Introduction/aim

The brain in Alzheimer’s disease shows glucose hypometabolism but may utilize ketones for energy production. Ketone levels can potentially be boosted through oral intake of Medium Chain Triglycerides (MCTs). The aim of this meta-analysis is to investigate the effect of MCTs on peripheral ketone levels and cognitive performance in patients with mild cognitive impairment and Alzheimer’s disease.

Methods

Medline, Scopus and Web of Science were searched for literature up to March 1, 2019. Meta-analyses were performed by implementing continuous random-effects models and outcomes were reported as weighted Mean Differences (MDs) or Standardized Mean Differences (SMDs).

Results

Twelve records (422 participants) were included. Meta-analysis of RCTs showed that, compared with placebo, MCTs elevated beta-hydroxybutyrate [MD = 0.355; 95 % CI (0.286, 0.424), I² = 0 %], showed a trend towards cognitive improvement on ADAS-Cog [MD = −0.539; 95% CI (−1.239, −0.161), I² = 0 %], and significantly improved cognition on a combined measure (ADAS-Cog with MMSE) [SMD = −0.289; 95 % CI (−0.551, −0.027), I² = 0 %].

Conclusions

In this meta-analysis, we demonstrated that MCTs can induce mild ketosis and may improve cognition in patients with mild cognitive impairment and Alzheimer’s disease. However, risk of bias of existing studies necessitates future trials.

中文翻译：

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中链甘油三酸酯诱导轻度酮症，并可能改善阿尔茨海默氏病的认知。对人体研究的系统回顾和荟萃分析。

简介/目标

阿尔茨海默氏病的大脑显示葡萄糖代谢不足，但可能利用酮来产生能量。口服摄入中链甘油三酸酯（MCTs）可能会提高酮水平。这项荟萃分析的目的是研究MCT对轻度认知障碍和阿尔茨海默氏病患者外周酮水平和认知能力的影响。

方法

检索截至2019年3月1日的Medline，Scopus和Web of Science文献。通过实施连续随机效应模型进行荟萃分析，并以加权均数差（MDs）或标准均数差（SMDs）报告结果。

结果

包括十二个记录（422名参与者）。对RCT的荟萃分析表明，与安慰剂相比，MCT升高了β-羟基丁酸酯[MD = 0.355； MS = 0.355。95％CI（0.286，0.424），I ² = 0％]，显示ADAS-Cog认知改善的趋势[MD = -0.539; 95％CI（-1.239，-0.161），I ² = 0％]，并通过联合测量（ADAS-Cog和MMSE）显着提高认知度[SMD = -0.289; 95％CI（-0.551，-0.027），I ² = 0％]。

结论

在这项荟萃分析中，我们证明了MCT可以诱导轻度酮症，并可以改善轻度认知障碍和阿尔茨海默氏病患者的认知。但是，现有研究存在偏差的风险，因此有必要进行进一步的试验。