Background:Ketosis in dairy cows is associated with body fat mobilization during the peripartal period.Sub-clinical and clinical ketosis arise more frequently in cows that are overfed energy during the entire dry(last...Background:Ketosis in dairy cows is associated with body fat mobilization during the peripartal period.Sub-clinical and clinical ketosis arise more frequently in cows that are overfed energy during the entire dry(last 50 to 45 days prior to parturition)or close-up period(last^28 days prepartum).Methods:A retrospective analysis was performed on 12 cows from a larger cohort that were fed a higher-energy diet[1.54 Mcal/kg of dry matter(DM);35.9%of DM corn silage and 13%of DM ground corn]during the close-up dry period,of which 6 did not develop clinical ketosis(OVE,0.83 mmol/L plasma hydroxybutyrate;BHB)and 6 were diagnosed with clinical ketosis(KET,1.4 mmol/L BHB)during the first week postpartum.A whole-transcriptome bovine microarray(Agilent Technologies)and metabolomics(GC-MS,LC-MS;Metabolon~?Inc.)were used to perform transcript and metabolite profiling of liver tissue harvested at-10 days relative to parturition which allowed to establish potential associations between prepartal transcriptome/metabolome profiles and susceptibility to clinical ketosis postpartum.Results:Cows in KET had greater(P=0.01)overall body weight between-2 and 1 week around parturition,but similar body condition score than OVE.Although dry matter intake(DMI)did not differ prepartum,KET cows had lower(P<0.01)DMI and similar milk yield as OVE cows during the first week postpartum.Transcriptome analysis revealed a total of 3065 differentially expressed genes(DEG;P≤0.05)in KET.Metabolomics identified 15 out of 313 total biochemical compounds significantly affected(P≤0.10)in KET.Among those,greater concentrations(P≤0.06,+2.3-fold)of glycochenodeoxycholate in KET cows also have been detected in humans developing non-alcoholic fatty liver disease.Bioinformatics analysis using the Kyoto Encyclopedia of Genes and Genomes(KEGG)pathway database and the DEG revealed that,among the top 20 most-impacted metabolic pathway categories in KET,65%were overall downregulated.Those included’Metabolism of cofactors and vitamins’,’Biosynthesis of other secondary metabolites’,’Lipid’,’Carbohydrate’,and’Glycan biosynthesis and metabolism’.The lower relative concentration of glucose-6-phosphate and marked downregulation of fructose-1,6-bisphosphatase 2 and pyruvate dehydrogenase kinase 4 support a strong impairment in gluconeogenesis in prepartal liver of cows developing KET postpartum.Among the top 20 most-impacted non-metabolic pathways,85%were downregulated.Pathways such as’mTOR signalling’and’Insulin signalling’were among those.’Ribosome’,’Nucleotide excision repair’,and’Adherens junctions’were the only upregulated pathways in cows with KET.Conclusions:The combined data analyses revealed more extensive alterations of the prepartal liver transcriptome than metabolome in cows overfed energy and developing ketosis postpartum.The causative link between these tissue-level adaptations and onset of clinical ketosis needs to be studied further.展开更多
Diabetes has been classified mainly into types 1 and 2.Some type 2 diabetes patients,when developing ketosis,have been labeled as having atypical diabetes.Lately,syndromes of ketosis-prone diabetes,primarily in patien...Diabetes has been classified mainly into types 1 and 2.Some type 2 diabetes patients,when developing ketosis,have been labeled as having atypical diabetes.Lately,syndromes of ketosis-prone diabetes,primarily in patients who we previously classified as type 2 diabetics,have emerged,and calls are being made to even reclassify diabetes.This mini-review will extensively deal with the historical,molecular,phenotypical,and clinical basis of why ketosis-prone diabetes is different than the traditional principles of type 1 and 2 diabetes and should be classified as such.Clinicians,especially those who are not diabetologists or endocrinologists,as well as hospitalists,intensivists,and primary care providers,will greatly benefit from this review.展开更多
