Ketone Body Infusion Increases Circulating Erythropoietin and Bone Marrow Glucose Uptake
2018; American Diabetes Association; Volume: 41; Issue: 12 Linguagem: Inglês
10.2337/dc18-1421
ISSN1935-5548
AutoresKatrine Meyer Lauritsen, Esben Søndergaard, Mads Svart, Niels Møller, Lars Christian Gormsen,
Tópico(s)Hyperglycemia and glycemic control in critically ill and hospitalized patients
ResumoSodium–glucose cotransporter 2 (SGLT2) inhibition was originally developed as a facile way of lowering blood glucose through increased renal elimination. However, clinical trials have demonstrated that SGLT2 inhibition not only improves glycemic control but also increases circulating ketone bodies and hematocrit (1,2). Recently, SGLT2 inhibitor–driven modest hyperketonemia has attracted much focus as a possible explanation of the improved cardiac outcome in patients treated with SGLT2 inhibitors (3), whereas the increased hematocrit has mostly been ascribed to hemoconcentration due to increased osmotic diuresis. In this Observation, we present data indicating that hyperketonemia directly stimulates circulating erythropoietin concentrations and is associated with increased bone marrow activity assessed by 18F-fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT). Seventeen healthy subjects undergoing either cardiac (study A) or brain (study B) PET/CT as part of protocols involving experimental hyperketonemia were investigated. Study A (4) consisted of 8 subjects (3 women) aged mean 60 (range 50–68) years with BMI mean 26 (range 22–35) kg/m2, and study B (5) of 9 subjects (4 women) aged 62 (56–69) years with BMI 24 (21–27) kg/m2. Both studies were randomized, single-blinded crossover trials in which participants were infused with either 7.5% Na-3-β-hydroxybutyrate (3-OHB) (infusion rate 0.18 g/kg/h [study A] and 0.22 g/kg/h [study B]) or saline (0.9%). In study A, bone marrow palmitate and glucose uptake …
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