Maddalena Marchiò1, Laura Roli2, Carmela Giordano3, Tommaso Trenti2, Azzurra Guerra4, Giuseppe Biagini5. 1. Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy; Pediatric Neurology, Polyclinic Hospital, Modena, Italy. 2. Department of Laboratory Medicine and Pathological Anatomy, AUSL Modena, Modena, Italy. 3. Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy. 4. Pediatric Neurology, Polyclinic Hospital, Modena, Italy. 5. Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy; Center for Neuroscience and Neurotechnology, University of Modena and Reggio Emilia, Modena, Italy. Electronic address: gbiagini@unimore.it.
Abstract
BACKGROUND & AIMS: The gastric hormones ghrelin and des-acyl ghrelin have been found to be altered in patients treated with antiepileptic drugs. However, it is unknown if these hormones could be modified by other antiepileptic treatments, such as the ketogenic diet. Especially, a reduction in ghrelin levels could be relevant in view of the growth retardation observed under ketogenic diet treatment. For this reason we aimed to determine the changes in ghrelin and des-acyl ghrelin plasma levels in children affected by refractory epilepsy and treated with the ketogenic diet up to 90 days. METHODS: Both peptides were measured by immunoassays in plasma obtained from 16 children. RESULTS: Ghrelin plasma levels were progressively reduced by the ketogenic diet, reaching a minimum corresponding to 42% of basal levels after 90 days of ketogenic diet (P < 0.05, Duncan's test). Des-acyl ghrelin plasma levels were similarly affected, reaching minimal levels at 30 days (65% of basal levels), and maintaining a significant reduction until 90 days after the onset of ketogenic diet (P < 0.01 for both time intervals). No significant changes in growth were observed during the monitored period of ketogenic diet administration. CONCLUSIONS: Ghrelin and des-acyl ghrelin are downregulated by the ketogenic diet in children affected by refractory epilepsy. Although no significant changes in growth were observed during the short time period of our investigation, the reduction in ghrelin availability may explain the reported growth retardation found in children treated with the ketogenic diet in the long-term.
BACKGROUND & AIMS: The gastric hormones ghrelin and des-acyl ghrelin have been found to be altered in patients treated with antiepileptic drugs. However, it is unknown if these hormones could be modified by other antiepileptic treatments, such as the ketogenic diet. Especially, a reduction in ghrelin levels could be relevant in view of the growth retardation observed under ketogenic diet treatment. For this reason we aimed to determine the changes in ghrelin and des-acyl ghrelin plasma levels in children affected by refractory epilepsy and treated with the ketogenic diet up to 90 days. METHODS: Both peptides were measured by immunoassays in plasma obtained from 16 children. RESULTS:Ghrelin plasma levels were progressively reduced by the ketogenic diet, reaching a minimum corresponding to 42% of basal levels after 90 days of ketogenic diet (P < 0.05, Duncan's test). Des-acyl ghrelin plasma levels were similarly affected, reaching minimal levels at 30 days (65% of basal levels), and maintaining a significant reduction until 90 days after the onset of ketogenic diet (P < 0.01 for both time intervals). No significant changes in growth were observed during the monitored period of ketogenic diet administration. CONCLUSIONS:Ghrelin and des-acyl ghrelin are downregulated by the ketogenic diet in children affected by refractory epilepsy. Although no significant changes in growth were observed during the short time period of our investigation, the reduction in ghrelin availability may explain the reported growth retardation found in children treated with the ketogenic diet in the long-term.
Authors: Maddalena Marchiò; Laura Roli; Chiara Lucchi; Anna Maria Costa; Matteo Borghi; Lorenzo Iughetti; Tommaso Trenti; Azzurra Guerra; Giuseppe Biagini Journal: Front Nutr Date: 2019-07-24
Authors: Csilla Ari; Cem Murdun; Craig Goldhagen; Andrew P Koutnik; Sahil R Bharwani; David M Diamond; Mark Kindy; Dominic P D'Agostino; Zsolt Kovacs Journal: Nutrients Date: 2020-08-15 Impact factor: 5.717