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An examination of biochemical parameters and their association with response to ketogenic dietary therapies.

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Title: An examination of biochemical parameters and their association with response to ketogenic dietary therapies.
Authors: Schoeler, Natasha E., Bell, Gail, Yuen, Alan, Kapelner, Adam D., Heales, Simon J. R., Cross, J. Helen, Sisodiya, Sanjay
Source: Epilepsia (Series 4). May2017, Vol. 58 Issue 5, p893-900. 8p.
Subjects: Ketogenic diet, Treatment of epilepsy, Acetoacetic acid, Energy metabolism, 3-Hydroxybutyric acid
Abstract: Objective In the absence of specific metabolic disorders, accurate predictors of response to ketogenic dietary therapies ( KDTs) for treating epilepsy are largely unknown. We hypothesized that specific biochemical parameters would be associated with the effectiveness of KDT in humans with epilepsy. The parameters tested were β-hydroxybutyrate, acetoacetate, nonesterified fatty acids, free and acylcarnitine profile, glucose, and glucose-ketone index ( GKI). Methods Biochemical results from routine blood tests conducted at baseline prior to initiation of KDT and at 3-month follow-up were obtained from 13 adults and 215 children with KDT response data from participating centers. One hundred thirty-two (57%) of 228 participants had some data at both baseline and 3 months; 52 (23%) of 228 had data only at baseline; 22 (10%) of 228 had data only at 3 months; and 22 (10%) of 228 had no data. KDT response was defined as ≥50% seizure reduction at 3-month follow-up. Results Acetyl carnitine at baseline was significantly higher in responders (p < 0.007). It was not associated with response at 3-month follow-up. There was a trend for higher levels of free carnitine and other acylcarnitine esters at baseline and at 3-month follow-up in KDT responders. There was also a trend for greater differences in levels of propionyl carnitine and in β-hydroxybutyrate measured at baseline and 3-month follow-up in KDT responders. No other biochemical parameters were associated with response at any time point. Significance Our finding that certain carnitine fractions, in particular baseline acetyl carnitine, are positively associated with greater efficacy of KDT is consistent with the theory that alterations in energy metabolism may play a role in the mechanisms of action of KDT. [ABSTRACT FROM AUTHOR]
Copyright of Epilepsia (Series 4) is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
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  Data: An examination of biochemical parameters and their association with response to ketogenic dietary therapies.
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  Data: &lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Schoeler%2C+Natasha+E%2E%22&quot;&gt;Schoeler, Natasha E.&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Bell%2C+Gail%22&quot;&gt;Bell, Gail&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Yuen%2C+Alan%22&quot;&gt;Yuen, Alan&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Kapelner%2C+Adam+D%2E%22&quot;&gt;Kapelner, Adam D.&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Heales%2C+Simon+J%2E+R%2E%22&quot;&gt;Heales, Simon J. R.&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Cross%2C+J%2E+Helen%22&quot;&gt;Cross, J. Helen&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;AR&quot; term=&quot;%22Sisodiya%2C+Sanjay%22&quot;&gt;Sisodiya, Sanjay&lt;/searchLink&gt;
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  Data: &lt;searchLink fieldCode=&quot;JN&quot; term=&quot;%22Epilepsia+%28Series+4%29%22&quot;&gt;Epilepsia (Series 4)&lt;/searchLink&gt;. May2017, Vol. 58 Issue 5, p893-900. 8p.
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  Data: &lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Ketogenic+diet%22&quot;&gt;Ketogenic diet&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Treatment+of+epilepsy%22&quot;&gt;Treatment of epilepsy&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Acetoacetic+acid%22&quot;&gt;Acetoacetic acid&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%22Energy+metabolism%22&quot;&gt;Energy metabolism&lt;/searchLink&gt;&lt;br /&gt;&lt;searchLink fieldCode=&quot;DE&quot; term=&quot;%223-Hydroxybutyric+acid%22&quot;&gt;3-Hydroxybutyric acid&lt;/searchLink&gt;
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  Data: Objective In the absence of specific metabolic disorders, accurate predictors of response to ketogenic dietary therapies ( KDTs) for treating epilepsy are largely unknown. We hypothesized that specific biochemical parameters would be associated with the effectiveness of KDT in humans with epilepsy. The parameters tested were β-hydroxybutyrate, acetoacetate, nonesterified fatty acids, free and acylcarnitine profile, glucose, and glucose-ketone index ( GKI). Methods Biochemical results from routine blood tests conducted at baseline prior to initiation of KDT and at 3-month follow-up were obtained from 13 adults and 215 children with KDT response data from participating centers. One hundred thirty-two (57%) of 228 participants had some data at both baseline and 3 months; 52 (23%) of 228 had data only at baseline; 22 (10%) of 228 had data only at 3 months; and 22 (10%) of 228 had no data. KDT response was defined as ≥50% seizure reduction at 3-month follow-up. Results Acetyl carnitine at baseline was significantly higher in responders (p &lt; 0.007). It was not associated with response at 3-month follow-up. There was a trend for higher levels of free carnitine and other acylcarnitine esters at baseline and at 3-month follow-up in KDT responders. There was also a trend for greater differences in levels of propionyl carnitine and in β-hydroxybutyrate measured at baseline and 3-month follow-up in KDT responders. No other biochemical parameters were associated with response at any time point. Significance Our finding that certain carnitine fractions, in particular baseline acetyl carnitine, are positively associated with greater efficacy of KDT is consistent with the theory that alterations in energy metabolism may play a role in the mechanisms of action of KDT. [ABSTRACT FROM AUTHOR]
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  Data: &lt;i&gt;Copyright of Epilepsia (Series 4) is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites without the copyright holder&#39;s express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.&lt;/i&gt; (Copyright applies to all Abstracts.)
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RecordInfo BibRecord:
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      – Type: doi
        Value: 10.1111/epi.13729
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      – Code: eng
        Text: English
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        PageCount: 8
        StartPage: 893
    Subjects:
      – SubjectFull: Ketogenic diet
        Type: general
      – SubjectFull: Treatment of epilepsy
        Type: general
      – SubjectFull: Acetoacetic acid
        Type: general
      – SubjectFull: Energy metabolism
        Type: general
      – SubjectFull: 3-Hydroxybutyric acid
        Type: general
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      – TitleFull: An examination of biochemical parameters and their association with response to ketogenic dietary therapies.
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              Text: May2017
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