The ketogenic diet:: Seizure control correlates better with serum β-hydroxybutyrate than with urine ketones
The ketogenic diet:: Seizure control correlates better with serum β-hydroxybutyrate than with urine ketones
复制标题
DOI：
10.1177/088307380001501203
复制
发表时间：
2000-12-01
影响因子：
1.9
通讯作者：
Freeman, JM
中科院分区：
文献类型：
--
作者：
Gilbert, DL;Pyzik, PL;Freeman, JM
本研究的目的是确定β-羟基丁酸水平与生酮饮食儿童癫痫控制之间的关系。74名接受生酮饮食的儿童接受常规随访，其血液中β-羟基丁酸盐水平与癫痫控制相关。42名入院开始生酮饮食的儿童通过试纸测量尿酮，并与β-羟基丁酸盐的同时血液水平相关。血β-羟丁酸水平与癫痫控制有统计学相关性（P =.003）.血β-羟丁酸水平大于4 mmol/L的儿童比血β-羟丁酸水平小于4 mmol/L的儿童更容易出现癫痫发作频率降低。当血液β-羟基丁酸水平超过2 mmol/L时，试纸上发现尿酮为4+（160 mmol/L）。癫痫控制与血液β-羟基丁酸水平相关，当血液β-羟基丁酸水平大于4 mmol/L时更有可能。在生酮饮食的儿童中通过试纸测量尿酮的传统方法提供了对血酮症程度的不太理想的评估。三到四加（80-160 mmol/L）尿酮是必要的，但不一定足够，以实现最佳的癫痫控制儿童生酮饮食。然而，目前，尿酮是唯一容易获得的廉价的方法来评估酮。
The objective of this study was to determine the relationship between beta -hydroxybutyrate levels and seizure control in children on the ketogenic diet. Seventy-four children on the ketogenic diet presenting for routine follow-up visits had blood levels of beta -hydroxybutyrate correlated with their seizure control. Forty-two children admitted for initiation of the ketogenic diet had urine ketones measured by dipstick and correlated with simultaneous blood levels of beta -hydroxybutyrate. Blood beta -hydroxybutyrate levels statistically correlated with seizure control (P =.003). Children with blood beta -hydroxybutyrate levels greater than 4 mmol/L were significantly more likely to have a decrease in seizure frequency than those with levels less than 4 mmol/L. Urine ketones of 4+ (160 mmol/L) were found on dipstick when blood beta -hydroxybutyrate levels exceeded 2 mmol/L. Seizure control correlates with blood beta -hydroxybutyrate levels and is more likely when blood beta -hydroxybutyrate levels are greater than 4 mmol/L. The traditional measurement of urine ketones by dipsticks in children on the ketogenic diet provides a less than optimal assessment of the degree of blood ketosis. Three to four plus (80-160 mmol/L) urine ketones are necessary, but not necessarily sufficient, to achieve optimal seizure control in children on the ketogenic diet. At present, however, urine ketones are the only readily available inexpensive approach to ketone assessment.