Abdominal fat distribution modulates the metabolic effects of exogenous ketones in individuals with new-onset prediabetes after acute pancreatitis: Results from a randomized placebo-controlled trial

Eighteen individuals with new-onset prediabetes after acute pancreatitis received a ketone monoester supplement or placebo in a randomized crossover design, and abdominal fat phenotypes were determined by 3T MRI. Blood glucoregulatory peptides were analyzed as total area under the curve over 150 minutes. Total AUCs for insulin and C-peptide were significantly higher after ketone supplementation in individuals with high intra-pancreatic fat, skeletal muscle fat and subcutaneous fat volume and with low visceral fat volume and intra-hepatic fat, while the GLP-1 AUC was not associated with any adiposity phenotype.