195].
Cov amyloid beta conglomerate kuj tau siv nyob rau hauv cov hlab ntsha ntawm lub paj hlwb ua rau ntau dua los yog tsis tshua muaj angiopathies uas yog lub luag hauj lwm rau qhov dav micro los ntshav tag nrho cov cheeb tsam ntawm lub hlwb. Tam sim no, nws ntseeg tau tias qhov tso tawm ntawm amyloid plaques pib 20 xyoo ua ntej kev txhim kho ntawm kev kho mob tshwm sim [199].
Qhov thib ob tseem ceeb mechanism nyob rau hauv lub etiology ntawm Alzheimer's kab mob yog ib tug aggregation ntawm neurofibrillary tangles muaj li ntawm tau protein. Vim yog kev sib sau ntau dhau ntawm A, hyperphosphorylation ntawm cov qauv no tshwm sim, uas ua rau nws cov aggregation mus rau hauv loj, cov kab mob pathological. Nws tau raug pov thawj tias cov qauv no nyob rau hauv thawj theem ntawm tus kab mob muaj nyob rau hauv lub hippocampus.
Raws li tus kab mob loj hlob tuaj, nws tuaj yeem pom nyob rau hauv cov neurons ntawm tag nrho lub paj hlwb cortex [195]. Cov txheej txheem saum toj no ua rau muaj kev txo qis ntawm cov neurons hauv cerebral cortex thiab cov cheeb tsam subcortical tshwj xeeb. Cov kev tshawb fawb tsiaj tau pom tias KD txo qhov ntim ntawm A thiab tau cov protein sib sau ua ke, thiab txo lawv cov toxicity [20,26,78].
Txawm li cas los xij, qhov kev cuam tshuam no txwv rau kev tiv thaiv kev tsim cov plaque tshiab. Yog li, nws tuaj yeem kwv yees tias KDmay sawv cev rau kev kho kom zoo nkauj ntxiv, ua rau qeeb qeeb ntawm cov kab mob thiab kev cuam tshuam ntawm kev paub txog kev ua haujlwm.
Tsis tas li ntawd, cov txheej txheem inflammatory pib los ntawm pawg A thiab tau protein tuaj yeem cuam tshuam qhov kev nthuav dav ntawm tus kabmob mus rau thaj chaw tshiab ntawm lub hlwb. Pro-inflammatorycytokines kuj tseem ua lub luag haujlwm tseem ceeb hauv kev puas tsuaj ntawm cov ntaub so ntswg hauv hlwb [138–141].Oxidative kev nyuaj siab thiab ib puag ncig tej yam yuav ua rau kev loj hlob ntawm tus kab mob los ntawm kev cuam tshuam ntawm hypothalamic-pituitary-adrenal (HPA) axis thiab tsis txaus tshem tawm ntawm neurotoxic. 4-hydroxynonenal [200].
Tsis tas li ntawd, ApoEε4 allele lub luag haujlwm rau qhov pib lig Alzheimer's kab mob ua rau kom nrawm ntawm cellular aging, nrog rau cov kab mob neuroinflammation thiab oxidative stress [201]. Cov kev tshawb fawb tau ua ntawm cov kab ntawm tes thiab tsiaj txhu muab pov thawj tias cov kab mob pathological uas tau hais los saum toj no tuaj yeem txo qis los ntawm kev siv KD, los ntawm kev txwv qhov mob thiab oxidative kev nyuaj siab [6–10,40,83].
4.4.2. Khoom noj khoom haus kho mob
Tsis muaj peev xwm kho AD hnub no. Txoj hauv kev tam sim no rau tus kab mob no yog los ntawm kev ncua cov tsos mob hnyav kom ntev li ntev tau [202]. Kev txo qis ntawm tus kab mob no tuaj yeem ua tiav ob txoj hauv kev: cov tshuaj pharmacological thiab tsis yog tshuaj.
Lub tom kawg yog tsom rau kev paub kev paub, kev ua si lub cev, thiab kev noj zaub mov tshwj xeeb.Ib qho kev noj haus zoo li no yog Mediterranean Diet. Extra-virgin txiv roj roj (EVOO) muaj nyob rau hauv cov zaub mov no zoo li tseem ceeb heev. Raws li Klimova thiab lwm tus [202], oleuropein, cov coiridoid muaj nyob hauv EVOO, tuaj yeem ua rau muaj kev tiv thaiv neuroprotective, uas qhia tau hais tias nws muaj peev xwm siv los tiv thaiv cov kab mob neurodegenerative, tshwj xeeb AD [202,203].