Introduction: Electrolyte’s profile in non-acidosis diabetic ketosis is poorly specified. We aimed to determine the nature of diabetic ketosis decompensations as well as the profile of kalemia and factors associated ...Introduction: Electrolyte’s profile in non-acidosis diabetic ketosis is poorly specified. We aimed to determine the nature of diabetic ketosis decompensations as well as the profile of kalemia and factors associated with its disorders at diagnosis of acidosis compared to non-acidosis diabetic ketosis. Methods: The study was retrospective from 1 January 2010 to 31 December 2011 in Yalgado Ouédraogo teaching hospital. Diabetic in-patients suffering from simple ketosis, keto-acidosis or mixed decompensation, who achieved blood electrolytes assessment before intensive insulin therapy were included. Results: Sixty two patients were studied. The sex ratio was 0.7 and the mean age was 41.7 years. Keto-acidosis, simple ketosis and mixed decompensation were diagnosed respectively in 18 (29%), 32 (51.6%) and 12 (19.4%) patients. Kalemia was normal in 42 (67.7%), while hypokalemia and hyperkalemia were reported respectively in 11 (17.8%) and 9 (14.5%) patients. Kalemia was often normal in all types of ketosis decompensation and disorders of kalemia occurred more in patients with keto-acidosis (50%) than those with simple ketosis (21.9%);p = 0.04. Renal failure was diagnosed in 10 patients (50%) with and 2 (4.8%) without kalemia’s disorders;p = 0.0001. Seven patients (35%) with and 4 (9.5%) without kalemia’s disorders suffered from unconsciousness;p = 0.02. It happens more in hyperkalemia (44.4%) than in normal kalemia condition (9.5%);p = 0.02. Conclusion: If kalemia is often normal in all types of diabetic ketosis emergencies, hypokalemia is the most initial frequent potassium disorder.展开更多
The Bigu-herbs regimen,a Taoism(Taoism is an ancient Chinese Taoist philosophy system)special health-preserving technique to achieve longevity through strict abstinence from food,limits the intake of grains and uses h...The Bigu-herbs regimen,a Taoism(Taoism is an ancient Chinese Taoist philosophy system)special health-preserving technique to achieve longevity through strict abstinence from food,limits the intake of grains and uses herbs to replace normal diet to gain energy.Practicing Bigu-herbs regimen for several weeks to several years can make one lose weight,prevent diseases,and prolong life.The modern ketogenic diet(KD)mainly limits carbohydrate intake and increase fat intake.The low-carbohydrate,high-fat,and adequate protein diet is well known for its antiepileptic and neurotrophic effects.Limiting the intake of carbohydrate results in energy metabolism reprogramming to mobilize the steatolysis,energize and promote ketone bodies(KBs)production,achieving a state of nutritional ketosis(NK).The researchers summarized how ketone bodies or NK affects diseases and the aging process,as well as the side effects of KD.NK has a favorable effect on caloric intake,lipid parameters,glycemic index,and insulin sensitivity;moreover,it can be used as a treatment option for diabetes,obesity,and other metabolic disorders.NK is recognized as being neuroprotective and is good for epilepsy,Alzheimer’s disease,and emotional disturbance.Targeting the metabolic differences between tumor and normal cells,NK limits the use of glucose and impairs energy metabolism in cancer cells,inhibiting their growth and rendering them susceptible to clinical treatments.NK also affects inflammation and the release of cytokines,regulate gut flora,extend longevity and health span,and preserve physiologic functions.The side effects of KDs are controllable under the guidance of a specially trained dietitian and medical team.展开更多
