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perissiou-et-al-2025-ketone-monoester-ingestion-improves-cardiac-function-in-adults-with-type-2-diabetes-a-double-blind2.16 MB
Published VersionCC BY V4.0, Open Access
Journal article
Ketone monoester ingestion improves cardiac function in adults with type 2 diabetes: a double-blind, placebo-controlled, randomized, crossover trial
Journal of Applied Physiology, Vol.138(2), pp.546-558
2025
PMID: 39818982
Abstract
Type 2 diabetes (T2D) is a metabolic disease associated with cardiovascular dysfunction. The myocardium preferentially uses ketones over free fatty acids as a more energy-efficient substrate. The primary aim was to assess the effects of ketone monoester (Kme) ingestion on cardiac output index (˙𝑄 i). The secondary aims were to assess the effects of Kme ingestion on markers of cardiac hemodynamics, muscle oxygenation, and vascular function at rest, during and following step-incremental cycling. We undertook a double-blind, randomized, crossover design study in 13 adults [age, 66 ± 10 yr; body mass index (BMI), 31.3 ± 7.0 kg·m−2] with T2D. Participants completed two conditions, where they ingested a Kme (0.115 g·kg−1) or a placebo taste-matched drink. Cardiac function was measured using thoracic impedance cardiography, and muscle oxygenation of the calf was determined via near-infrared spectroscopy. Macrovascular endothelial function was measured by flow-mediated dilation (FMD), and microvascular endothelial function was measured via transdermal delivery of acetylcholine (ACh) and insulin. Circulating β-hydroxybutyrate [β-Hb] was measured throughout. Kme ingestion raised circulating β-Hb throughout the protocol (peak 1.9 mM; P = 0.001 vs. placebo). Kme ingestion increased ˙𝑄i by 0.75 ± 0.5 L·min−1·m−2 (P = 0.003), stroke volume index by 7.2 ± 4.5 mL·m−2 (P = 0.001), and peripheral muscle oxygenation by 9.9 ± 7.1% (P = 0.001) and reduced systemic vascular resistance index by −420 ± −225 dyn·s−1·cm−5·m−2 (P = 0.031) compared with the placebo condition. There were no differences between Kme and placebo in heart rate (P = 0.995), FMD (P = 0.542), ACh max (P = 0.800), and insulin max (P = 0.242). Ingestion of Kme improved ˙𝑄i, stroke volume index, and peripheral muscle oxygenation but did not alter macro- or microvascular endothelial function in people with T2D.
Details
- Title
- Ketone monoester ingestion improves cardiac function in adults with type 2 diabetes: a double-blind, placebo-controlled, randomized, crossover trial
- Authors
- M. Perissiou - University of PortsmouthZ. L. Saynor - University of SouthamptonK. Feka - University of the Sunshine Coast, Queensland, School of Health - Sports & Exercise ScienceC. Edwards - University of PortsmouthT. J. James - Liverpool John Moores UniversityJ. Corbett - University of PortsmouthH. Mayes - University of PortsmouthJ. Shute - University of PortsmouthM. Cummings - Portsmouth Hospitals NHS TrustM. I. Black - University of ExeterW. D. Strain - University of ExeterJ. P. Little - University of British ColumbiaA. I. Shepherd (Corresponding Author) - University of Portsmouth
- Publication details
- Journal of Applied Physiology, Vol.138(2), pp.546-558
- Publisher
- American Physiological Society
- Date published
- 2025
- DOI
- 10.1152/japplphysiol.00800.2024
- ISSN
- 1522-1601; 8750-7587
- PMID
- 39818982
- Copyright note
- Copyright © 2025 The Authors. Licensed under Creative Commons Attribution CC-BY 4.0. Published by the American Physiological Society.
- Data Availability
- The full anonymized dataset has been made open access and freely available as Supplemental Material on the University of Portsmouth repository (https://doi.org/10.17029/89279950-3254- 495a-b1aa-86573108b55c).
- Grant note
- This study was funded by the Science and Health Faculty of the University of Portsmouth as part of the start-up fund (to M.P.).
- Organisation Unit
- School of Health - Biomedicine; Healthy Ageing Research Cluster; School of Health - Sports & Exercise Science
- Language
- English
- Record Identifier
- 991127003802621
- Output Type
- Journal article
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