Immunomodulatory effect of a very-low-calorie ketogenic diet compared with bariatric surgery and a low-calorie diet in patients with excessive body weight

被引:35
作者
Lorenzo, Paula M. [1 ,2 ]
Sajoux, Ignacio [1 ,3 ]
Izquierdo, Andrea G. [1 ,2 ]
Gomez-Arbelaez, Diego [4 ]
Zulet, M. Angeles [2 ,5 ,6 ]
Abete, Itziar [2 ,5 ,6 ]
Castro, Ana I. [2 ,13 ]
Baltar, Javier [7 ]
Portillo, Maria P. [2 ,8 ,9 ,10 ]
Tinahones, Francisco J. [2 ,11 ]
Martinez, J. Alfredo [2 ,5 ,6 ,12 ]
Casanueva, Felipe F. [2 ,13 ]
Crujeiras, Ana B. [1 ,2 ]
机构
[1] Complejo Hosp Univ Santiago CHUS, Inst Invest Sanitaria IDIS, Epigen Endocrinol & Nutr Grp, SERGAS, Santiago, Spain
[2] Inst Salud Carlos III, CIBER Fisiopatol Obesidad & Nutr CIBERobn, Madrid, Spain
[3] Med Dept Pronokal Grp, Barcelona, Spain
[4] Univ Santander UDES, Fac Hlth Sci, Bucaramanga, Colombia
[5] Univ Navarra UNAV, Ctr Nutr Res, Dept Nutr Food Sci & Physiol, Pamplona, Spain
[6] Navarra Inst Hlth Res, IdiSNA, Pamplona, Spain
[7] Complejo Hosp Univ Santiago CHUS, Div Gen Surg, SERGAS, Santiago, Spain
[8] Univ Basque Country UPV EHU, Dept Nutr & Food Sci, Nutr & Obes Grp, Vitoria, Spain
[9] Lucio Lascaray Res Inst, Vitoria, Spain
[10] Bioaraba Hlth Res Inst, Vitoria, Spain
[11] Univ Malaga, Inst Invest Biomed Malaga IBIMA, Complejo Hosp Malaga Virgen Victoria, Unidad Gest Clin Endocrinol & Nutr, Malaga, Spain
[12] Univ Autonoma Madrid, Program Precis Nutr & Cardiometabol Hlth, IMDEA, CSIC, Madrid, Spain
[13] Complejo Hosp Univ Santiago CHUS, Inst Invest Sanitaria IDIS, Mol Endocrinol Grp, SERGAS, Santiago, Spain
关键词
In flammation; Immunonutrition; Nutritional ketosis; Obesity; Oxidative stress; PnK method; OXIDATIVE STRESS; OBESITY; INFLAMMATION; EXPRESSION; IMMUNONUTRITION; MANAGEMENT; ENDOCRINE; EXERCISE; MUSCLE; CANCER;
D O I
10.1016/j.clnu.2022.05.007
中图分类号
R15 [营养卫生、食品卫生]; TS201 [基础科学];
学科分类号
100403 ;
摘要
Background & aim: Inflammation and oxidative stress are the most probable mechanistic link between obesity and its co-diseases with cancer among them. The aim of this study was to evaluate whether the nutritional ketosis and weight loss induced by a very-low-calorie ketogenic diet (VLCKD) modulates the inflammatory and oxidative stress profile, compared with a standard, balanced hypocaloric diet (LCD) or bariatric surgery (BS) in patients with obesity. Methods: The study was performed in 79 patients with overweight or obesity and 32 normal-weight volunteers as the control group. Patients with obesity underwent a weight reduction therapy based on VLCKD, LCD or BS. The quantification of the circulating levels of a multiplexing test of cytokines and carcinogenesis/aging biomarkers, as well as of lipid peroxides and total antioxidant power, was carried out. Results: First, we observed that pro-inflammatory cytokines increase, while anti-inflammatory cytokines decrease under excessive body weight. Relevantly, when patients underwent weight loss strategies, it was shown that energy-restricted and surgical strategies of weight loss induced changes in circulating cytokine and lipid peroxides. This effect was more notable in patients following the VLCKD than the LCD or BS and it was observed mainly in the ketosis phase of the intervention. Particularly, IL-11, IL-12, IL-2, INF-gamma, INF-beta, Pentraxin-3 or MMP1 changed after VLCKD. Whereas, APRIL, TWEAK, osteocalcin and IL-28A increased after BS. Conclusion: As far as we know, this is the first study that evaluate the time-course of cytokines and oxidative stress markers after a VLCKD as compared with a standard LCD and BS. The observed results support the immunomodulatory effect of nutritional ketosis induced by a VLCKD synergistically with weight loss as a strategy to improve innate-immunity and to prevent infections and carcinogenesis in patients with obesity. (c) 2022 The Author(s). Published by Elsevier Ltd. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
引用
收藏
页码:1566 / 1577
页数:12
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