Effect of classic ketogenic diet treatment on lipoprotein subfractions in children and adolescents with refractory epilepsy

Author(s)

de Lima, Patricia Azevedo ; Prudencio, Mariana Baldini ; Murakami, Daniela Kawamoto ; de Brito Sampaio, Leticia Pereira ; Figueiredo Neto, Antonio Martins ; Teixeira Damasceno, Nagila Raquel

• Document type: Journal article
• Source: NUTRITION; v. 33, p. 271-277, JAN 2017.
• Web of Science Citations: 4

Abstract

Objective: The aim of this study was to evaluate the effects of the classic ketogenic diet (KD) on low density lipoprotein (LDL) and high-density lipoprotein (HDL) subfractions in children and adolescents with refractory epilepsy. Methods: This prospective study recruited children and adolescents of either sex, whose epilepsy was refractory to treatment with multiple drugs. To be included, the patient had to have an indication for treatment with the KD and be treated as an outpatient. At baseline and after 3 and 6 mo of the KD, lipid profile (total cholesterol {[}TC], triacylglycerols {[}TG], LDL cholesterol {[}LDL-C], and HDL cholesterol {[}HDL-C]), apolipoproteins (apoA-I and apoB), 10 subfractions of HDL, 7 sub-fractions of LDL, LDL phenotype, and LDL size were analyzed using the Lipoprint system. Results: The lipid profile components (TC, TG, LDL-C, HDL-C, apoA-I, and apoB) increased during the 3-mo follow-up, and remained consistent after 6 mo of treatment. Similarly, non-HDL-C, TC/HDL-C, LDL-C/HDL-C, and apoB/apoA-I ratios, representing atherogenic particles, significantly increased. In contrast, qualitative lipoprotein characteristics progressively changed during the follow-up period. Small LDL subfractions increased, and this profile was related with reduced LDL size (27.3 nm to 26.7 nm). The LDL phenotype became worse; 52.1% of the patients had a non-A phenotype after 6 mo of the KD. Small HDL subfractions decreased only after 6 mo of the KD. Conclusions: KD treatment promotes negative changes in lipoprotein size and phenotype, contributing to atherogenic risk in these patients. (C) 2016 Elsevier Inc. All rights reserved. (AU)

• FAPESP's process: 12/03775-0 - Impact of a ketogenic diet in the oxidative characteristics, physical and lipid lipoproteins of children with intractable epilepsy
• Grantee: Patricia Azevedo de Lima
• Support Opportunities: Scholarships in Brazil - Master
• FAPESP's process: 11/13616-4 - Optical and structural properties of elastomers and complex fluids of biological interest
• Grantee: Antonio Martins Figueiredo Neto
• Support Opportunities: Research Projects - Thematic Grants
• FAPESP's process: 14/26094-4 - Diet classic and modified ketogenic: evaluation of the therapeutic potential and impact on the oxidative, lipidomic profile, inflammatory and lipoproteins size in children and adolescents with refractory epilepsy
• Grantee: Patricia Azevedo de Lima
• Support Opportunities: Scholarships in Brazil - Doctorate
• FAPESP's process: 12/20789-5 - Study of inadequate intake of macro and micronutrients in children and adolescents in the dietary treatment for refractory epilepsy
• Grantee: Mariana Baldini Prudencio
• Support Opportunities: Scholarships in Brazil - Scientific Initiation