Though the cancer is a multifactorial disease,where various types of cancers exhibit varying mechanisms,pathways,genetic and cellular defects,the study of tumor micro-environment confirms that upregulated glycolysis a...Though the cancer is a multifactorial disease,where various types of cancers exhibit varying mechanisms,pathways,genetic and cellular defects,the study of tumor micro-environment confirms that upregulated glycolysis and hypoxia are the part and parcel of almost every cancer subtypes.Therefore,targeting them with nutritional ketosis and hyper-oxygenation therapies could create an unfavourable environment for cancers to thrive.The aim of this review is to study the significance of these interventions in the integrative cancer treatment.Extensive search has been carried out through the online scientific database like PubMed and other medical journals with the search words,‘cancer metabolism’,‘tumor micro environment’,‘hypoxia and tumor’,‘ketosis and cancer treatment’,‘hyperbaric oxygen therapy and cancer’and‘ozone therapy and cancer’.All biomolecule studies,preclinical and clinical studies,received as search results are reviewed.In addition,a nutritional book,named‘Healing with Whole Foods:Asian Traditions and Modern Nutrition’by Paul Pitchford is also referred.These studies recommend the use of various therapeutic approaches like ketogenic diet,ketone supplementation,hyperbaric oxygen therapy and intravenous ozone therapy,individually or in combination with standard therapies,based on its antitumor effects,safety,tolerability,its ability to potentiate the radio and chemo therapy,while decreasing its side effects and its efficiency to improve the quality of life.Rewardingly,when combined,the synergistic action of nutritional ketosis and hyperoxygenation therapies elicited profound,supra additive anti-cancer effects.As per present studies,these therapies are safe to include in an Integrative cancer treatment,though large clinical trials are needed to systematize its clinical usage.展开更多
We performed a retrospective study on diabetic ketosis decompensations in 101 diabetic patients in Endocrinology and Metabolic Diseases Service of the National Hospital and Universitary Koutoukou Hubert Maga (CNHU-HKM...We performed a retrospective study on diabetic ketosis decompensations in 101 diabetic patients in Endocrinology and Metabolic Diseases Service of the National Hospital and Universitary Koutoukou Hubert Maga (CNHU-HKM) for a period of 3 years. Objective: The main objective of the study was to identify the underlying factors of ketosis decompensations for a more focused education program. Results: The mean age was 43.84 years. In half of cases (49.5%), the ketosis decompensations were inaugural for the diabetes. Type 2 diabetes was predominant with a frequency of 85.1% versus 14.9% for type 1 diabetes. The overall prevalence rate of ketosis decompensations was 21.82%. The precipitating factors were infections (51.49%) and treatment withdrawal (25.74%). The average blood glucose was 4.46 g/L with ranges of 1.86 g/L and 13 g/L. The outcome was favorable in 89.1% of cases. The mortality rate was 7.9%. The average hospital stay was 13.23 days. Conclusion: This study showed that ketosis decompensations are still frequent. The main precipitating factors are infection and therapeutic noncompliance. Preventive actions are needed through screening programs, regular monitoring and targeted education.展开更多
目的研究钠-葡萄糖共转运蛋白2抑制剂(SGLT2i)致酮症/酮症酸中毒的发生规律及特点。方法收集PubMed、Science Direct、Web of Science、中国知网、万方、维普数据库纳入的SGLT2i导致酮症/酮症酸中毒的病例。分析患者性别、年龄、药品用...目的研究钠-葡萄糖共转运蛋白2抑制剂(SGLT2i)致酮症/酮症酸中毒的发生规律及特点。方法收集PubMed、Science Direct、Web of Science、中国知网、万方、维普数据库纳入的SGLT2i导致酮症/酮症酸中毒的病例。分析患者性别、年龄、药品用法用量、不良反应发生时间、临床表现、糖尿病类型、诱发因素等信息。结果共纳入111例患者,其中男性53例(47.75%),女性58例(52.25%)。年龄分布在17~83岁,其中年龄30~<60岁者68例(61.26%),占比最大。酮症/酮症酸中毒的发生可分为药物直接引起和危险因素诱发,其中药物直接引起的有46例(41.44%),手术、感染、低碳水摄入等危险因素诱发的有65例(58.55%),临床症状大多为恶心、呕吐、纳差、腹痛、乏力、呼吸困难、意识模糊。结论SGLT2i导致的酮症/酮症酸中毒多为危险因素诱发,建议手术或感染情况下及时停用药物,避免突然减量/停用胰岛素,避免低碳水摄入及剧烈运动等情况发生。建议用药期间定期检测患者酮体水平,以便为临床用药提供指导。展开更多