Kev ua EVOO tau kawm siv cov tsiaj nas ua qauv. Raws li cov txiaj ntsig tau, nws tau txiav txim siab tias cov khoom xyaw nquag ntawm EVOO txhim kho kev paub txog kev ua haujlwm ntawm cov hlwb hauv hlwb los ntawm kev txhim kho hippocampus synaptic kev ua si thiab txo qis kev sib sau ntawm A aggregate. EVOO kuj tseem tuaj yeem txo cov cytotoxic thiab neuroinflammatory kev tshwm sim ntawm kev sib sau ntawm A aggregates [202,203].
Lub sijhawm ntev ntawm EVOO, tsis suav nrog kev cuam tshuam rau cov metabolism ntawm A aggregates, cuam tshuam qhov txo qis ntawm phosphorylation ntawm tau protein [203]. Kev noj zaub mov nplua nuj hauv EVOO tau piav qhia tias yog ib qho uas tsis muaj kev cuam tshuam xws li kev tuag ntawm tes lossis neurodegeneration [202].
Lwm cov khoom noj ntawm Mediterranean yog walnuts (Juglans regia L.) uas, los ntawm cov ntsiab lus siab ntawm antioxidants xws li n-3 -linolenic acid, juglone, los yog tocopherol (vitamin E), yog ib qho tseem ceeb rau kev tiv thaiv. Cov nyhuv neuroinflammatory ntawm kev noj haus.Ua kom muaj txiaj ntsig ntawm kev noj zaub mov ntawm cov nas kuaj nrog cov walnuts ua rau kev nco thiab kev kawm muaj peev xwm [204].
4.4.3. Cov ntaub ntawv kho mob
Ntau cov kev tshawb fawb kuj qhia tau hais tias kev tiv thaiv insulin tuaj yeem ua rau muaj txiaj ntsig zoo rau kev txhim kho cov kab mob neurodegenerative [69]. Concomitant hyperglycemia ua rau kev hloov pauv hauv lub hlwb, ua rau kev nco tsis zoo.
Weinstein et al. [205] tsis tau sau tseg txog qhov txo qis ntawm cov teeb meem grey hauv cov tub ntxhais hluas nrog hyperglycemia, thaum Kerti li al. [206] tau pom qhov txo qis hauv hippocampal ntim. Ntau qhov kev tshawb fawb tau sau tseg txog kev sib koom ua ke ntawm kev cuam tshuam cov tshuaj insulin nrog cov protein A [70,71] thiab yog li Alzheimer's disease [72-74]. Cov kev tshawb fawb tau ua rau Alzheimer's cov neeg mob qhia tias KD normalizes carbohydrate metabolism hauv lub hlwb, txo cov qib insulin, thiab nce insulin rhiab heev [75-77].
Cov neeg mob tau pom cov qhab nia siab dua hauv kev ntsuam xyuas kev txawj ntse, uas qhia tau tias muaj peev xwm ua tau zoo hauv cov kab mob neurodegenerative [75,76]. Cov kev tshawb fawb soj ntsuam tau ua kom deb li deb (Table 3) qhia tias kev noj haus ketogenic txhim kho kev paub txog kev ua haujlwm ntawm Alzheimer's cov neeg mob.
Qhov tseem ceeb ntawm cov xwm txheej tseem ceeb tseem nyob hauv kev soj ntsuam ntawm cov kws tshawb fawb, tab sis kev tiv thaiv thiab ua lub neej noj qab haus huv yog qhov tseem ceeb hauv kev kho thiab txo qis kev pheej hmoo ntawm neurodegeneration. Qhov no yog ib qho tseem ceeb heev vim hais tias tam sim no lub tswv yim pharmacotherapy yog raws li alleviating cov tsos mob ntawm tus kab mob, tab sis nws tsis pab mus rau kev sib ntaus tawm tsam nws ua rau.
