A ketogenic diet (KD) can induce weight loss and improve glycemic regulation, potentially reducing the risk of developing type 2 diabetes. To elucidate the underlying mechanisms behind these beneficial effects of a KD, we investigated the impact of a KD on organ-specific insulin sensitivity (IS) in skeletal muscle, liver, and adipose tissue. We hypothesized that a KD would increase IS in skeletal muscle. The study included 11 individuals with obesity who underwent a randomized, crossover trial with two three-week interventions: 1) KD and 2) standard diet. Skeletal muscle IS was quantified as the increase in glucose disposal during a hyperinsulinemic-euglycemic clamp (HEC). Hepatic IS and adipose tissue IS were quantified as the relative suppression of endogenous glucose production (EGP) and the relative suppression of palmitate flux during the HEC. The KD led to a 2.2 kg weight loss, increased insulin-stimulated glucose disposal, whereas the relative suppression of EGP during the HEC was similar. In addition, the KD decreased insulin-mediated suppression of lipolysis. In conclusion, a KD increased skeletal muscle IS in individuals with obesity.

中文翻译：

---

为期三周的生酮饮食可提高肥胖个体的骨骼肌胰岛素敏感性——一项随机对照交叉试验


生酮饮食 (KD) 可以减轻体重并改善血糖调节，从而可能降低患 2 型糖尿病的风险。为了阐明生酮饮食这些有益作用背后的潜在机制，我们研究了生酮饮食对骨骼肌、肝脏和脂肪组织中器官特异性胰岛素敏感性 (IS) 的影响。我们假设 KD 会增加骨骼肌的 IS。该研究纳入了 11 名肥胖患者，他们接受了一项随机交叉试验，其中包括两项为期三周的干预措施：1) KD 和 2) 标准饮食。骨骼肌 IS 被量化为高胰岛素正常血糖钳夹 (HEC) 期间葡萄糖处理的增加。肝脏 IS 和脂肪组织 IS 被量化为 HEC 期间内源性葡萄糖产生 (EGP) 的相对抑制和棕榈酸酯流量的相对抑制。 KD 导致体重减轻 2.2 公斤，增加胰岛素刺激的葡萄糖处理，而 HEC 期间 EGP 的相对抑制是相似的。此外，KD 还降低了胰岛素介导的脂肪分解抑制作用。总之，KD 增加了肥胖个体的骨骼肌 IS。