文摘Background:Ketosis in dairy cows is associated with body fat mobilization during the peripartal period.Sub-clinical and clinical ketosis arise more frequently in cows that are overfed energy during the entire dry(last 50 to 45 days prior to parturition)or close-up period(last^28 days prepartum).Methods:A retrospective analysis was performed on 12 cows from a larger cohort that were fed a higher-energy diet[1.54 Mcal/kg of dry matter(DM);35.9%of DM corn silage and 13%of DM ground corn]during the close-up dry period,of which 6 did not develop clinical ketosis(OVE,0.83 mmol/L plasma hydroxybutyrate;BHB)and 6 were diagnosed with clinical ketosis(KET,1.4 mmol/L BHB)during the first week postpartum.A whole-transcriptome bovine microarray(Agilent Technologies)and metabolomics(GC-MS,LC-MS;Metabolon~?Inc.)were used to perform transcript and metabolite profiling of liver tissue harvested at-10 days relative to parturition which allowed to establish potential associations between prepartal transcriptome/metabolome profiles and susceptibility to clinical ketosis postpartum.Results:Cows in KET had greater(P=0.01)overall body weight between-2 and 1 week around parturition,but similar body condition score than OVE.Although dry matter intake(DMI)did not differ prepartum,KET cows had lower(P<0.01)DMI and similar milk yield as OVE cows during the first week postpartum.Transcriptome analysis revealed a total of 3065 differentially expressed genes(DEG;P≤0.05)in KET.Metabolomics identified 15 out of 313 total biochemical compounds significantly affected(P≤0.10)in KET.Among those,greater concentrations(P≤0.06,+2.3-fold)of glycochenodeoxycholate in KET cows also have been detected in humans developing non-alcoholic fatty liver disease.Bioinformatics analysis using the Kyoto Encyclopedia of Genes and Genomes(KEGG)pathway database and the DEG revealed that,among the top 20 most-impacted metabolic pathway categories in KET,65%were overall downregulated.Those included’Metabolism of cofactors and vitamins’,’Biosynthesis of other secondary metabolites’,’Lipid’,’Carbohydrate’,and’Glycan biosynthesis and metabolism’.The lower relative concentration of glucose-6-phosphate and marked downregulation of fructose-1,6-bisphosphatase 2 and pyruvate dehydrogenase kinase 4 support a strong impairment in gluconeogenesis in prepartal liver of cows developing KET postpartum.Among the top 20 most-impacted non-metabolic pathways,85%were downregulated.Pathways such as’mTOR signalling’and’Insulin signalling’were among those.’Ribosome’,’Nucleotide excision repair’,and’Adherens junctions’were the only upregulated pathways in cows with KET.Conclusions:The combined data analyses revealed more extensive alterations of the prepartal liver transcriptome than metabolome in cows overfed energy and developing ketosis postpartum.The causative link between these tissue-level adaptations and onset of clinical ketosis needs to be studied further.
文摘Diabetes has been classified mainly into types 1 and 2.Some type 2 diabetes patients,when developing ketosis,have been labeled as having atypical diabetes.Lately,syndromes of ketosis-prone diabetes,primarily in patients who we previously classified as type 2 diabetics,have emerged,and calls are being made to even reclassify diabetes.This mini-review will extensively deal with the historical,molecular,phenotypical,and clinical basis of why ketosis-prone diabetes is different than the traditional principles of type 1 and 2 diabetes and should be classified as such.Clinicians,especially those who are not diabetologists or endocrinologists,as well as hospitalists,intensivists,and primary care providers,will greatly benefit from this review.