4.5. Tus kab mob Parkinson
4.5.1. Etiopathogenesis thiab lub luag haujlwm muaj peev xwm ntawm Ketogenic noj zaub mov
Parkinson tus kab mob yog ib qho ntawm cov kab mob neurodegenerative tseem ceeb tshaj plaws ntawm Alzheimer's disease. Nws tshwm sim feem ntau hauv cov zej zog zoo tsim. Cov xwm txheej txaus ntshai rau PD suav nrog ib puag ncig cov co toxins, tshuaj, genomic tsis xws luag, thiab kev puas tsuaj ntawm lub paj hlwb [211,212].
Qhov kev pheej hmoo ntawm kev tsim PD nce nrog lub hnub nyoog ntawm tus neeg mob. Qhov kev pheej hmoo ntawm kev tsim PD hauv cov neeg muaj hnub nyoog ntawm 85 txog 89 yog 3.5%. Hauv kev sib piv, cov neeg muaj hnub nyoog qis dua 60 xyoo muaj qhov tshwm sim ntawm kev loj hlob ntawm PD ntawm qib 1% [212,213].
Kev kuaj mob ntawm PD tshwm sim tom qab thawj cov tsos mob ntawm psychomotor tshwm sim, uas suav nrog cov leeg nruj, so tremors, thiab lub cev muaj zog retardation [214]. Bradykinesia yog suav tias yog thawj qhov kev kuaj mob rau tus kab mob [215].
Ntxiv nrog rau cov tsos mob ntawm lub cev muaj zog, PD yog nrog cem quav, salivation, dysgraphia, thiab tseem ceeb heev kev paub thiab kev coj cwj pwm tsis zoo, kev nyuaj siab, kev puas siab puas ntsws, pw tsaug zog tsis zoo, dementia, thiab hnov qab [216]. Lub sij hawm pib ntawm tus kab mob yog tus cwj pwm los ntawm posturaldefect thiab nyuaj rau kev taug kev.
Kev khov ntawm kev taug kev, txhais tau hais tias luv luv, tsis muaj qhov tsis muaj kev txwv ntawm ko taw kev loj hlob txawm tias lub siab xav mus taug kev yog pom ntau zaus [217,218] .Qhov tseem ceeb ntawm lub luag haujlwm rau kev txhim kho cov tsos mob ntawm tus kab mob yog thedegeneration ntawm neurons hauv cov teeb meem dub, koom nrog hauv dopamine kis ntawm lub nucleus basalis thiab striatum [219].
Kev puas tsuaj rau cov neurons no ua rau kev thauj mus los tsis zoo uas ua rau muaj kev cuam tshuam ntawm cov neuronal circuits cuam tshuam nrog thaj chaw ntawm lub pob txha caj qaum thiab lub cev muaj zog, uas thaum kawg tshwm sim raws li kev txav tsis zoo [220].Cov tsos mob ntawm PD tsuas yog tshwm sim thaum cov dopamine tam sim no nyob rau hauv lub basal nuclei thiab blackmatter poob. mus rau 20% ntawm nws cov nqi siab tshaj [221].
Tsis tas li ntawd, ib qho ntawm cov neuropathologies nrhiav tau hauv PD uas tuaj yeem ua rau kev tuag ntawm dopaminergic neurons yog Lewy lub cev thiab Lewy neurites, muaj li ntawm misfolded -synuclein [222].Tam sim no, cov tshuaj tseem ceeb rau kev kho mob ntawm PD yog levodopa (L-DOPA) , uas muaj kev cuam tshuam rau PD cov tsos mob tab sis tsis muaj cov nyhuv neuroprotective.
Nws kuj tseem pom tias L-DOPA tuaj yeem ua rau muaj kev sib sau ua ke ntawm -synuclein, los ntawm cov metabolite 5-S-cysteineldopamine, uas ua rau oxidative kev nyuaj siab hauv vivo, yog li txhawb nqa dopamine depletion [223]. Cov kev tshawb fawb qhia tias KD txhim kho bioavailability. ntawm L-DOPA, uas cuam tshuam nrog kev txo qis hauv kev noj zaub mov muaj protein ntau.
