An attempt to differentiate dysmetabolism variants based on biological age in combination with the induction of physiological ketosis: mini-review and own results

Abstract

Background: Metabolic flexibility describes the body's adaptive ability to changing metabolic or energy
requirements.

Objective: To determine the possibility of detecting dysmetabolism based on bioimpedancometry
(systemic dysmetabolism) and metabolic flexibility (local dysmetabolism) by the intensity of switching
from the glucogenic to the ketogenic variant of energy supply. Biological (metabolic) clock was calculated
by the difference between chronological age (CHR-age) minus biological (metabolic) age (MET-age), as
more than 1year difference.

Material and methods: The biological age was determined with tetrapolar bioimpedansometry. The
amino acid L-lysine was taken orally to induce ketosis, the content of ketones in the exhaled air was
dynamically recorded for 3 hours.

Results: Group with younger MET-age FM(fate mass): r = -0,36; p = 0,04( y = 18,1 - 0,08*x) and
intracellular fluid (ICF): r = -0,5 p = 0,002( y = 1796,2 - 8,9*x) and group with older MET-age - ICF:
r = -0,32; p = 0,074 (y = 24,38 - 0,08*x) (not significant or loss of reliability), FM: r = -0,36; p = 0,04
(y = 18,1 - 0,08*x). At the same time, highly sensitive CRP (hsCRP) above 5 mg/l was found much
more often in group (26% v.s.2%, Chi-square (df=1) - 6,50, p= 0,01), as well as cholesterol over 6.5
mmol/l. Moreover, hsCRP significant more higher in older MET-age group: mean - 3,5 (95%CI =2,3 -
4,7) v.s. 1,9 (95%CI=1,5 - 2,3). These data clearly indicate the presence metabolic dysfunction (systemic
dysmetabolism) in the group with premature metabolic (biological) age. A significant relationship was
found between the degree of hepatic ketosis and the difference between biological and chronological
age, i.e. younger age was characterized by higher metabolic flexibility. The KETO-MET-younger group
(group-2) has significantly more Body Cells Mass (BCM) proportion (50,5 (95%CI =50,0-51,1) v.s.
43,9(95%CI =42,8-45,0) ) and less content of Fat Mass (in kg) (14,7 (95%CI =13,7-15,6) v.s. 27,9(95%CI
=25,3-30,5), according to the results of BIM-V. KETO-Lysine test revealed a significantly more frequent
increase in blood ALT activity (more than 30 IU) in the older MET-age group (41% vs. 5%),

Conclusions: The results deepen the scientific understanding of the metabolic flexibility assessment
according to the original indicator - the induction of physiological ketosis by an amino acid metabolized
in the liver, and make it possible to implement a personalized approach in the diagnosis and differentiation
of metabolic disorders.