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Ketosis proportionately spares glucose utilization in brain.

Yifan Zhang1, Youzhi Kuang, Kui Xu

  • 1Department of Biomedical Engineering, School of Medicine, Case Western Reserve University, Cleveland, Ohio 44106-4954, USA.

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Chronic ketosis reduces brain glucose metabolism. Ketogenic diets lower cerebral metabolic rates of glucose (CMRglc) in rats, with reductions correlating to ketone body levels.

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Area of Science:

  • Neuroscience
  • Metabolic Research
  • Biochemistry

Background:

  • The brain primarily uses glucose for energy but can adapt to using ketone bodies during fasting or ketogenic diets.
  • The precise impact of sustained ketosis on cerebral glucose metabolism remains unclear.

Purpose of the Study:

  • To investigate if chronic ketosis, induced by a ketogenic diet, alters cerebral metabolic rates of glucose (CMRglc).
  • To quantify the relationship between plasma ketone levels and CMRglc in rats.

Main Methods:

  • Utilized 2-[(18)F]fluoro-2-deoxy-D-glucose and positron emission tomography in young adult rats.
  • Administered standard or ketogenic diets for 3 weeks.
  • Determined CMRglc in the cerebral cortex and cerebellum using Gjedde-Patlak analysis.

Main Results:

  • Ketotic rats exhibited significantly lower average CMRglc in both the cerebral cortex and cerebellum compared to the standard diet group.
  • CMRglc reduction correlated linearly with increased plasma ketone bodies, approximately 9% decrease per 1 mmol/L increase.
  • These findings were supported by a meta-analysis, indicating a significant role for ketosis degree and duration.

Conclusions:

  • Chronic ketosis leads to a significant reduction in the brain's glucose metabolism.
  • The extent and duration of ketosis are key factors influencing the decrease in cerebral metabolic rates of glucose.