Kev sib xyaw ua ke ntawm cov tsos mob tswj cov tshuaj kho mob thiab KD tuaj yeem ua tau zoo hauv kev tiv thaiv kab mob ntxiv [78,121,224].Kashiwaya li al. [225] tau ua ib txoj kev tshawb fawb los qhia txog cov teebmeem neuroprotective ntawm -HB. Heroin analog, 1-methyl-4-phenylpyridinium, MPP(+), tau siv los ua kom cov blackmatter dopaminergic cell tuag los ntawm inhibiting lub multi-enzyme mitochondrial NADH dehydrogenase complex, ua rau Parkinson tus kab mob zoo li mob hauv kab lis kev cai ntawm midbrainneurons.
Ib txoj kev tshawb fawb tau lees paub qhov kev tshawb pom yav dhau los uas -HB muaj cov teebmeem neuroprotective ondopaminergic neurons [225–227]. Qhov no cuam tshuam rau kev ua pa ntawm mitochondrial thiab nce ATP ntau lawm.
KBs kuj ua rau kom muaj txiaj ntsig ntawm mitochondrial respiratorychain los ntawm kev txo cov pa oxygen dawb radicals [35] .Ib qho kev kho mob tam sim no rau PD yog tsom rau KATP channels, kev qhib qhov uas tau pom tias muaj cov teebmeem neuroprotective thiab txo cov neuronalexcitability. Txawm li cas los xij, nws tau xav tias kev ua kom KATP channel nyob rau ntawm GABAergicneurons yuav yog ib qho ntawm cov ua rau PD txoj kev loj hlob los ntawm inhibition ntawm GABABreceptors, uas nyob rau hauv lem stimulates glutamatergic terminals rau secrete -synuclein [228].
Cov teebmeem ntawm agonists lossis antagonists tau sim hauv cov qauv tsiaj yog qhov tsis txaus ntseeg, qhia tias lawv qhov cuam tshuam rau cov channel no nyuaj rau kwv yees vim qhov muaj ntau ntawm KATPchannels hauv lub hlwb [228,229]. Txawm li cas los xij, nyob rau hauv kev sib piv rau ib tus neeg cov tshuaj cuam tshuam rau KATP channel, cov khoom noj ketogenic ua rau tib lub sijhawm ntawm ntau cov txheej txheem pathological, muab cov txiaj ntsig kho tau zoo dua.
y kev kho mob zoo dua.
4.5.2 ib. Cov ntaub ntawv kho mob
Nyob rau hauv xyoo tas los no, PD tau nce ntxiv nrog kev hloov pauv hauv gutmicrobiota [113,121,230,231]. Alfonsetti et al. [113] tshuaj xyuas microbiome muaj pes tsawg leeg thiab cov teebmeem ntawm kev noj zaub mov, probiotic, prebiotic, thiab kev tswj hwm synbiotic ntawm cov txheej txheem pathological tshwm sim hauv chav kawm PD.
Cov kev tshawb fawb qhia tias cov microbiota ntawm PD cov neeg mob txawv qhov txawv ntawm cov neeg noj qab haus huv thiab yog tus cwj pwm los ntawm tsawg tus lej ntawm Prevotellaceae thiab nce tus naj npawb ntawm Enterobacteriaceae [232].
Kev hloov pauv hauv qhov zoo ntawm microbiota ua rau lub plab hnyuv permeability tsis zoo (piv txwv li, "cov plab hnyuv"), uas, dhau los ntawm LPS tsim los ntawm cov kab mob, induces inflammatory dab thiab oxidative kev nyuaj siab, yog li txhawb -synuclein aggregation [233]. Kev noj zaub mov ketogenic paub tias thim rov qab qhov sib piv thiab yog li nce Prevotella thiab txo qis Enterobacteriaceae [131].
Kev hloov pauv hauv kev noj zaub mov zoo (suav nrog ntau dua omega-3 polyunsaturated fatty acids, probiotics, prebiotics, thiab synbiotics rau hauv kev noj haus) tau pom tias muaj txiaj ntsig zoo ntawm cov kab mob, los ntawm plab-sealing, anti-inflammatory, oxidative. Kev ntxhov siab-relieving, thiab BDNFupregulation teebmeem [113].A randomized tswj kev sim ua nyob rau hauv 2018 los ntawm Phillips li al. [234] rau 8 lub lis piam ntawm 47 cov neeg mob tau pom tias ob qho tib si cov rog rog thiab cov rog tsawg tau muaj txiaj ntsig zoo rau cov tsos mob ntawm lub cev muaj zog thiab tsis yog lub cev muaj zog.
