Exploring physiological beta-hydroxybutyrate level in children treated with the classical ketogenic diet for drug-resistant epilepsy  

作　　者：Xiaoying Qiao Zimeng Ye Jialun Wen Sufang Lin Dezhi Cao Li Chen Dongfang Zou Huafang Zou Man Zhang Zhibin Chen Patrick Kwan Ingrid E.Scheffer Jiong Qin Jianxiang Liao 

机构地区：[1]Department of Neurology,Shenzhen Children’s Hospital,Shenzhen 518038,Guangdong,China [2]Department of Medicine(Austin Hospital),University of Melbourne,Melbourne,Victoria 3084,Australia [3]Department of Neurosciences,Central Clinical School,Alfred Hospital,Monash University,Melbourne,Victoria 3004,Australia [4]Department of Medicine,Royal Melbourne Hospital,The University of Melbourne,Parkville,Victoria 3050,Australia [5]School of Public Health and Preventive Medicine,Monash University,Melbourne,Victoria 3004,Australia [6]Murdoch Children’s Research Institute,Melbourne,VIC 3052,Australia [7]Department of Pediatrics,University of Melbourne,Royal Children’s Hospital,Melbourne,Victoria 3010,Australia [8]Department of Neurology,Royal Children’s Hospital,Melbourne,Victoria 3052,Australia [9]Department of Pediatrics,Peking University People’s Hospital,Beijing 100000,China [10]Department of Pediatrics,Peking University First Hospital,Beijing 100034,China

出　　处：《Acta Epileptologica》2025年第1期86-93,共8页癫痫学报(英文)

基　　金：supported by the Sanming Project of Medicine in Shenzhen(No.SZSM201812005,SZSM202311028);the Shenzhen Key Medical Discipline Construction Fund(No.SZXK033);the Shenzhen Fund for Guangdong Provincial Highlevel Clinical Key Specialties(No.SZGSP012);the Shenzhen Fund(No.JCYJ20200109150818777);Basic Applied Basic Research Fund Committee of Guangdong Province(2020A1515110612);Shenzhen KCXFZ20211020163549011;Guangdong High level Hospital Construction Fund.

摘　　要：Background The ketogenic diet(KD)therapy is a primary treatment for drug-resistant epilepsy,and beta-hydroxybutyrate(BHB)is the main ketone produced during KD.However,the pattern of increase in BHB levels is not well understood,and the reference range for BHB need to be defined.The aim of this study was to evaluate the BHB levels in the first three months,especially one week,after KD initiation,and to explore the physiological reference range for BHB.Methods In our study,a fasting initiation strategy was used for the majority of patients(252/300,84%)who underwent fasting for 24–48 h,the rest fasted for at least 12 h.The concentration of blood BHB was measured four times a day during the first week,at one month and three months.Seizure frequency was recorded at one week,one month and three months.Responders were defined as those with a seizure reduction 50%or more compared to baseline.BHB levels were compared between responders and non-responders.The BHB levels of responders were used to calculate the reference range.Results A total of 300 patients were recruited,of whom 172(57%)had accessible BHB data.BHB levels rapidly rose to 2.0 mmol/L at 19 h,peaked at 4.2 mmol/L at 43 h of therapy,and stabilized by three months.The reference range for BHB was 1.1 to 4.9 mmol/L.Conclusions BHB levels increased rapidly following fasting,reaching the peak at day 2,stabilizing from the end of the first week through three months.The lower reference limit for BHB to ensure KD efficacy should be set at 1.1 mmol/L.

关 键 词：Ketogenic diet BETA-HYDROXYBUTYRATE Reference range CHILDREN EPILEPSY 

分 类 号：R74[医药卫生—神经病学与精神病学]