文摘Introduction: Electrolyte’s profile in non-acidosis diabetic ketosis is poorly specified. We aimed to determine the nature of diabetic ketosis decompensations as well as the profile of kalemia and factors associated with its disorders at diagnosis of acidosis compared to non-acidosis diabetic ketosis. Methods: The study was retrospective from 1 January 2010 to 31 December 2011 in Yalgado Ouédraogo teaching hospital. Diabetic in-patients suffering from simple ketosis, keto-acidosis or mixed decompensation, who achieved blood electrolytes assessment before intensive insulin therapy were included. Results: Sixty two patients were studied. The sex ratio was 0.7 and the mean age was 41.7 years. Keto-acidosis, simple ketosis and mixed decompensation were diagnosed respectively in 18 (29%), 32 (51.6%) and 12 (19.4%) patients. Kalemia was normal in 42 (67.7%), while hypokalemia and hyperkalemia were reported respectively in 11 (17.8%) and 9 (14.5%) patients. Kalemia was often normal in all types of ketosis decompensation and disorders of kalemia occurred more in patients with keto-acidosis (50%) than those with simple ketosis (21.9%);p = 0.04. Renal failure was diagnosed in 10 patients (50%) with and 2 (4.8%) without kalemia’s disorders;p = 0.0001. Seven patients (35%) with and 4 (9.5%) without kalemia’s disorders suffered from unconsciousness;p = 0.02. It happens more in hyperkalemia (44.4%) than in normal kalemia condition (9.5%);p = 0.02. Conclusion: If kalemia is often normal in all types of diabetic ketosis emergencies, hypokalemia is the most initial frequent potassium disorder.
基金the National Natural Science Foundation of China(81372660)Key Medical Science Research Fund of Hangzhou(2011ZD001)+4 种基金Medical Science Research Fund of Zhejiang Province,China(2013KYA157)Traditional Chinese Medicine Science and Technology Project of Zhejiang Province(2013ZA104)Zhejiang Province Public Welfare Technology Application Research Project(2016C03SA100727)Hangzhou Science and Technology Bureau(20140633B30)Department of Oncology,Key Laboratory of Clinical Cancer Pharmacology and Toxicology Research of Zhejiang Province,Affiliated Hangzhou First People’s Hospital,Zhejiang University School of Medicine(Hangzhou Cancer Hospital),Hangzhou,Zhejiang 310006,China.
文摘The Bigu-herbs regimen,a Taoism(Taoism is an ancient Chinese Taoist philosophy system)special health-preserving technique to achieve longevity through strict abstinence from food,limits the intake of grains and uses herbs to replace normal diet to gain energy.Practicing Bigu-herbs regimen for several weeks to several years can make one lose weight,prevent diseases,and prolong life.The modern ketogenic diet(KD)mainly limits carbohydrate intake and increase fat intake.The low-carbohydrate,high-fat,and adequate protein diet is well known for its antiepileptic and neurotrophic effects.Limiting the intake of carbohydrate results in energy metabolism reprogramming to mobilize the steatolysis,energize and promote ketone bodies(KBs)production,achieving a state of nutritional ketosis(NK).The researchers summarized how ketone bodies or NK affects diseases and the aging process,as well as the side effects of KD.NK has a favorable effect on caloric intake,lipid parameters,glycemic index,and insulin sensitivity;moreover,it can be used as a treatment option for diabetes,obesity,and other metabolic disorders.NK is recognized as being neuroprotective and is good for epilepsy,Alzheimer’s disease,and emotional disturbance.Targeting the metabolic differences between tumor and normal cells,NK limits the use of glucose and impairs energy metabolism in cancer cells,inhibiting their growth and rendering them susceptible to clinical treatments.NK also affects inflammation and the release of cytokines,regulate gut flora,extend longevity and health span,and preserve physiologic functions.The side effects of KDs are controllable under the guidance of a specially trained dietitian and medical team.