Txawm li cas los xij, kev noj zaub mov ketogenic tau nthuav tawm ntau dua kev txhim kho hauv qhov tsis yog lub cev muaj zog ntawm kev muaj peev xwm ua haujlwm txhua hnub, piv txwv li, tso zis cuam tshuam, mob, nkees, lossis kev paub tsis meej piv rau cov khoom noj muaj roj tsawg.
5. Cov teebmeem tsis zoo ntawm kev noj haus Ketogenic
Cov kev tshawb fawb soj ntsuam pom tau hais tias kev tswj hwm kev noj zaub mov ketogenic tuaj yeem nyuaj rau cov neeg mob. Kev ua siab ntev thiab tsis muaj kev txhawb siab yuav ua rau muaj kev cuam tshuam ntawm kev noj haus [158]. Kev hloov kho kev noj haus Ketogenic xws li MAD tau zoo dua nyob rau hauv cov menyuam yaus uas muaj mob vwm [170], thaum txo kev ntxhov siab thiab kev paub txog kev ua haujlwm tau pom nyob hauv pab pawg siv feem ntau MCTD (20/28 cov menyuam yaus) [159], qhia tias kev hloov pauv ntawm cov khoom noj ketogenic tuaj yeem cuam tshuam. nrog kev ua raws ntau dua.
Txij li thaum cov pab pawg siv cov khoom noj ketogenic feem ntau yog cov menyuam yaus uas muaj mob vwm, nws qhov sib npaug yog qhov tseem ceeb hauv kev txiav txim siab tus menyuam txoj kev loj hlob. Kev noj zaub mov yuav tsum muaj qhov sib npaug los tiv thaiv qhov tsis txaus los ntawm kev tso tseg tag nrho cov khoom lag luam nplua nuj hauv carbohydrates thiab lwm yam khoom noj xws li thiamin, folate, vitamin A, vitamin E, vitamin B6, calcium, magnesium, hlau, lossis vitamin K [235] .
Cov neeg mob yuav raug kev txom nyem los ntawm qhov tsis txaus ntawm cov khoom noj fiber ntau, uas yog qhov tseem ceeb rau kev ua haujlwm ntawm cov hnyuv, vim yog kev cais tawm ntawm qee pawg ntawm cov khoom. Ib qho tsis muaj fiber ntau ua rau muaj kev cuam tshuam ntawm kev nqus ntawm cov as-ham, cuam tshuam rau kev tsim cov tshuaj hormones lub luag haujlwm rau satiety, thiab txo qis hauv kev tiv thaiv kab mob [236].Lub sijhawm nyuaj tshaj plaws rau cov neeg mob yog kev qhia txog KD.
Thaum lub sijhawm no, lawv cov kev mob tshwm sim feem ntau ntawm kev noj zaub mov yog hypoglycemia, lub cev qhuav dej, thiab mob plab zom mov [237,238] .Hauv txoj kev tshawb fawb los ntawm Lin li al. [237], 57 ntawm 126 tus menyuam yaus tau ntuav ntuav.Hypoglycemia qis dua 40 mg/dL tshwm sim hauv 44 tus neeg mob. Tsis tas li ntawd, cem quav, chim siab, lossis kev hloov mus rau qhov tsis zoo kuj tau pom. Rau tus neeg mob tau tsim cov ketones ntau dhau nrog cov zis ketone theem ntawm 160 mg / dL, uas tshwm sim hauv lub ntsej muag yaug.
Ntau yam tsis zoo tshwm sim hauv plab tuaj yeem tshwm sim thaum siv KD. Ib qho ntawm cov ntsiab lus tseem ceeb yog cem quav, uas yuav tshwm sim los ntawm qhov tsis txaus ntawm cov khoom noj muaj fiber ntau hauv kev noj haus.Kev cem quav tuaj yeem tswj tau los ntawm kev nce cov fiber ntau hauv kev noj zaub mov, kev ua yeeb yam, lossis kev tswj hwm polyethylene glycol [238].Ib qho kev sib cav ntau dua nyob ib ncig ntawm kev siv cov khoom noj muaj roj ntau yog nws cov txiaj ntsig ntawm lipid profile. Kev noj cov zaub mov uas muaj roj ntau ntxiv yog qhov ua rau muaj cov roj ntsha lipid ntau ntxiv.
