Department of Paediatric Neurology, the Independent Public Healthcare Centre - Municipal Hospital Complex, Chorzów, Poland.
Chair and Department of Medical and Molecular Biology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia in Katowice, Zabrze, Poland.
Neuro Endocrinol Lett. 2021 Nov 30;42(7):489-499.
Recently, inflammation have been proposed as one of the mechanisms underlying the patology of drug-resistant epilepsy (DRE). Ketogenic diet (KD) is one of the therapeutic methods used in DRE. There are some data that adipokines may modulate inflammatory processes and their concentrations are influenced by KD. Therefore, the aim of this study was to evaluate the influence of KD on serum leptin, chemerin and resistin in children with DRE.
A cross-sectional observational study performed on 72 subjects aged 3-9 years, divided into 3 groups: 24 children with DRE treated with KD, 26 treated with valproic acid (VPA), and a control group of 22 children.
Anthropometric measurements (weight, heigth, BMI, waist to hip circumerences ratio) were performed in all participants. Biochemical tests included serum fasting glucose, insulin, beta-hydroxybutyric acid, lipid profile, alanine aminotransferase and aspartate aminotransferase activities and blood gasometry. Serum levels of leptin, chemerin and resistin were assayed using commercially available ELISA tests.
Serum levels of leptin and chemerin in the KD group were significantly lower and resistin - higher in comparison to patients receiving VPA and the control group. In children treated with the KD, leptin concentrations correlate with insulin levels and HOMA-IR scores. Chemerin levels in this group, in contrast, show negative correlation with body mass and height expressed as standard deviation scores from the mean for age and sex.
Modification of pro-inflammatory adipocytokine levels is potentially one of the mechanisms of anticonvulsant effects of KD in children with refractory epilepsy.
最近，炎症被认为是耐药性癫痫（DRE）发病机制之一。生酮饮食（KD）是治疗 DRE 的方法之一。有一些数据表明，脂肪细胞因子可能调节炎症过程，其浓度受 KD 影响。因此，本研究旨在评估 KD 对 DRE 患儿血清瘦素、趋化素和抵抗素的影响。
对 72 名 3-9 岁儿童进行横断面观察性研究，分为 3 组：24 名接受 KD 治疗的 DRE 儿童、26 名接受丙戊酸（VPA）治疗的儿童和 22 名对照组儿童。
所有参与者均进行了人体测量学测量（体重、身高、BMI、腰臀比）。生化测试包括血清空腹血糖、胰岛素、β-羟丁酸、血脂谱、丙氨酸氨基转移酶和天冬氨酸氨基转移酶活性以及血气分析。使用商业 ELISA 试剂盒检测血清瘦素、趋化素和抵抗素水平。
与接受 VPA 治疗的患者和对照组相比，KD 组血清瘦素和趋化素水平显著降低，抵抗素水平升高。在接受 KD 治疗的儿童中，瘦素浓度与胰岛素水平和 HOMA-IR 评分相关。相比之下，该组的趋化素水平与体重和身高呈负相关，用年龄和性别均数的标准差评分表示。
炎症性脂肪细胞因子水平的改变可能是 KD 对耐药性癫痫儿童抗惊厥作用的机制之一。
