Médecine interne: libre accès
Libre accès

Abstrait

Investigation of Elevated Ketone Bodies in Low Carbohydrate Diet (LCD)

Hiroshi Bando, Ebe K, Tetsuo Muneta, Masahiro Bando, Yoshikazu Yonei

Background: Discussion has been continued concerning Calorie Restriction (CR) and Low Carbohydrate Diet (LCD). For years, authors have investigated LCD associated with lipids, renal function and Ketone Bodies (KB) for clinical application of super LCD formular meal. In this study, 3-hydroxybutyric acid (3-OHBA) and acetoacetic acid (AcAc) was measured.

Subjects and Methods: The subjects were 105 patients with type 2 diabetes mellitus (T2DM), (M/F 47/58, 62.7 years. in average) they were admitted for treatment of T2DM. The protocol consists of 3 steps. 1. Calorie Restriction (CR) diet was given on day 1 and 2 with 60% of carbohydrates. 2. Low Carbohydrate Diet (LCD) was given after day 3 with 12% of carbohydrates which is super-LCD formula meal. 3. Total ketone bodies (T-KB), 3-OHBA and AcAc were measured, and investigated the value and ratio of these markers.

Results: Median T-KB was 349, 415, 486, 415, 445 μmol/L, in day 4-6, 7-9, 10-11, 12-15, 21-30, in 5 groups.

Discussion and Conclusion: Hyperketonemia is due to continuation of LCD, which is physiological ketosis without clinically hazardous acidosis. As value of 3-OHBA increased, the ratio of 3-OHBA/T-KB increased. These results may become the fundamental data for clarifying the pathophysiological role of 3-OHBA and AcAc in hyperketonemia from carbohydrate restriction. respectively. There was significant correlation between value of 3-OHBA and ratio of 3-OHBA/T-KB (p<0.01, r=0.72). When 3-OHBA value was less or more than 1000 μmol/L, 3-OHBA ratio showed 65-89% or 90-94%, respectively.