Hauv kev kawm ua los ntawm Cai et al. [239], nws tau pom tias cov menyuam yaus raug kev txom nyem los ntawm hyperlipidemia thaum noj KD, tab sis tib lub sijhawm, cov kev mob tshwm sim no tsis tshua muaj ntau dua li cov lus hais saum toj no. Qhov nruab nrab cholesterol theem ntawm cov neeg mob tau kawm tau me ntsis siab dua ua ntej pib noj zaub mov.Muaj cov lus teb sai rau cov kev hloov pauv tsis zoo txog qhov nce hauv serumlipid feem. Cov kws tshawb fawb Guzel et al. [166] npaj kom txo cov rog noj kom tsawg los ntawm 20-25% txhawm rau txhim kho lipid profile.
Cov txheej txheem yog txhawm rau tshem tawm cov khoom uas muaj cov rog tsis txaus thiab cov qe qe, ntxiv rau, atorvastatin 10 mg ib hnub yog tswj hwm los tiv thaiv cov roj cholesterol biosynthesis.
Kev tshawb fawb los ntawm Freeman et al. [18] kuj qhia txog qhov tsis zoo ntawm cov khoom noj ketogenic ntawm ob lub raum thiab cov zis. Hauv ib pawg ntawm 150 tus menyuam yaus, 3 ntawm lawv muaj pob zeb urate thiab 3 ntawm lawv muaj calcium oxalate lossis phosphate pob zeb. Yog li ntawd nws tau pom zoo kom siv potassiumcitrate los ua kev tiv thaiv thoob plaws hauv kev noj haus [18,240].
6. Cov lus xaus
Kev hloov pauv ntawm kev noj zaub mov tuaj yeem muaj txiaj ntsig zoo rau lub cev ntawm peb lub cev, tab sis kuj tseem nyob ntawm txoj kev loj hlob thiab ntau yam kab mob. Qhov kev tshuaj xyuas no muab pov thawj tias kev noj zaub mov ketogenic tuaj yeem muab cov txiaj ntsig kho mob rau cov neeg mob uas muaj teeb meem hauv lub paj hlwb uas cuam tshuam nrog kev ntxhov siab oxidative thiab neuro-mob lossis cuam tshuam hauv hlwb metabolism.
Kev tshuaj xyuas ntawm cov ntaub ntawv tshawb fawb qhia tau hais tias KD tuaj yeem cuam tshuam tsis yog kev loj hlob ntawm cov kab mob hauv lub paj hlwb, tab sis kuj yog cov chav kawm thiab cov txiaj ntsig ntawm lawv txoj kev kho mob. Kev ua tau zoo ntawm KD tau raug pov thawj hauv kev qaug dab peg thiab lwm yam kab mob neurological, xws li kev nyuaj siab, migraine, lossis kab mob neurodegenerative xws li AD thiab PD. KD yuav tsum tau suav tias yog ib qho kev xaiv kho mob rau lwm yam kab mob neurological.
Sau Kev Koom Tes: Kev Ntseeg, IP-C.; txheej txheem, IP-C.; sau ntawv-kev npaj ua ntej, DP, KK, thiab PR; tshuaj xyuas thiab kho, IP-C. Txhua tus kws sau ntawv tau nyeem thiab pom zoo rau kev luam tawm ntawm cov ntawv sau.
Cov Nyiaj Txiag: Cov kev tshawb fawb no tsis tau txais nyiaj txiag sab nraud.
Institutional Review Board Statement: Tsis siv tau.
Cov Lus Qhia Txog Kev Pom Zoo: Tsis siv tau.
Cov Lus Qhia Muaj Cov Ntaub Ntawv: Tsis siv tau.
Kev tsis sib haum xeeb ntawm kev txaus siab: Cov neeg sau ntawv tshaj tawm tsis muaj teeb meem ntawm kev txaus siab.
Cov ntaub ntawv
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7. Shimazu, T.; Hirschey, M. Newman, J.; He, W.; Shirakawa, K.; Le Moan, N.; Grueter, CA; Lim, H.; Saunders, LR; Stevens, RD; ua al. Suppression of Oxidative Stress by -Hydroxybutyrate, an Endogenous Histone Deacetylase Inhibitor.Science 2013, 339, 211–214. [CrossRef]
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