The impact of the ketogenic diet on arterial morphology and endothelial function in children and young adults with epilepsy: A case–control study

• Published in: Seizure (London, England) Vol. 23; no. 4; pp. 260 - 265
• Main Authors: Coppola, Giangennaro, Natale, Francesco, Torino, Annarita, Capasso, Rosanna, D’Aniello, Alfredo, Pironti, Erica, Santoro, Elena, Calabrò, Raffaele, Verrotti, Alberto
• Format: Journal Article
• Language: English
• Published: England Elsevier Ltd 01.04.2014
• Subjects: Adolescent; Adult; Anticonvulsants - therapeutic use; Arterial morphology; Blood Pressure - drug effects; Blood Pressure - physiology; Carotid Arteries - diagnostic imaging; Carotid Arteries - drug effects; Carotid artery stiffness; Carotid Intima-Media Thickness; Case-Control Studies; Child; Child, Preschool; Cholesterol - blood; Cohort Studies; Diet, Ketogenic - adverse effects; Echocardiography; Endothelial function; Epilepsy - diet therapy; Epilepsy - drug therapy; Epilepsy - pathology; Female; Humans; Infant; Ketogenic diet; Male; Neurology; Triglycerides - blood; Tunica Intima - drug effects; Tunica Intima - pathology; Vascular Stiffness - physiology; Young Adult; Arterial morphology; Endothelial function; Ketogenic diet; Carotid artery stiffness
• ISSN: 1059-1311; 1532-2688
• DOI: 10.1016/j.seizure.2013.12.002

Abstract Purpose The present study aimed to assess the impact of the ketogenic diet on arterial morphology and endothelial function of the big vessels of the neck and on cardiac diastolic function, in a cohort of epileptic children and young adults treated with the ketogenic diet. Methods Patients were recruited based on the following inclusion criteria: (1) patients who were or had been on the ketogenic diet for a time period of at least six months. Each patient underwent measurement of carotid intima media thickness, carotid artery stiffness, echocardiography, and diastolic function assessment. Patients with drug resistant epilepsy, matched for number, age and sex and never treated with ketogenic diet, were recruited as controls. Results The population study was composed by 43 epilepsy patients (23 males), aged between 19 months and 31 years (mean 11 years). Twenty-three patients were or had been treated with ketogenic diet, and 20 had never been on it (control group). Subjects treated with the ketogenic diet had higher arterial stiffness parameters, including AIx and β-index and higher serum levels of cholesterol or triglycerides compared to those who had never been on the diet (control group) ( p < 0.001). Conclusions Arterial stiffness is increased in children and young adults treated with the ketogenic diet, before the increase of the intima media thickness. This supports that arterial stiffness is an early marker of vascular damage.