文摘Though the cancer is a multifactorial disease,where various types of cancers exhibit varying mechanisms,pathways,genetic and cellular defects,the study of tumor micro-environment confirms that upregulated glycolysis and hypoxia are the part and parcel of almost every cancer subtypes.Therefore,targeting them with nutritional ketosis and hyper-oxygenation therapies could create an unfavourable environment for cancers to thrive.The aim of this review is to study the significance of these interventions in the integrative cancer treatment.Extensive search has been carried out through the online scientific database like PubMed and other medical journals with the search words,‘cancer metabolism’,‘tumor micro environment’,‘hypoxia and tumor’,‘ketosis and cancer treatment’,‘hyperbaric oxygen therapy and cancer’and‘ozone therapy and cancer’.All biomolecule studies,preclinical and clinical studies,received as search results are reviewed.In addition,a nutritional book,named‘Healing with Whole Foods:Asian Traditions and Modern Nutrition’by Paul Pitchford is also referred.These studies recommend the use of various therapeutic approaches like ketogenic diet,ketone supplementation,hyperbaric oxygen therapy and intravenous ozone therapy,individually or in combination with standard therapies,based on its antitumor effects,safety,tolerability,its ability to potentiate the radio and chemo therapy,while decreasing its side effects and its efficiency to improve the quality of life.Rewardingly,when combined,the synergistic action of nutritional ketosis and hyperoxygenation therapies elicited profound,supra additive anti-cancer effects.As per present studies,these therapies are safe to include in an Integrative cancer treatment,though large clinical trials are needed to systematize its clinical usage.
文摘We performed a retrospective study on diabetic ketosis decompensations in 101 diabetic patients in Endocrinology and Metabolic Diseases Service of the National Hospital and Universitary Koutoukou Hubert Maga (CNHU-HKM) for a period of 3 years. Objective: The main objective of the study was to identify the underlying factors of ketosis decompensations for a more focused education program. Results: The mean age was 43.84 years. In half of cases (49.5%), the ketosis decompensations were inaugural for the diabetes. Type 2 diabetes was predominant with a frequency of 85.1% versus 14.9% for type 1 diabetes. The overall prevalence rate of ketosis decompensations was 21.82%. The precipitating factors were infections (51.49%) and treatment withdrawal (25.74%). The average blood glucose was 4.46 g/L with ranges of 1.86 g/L and 13 g/L. The outcome was favorable in 89.1% of cases. The mortality rate was 7.9%. The average hospital stay was 13.23 days. Conclusion: This study showed that ketosis decompensations are still frequent. The main precipitating factors are infection and therapeutic noncompliance. Preventive actions are needed through screening programs, regular monitoring and targeted education.
文摘目的研究钠-葡萄糖共转运蛋白2抑制剂(SGLT2i)致酮症/酮症酸中毒的发生规律及特点。方法收集PubMed、Science Direct、Web of Science、中国知网、万方、维普数据库纳入的SGLT2i导致酮症/酮症酸中毒的病例。分析患者性别、年龄、药品用法用量、不良反应发生时间、临床表现、糖尿病类型、诱发因素等信息。结果共纳入111例患者,其中男性53例(47.75%),女性58例(52.25%)。年龄分布在17~83岁,其中年龄30~<60岁者68例(61.26%),占比最大。酮症/酮症酸中毒的发生可分为药物直接引起和危险因素诱发,其中药物直接引起的有46例(41.44%),手术、感染、低碳水摄入等危险因素诱发的有65例(58.55%),临床症状大多为恶心、呕吐、纳差、腹痛、乏力、呼吸困难、意识模糊。结论SGLT2i导致的酮症/酮症酸中毒多为危险因素诱发,建议手术或感染情况下及时停用药物,避免突然减量/停用胰岛素,避免低碳水摄入及剧烈运动等情况发生。建议用药期间定期检测患者酮体水平,以便为临床用药提供指导。