International Center for the Assessment of Nutritional Status (ICANS), Department of Food Environmental and Nutritional Sciences (DeFENS), University of Milan, Via Sandro Botticelli 21, 20133 Milan, Italy.
Human Nutrition and Eating Disorder Research Center, Department of Public Health, Experimental and Forensic Medicine, University of Pavia, Via Agostino Bassi 21, 27100 Pavia, Italy.
Nutrients. 2019 Jul 25;11(8):1716. doi: 10.3390/nu11081716.
The classical ketogenic diet (cKD) is an isocaloric, high fat, very low-carbohydrate diet that induces ketosis, strongly influencing leptin and ghrelin regulation. However, not enough is known about the impact of a long-term cKD. This study evaluated the effects of a 12-month cKD on ghrelin and leptin concentrations in children, adolescents and adults affected by the GLUT1-Deficiency Syndrome or drug resistant epilepsy (DRE). We also investigated the relationship between the nutritional status, body composition and ghrelin and leptin variations. We carried out a longitudinal study on 30 patients: Twenty-five children and adolescents (15 females, 8 ± 4 years), and five adults (two females, 34 ± 16 years). After 12-monoths cKD, there were no significant changes in ghrelin and leptin, or in the nutritional status, body fat, glucose and lipid profiles. However, a slight height z-score reduction (from -0.603 ± 1.178 to -0.953 ± 1.354, ≤ 0.001) and a drop in fasting insulin occurred. We found no correlations between ghrelin changes and nutritional status and body composition, whereas leptin changes correlated positively with variations in the weight z-score and body fat ( 0.4534, 0.0341; 0.5901, 0.0135; respectively). These results suggest that a long-term cKD does not change ghrelin and leptin concentrations independently of age and neurological condition.
经典生酮饮食（cKD）是一种等热量、高脂肪、低碳水化合物的饮食，可诱导酮症，强烈影响瘦素和胃饥饿素的调节。然而，对于长期 cKD 的影响还知之甚少。本研究评估了 12 个月 cKD 对 GLUT1 缺乏综合征或耐药性癫痫（DRE）患儿、青少年和成人的胃饥饿素和瘦素浓度的影响。我们还研究了营养状况、身体成分与胃饥饿素和瘦素变化之间的关系。我们对 30 名患者进行了一项纵向研究：25 名儿童和青少年（15 名女性，8 ± 4 岁），5 名成年人（2 名女性，34 ± 16 岁）。经过 12 个月的 cKD，胃饥饿素和瘦素以及营养状况、体脂肪、血糖和血脂谱均无显著变化。然而，身高 z 分数略有下降（从-0.603 ± 1.178 降至-0.953 ± 1.354， ≤ 0.001），空腹胰岛素水平降低。我们发现胃饥饿素的变化与营养状况和身体成分之间没有相关性，而瘦素的变化与体重 z 分数和体脂肪的变化呈正相关（ 0.4534， 0.0341； 0.5901， 0.0135；分别）。这些结果表明，长期 cKD 不会改变瘦素和胃饥饿素的浓度，而与年龄和神经状况无关。
