Effect of a high-fat ketogenic diet on plasma levels of lipids, lipoproteins, and apolipoproteins in children
Effect of a high-fat ketogenic diet on plasma levels of lipids, lipoproteins, and apolipoproteins in children
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DOI：
10.1001/jama.290.7.912
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发表时间：
2003-08-20
影响因子：
120.7
通讯作者：
Freeman, JM
中科院分区：
文献类型：
--
作者：
Kwiterovich, PO;Vining, EPG;Freeman, JM
目的探讨生酮饮食对难治性癫痫患儿血浆主要载脂蛋白B（apoB）、低密度脂蛋白（LDL）和极低密度脂蛋白（VLDL）水平的影响;和主要的载脂蛋白A-I（apoA-I）-脂蛋白，高密度脂蛋白（HDL）。设计，设置和患者一项为期6个月的前瞻性队列研究，纳入141名儿童（平均[SD]年龄，70名男孩为5.2 [3.8]岁，71名女孩为6.1 [4.4]岁），患有难以治疗的癫痫发作，住院开始高脂肪生酮饮食，并作为门诊患者进行随访。该队列由1994年至2001年期间接受生酮饮食计划的371例患者组成。在12个月（n = 59）和24个月（n = 27）后还研究了该队列的一个子集。干预由高比例的脂肪、碳水化合物和蛋白质组合（4：1 [n = 102]、3.5：1 [n = 7]或3：1 [n = 32]）组成的生酮饮食。饮食开始后，调整热量和比例，以保持理想的体重身高和最大尿酮症癫痫控制。主要结果测量基线和6个月随访时总胆固醇，VLDL，LDL，HDL和非HDL胆固醇水平的差异;甘油三酯;总apoB;和apoA-I。结果6个月时，高脂生酮饮食显著增加了总胆固醇（58 mg/dL [1.50 mmol/L]）、LDL（50 mg/dL [1.30 mmol/L]）、VLDL（8 mg/dL [0.21 mmol/L]）和非HDL胆固醇（63 mg/dL [1.63 mmol/L]）的平均血浆水平（P
Context Little prospective long-term information is available on the effect of a ketogenic diet on plasma lipoproteins in children with difficult-to-control seizures.Objective To determine the effect in children with intractable seizures of a high-fat ketogenic diet on plasma levels of the major apolipoprotein B (apoB)-containing lipoproteins, low-density lipoprotein (LDL) and very LDL (VLDL); and the major apolipoprotein A-I (apoA-I)-containing lipoprotein, high-density lipoprotein (HDL).Design, Setting, and Patients A 6-month prospective cohort study of 141 children (mean [SD] age, 5.2 [3.8] years for 70 boys and 6.1 [4.4] years for 71 girls) with difficult-to-treat seizures who were hospitalized for initiation of a high-fat ketogenic diet and followed up as outpatients. This cohort constituted a subgroup of the 371 patients accepted into the ketogenic diet program between 1994 and 2001. A subset of the cohort was also studied after 12 (n = 59) and 24 (n = 27) months.Intervention A ketogenic diet consisting of a high ratio of fat to carbohydrate and protein combined (4:1 [n = 102], 3.5:1 [n = 7], or 3:1 [n = 32]). After diet initiation, the calories and ratio were adjusted to maintain ideal body weight for height and maximal urinary ketosis for seizure control.Main Outcome Measures Differences at baseline and 6-month follow-up for levels of total, VLDL, LDL, HDL, and non-HDL cholesterol; triglycerides; total apoB; and apoA-I.,Results At 6 months, the high-fat ketogenic diet significantly increased the mean plasma levels of total (58 mg/dL [1.50 mmol/L]), LDL (50 mg/dL (1.30 mmol/L]), VLDL (8 mg/dL [0.21 mmol/L]), and non-HDL cholesterol (63 mg/dL [1.63 mmol/L]) (P