• Clinical and Experimental Pediatrics
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• 제46권11호
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• pp.1131-1134
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• 2003

저자들은 영아성 경축 환아에서 케톤생성 식이요법 중 단백열량부족증(Kwashiorkor)을 포함한 중증의 탈수, 급성신부전과 흡인성 폐렴을 동반한 영아성 경축 1례를 경험하여 문헌 고찰과 함께 보고하여 케톤생성 식이요법시 참고를 하고자 한다.

• Clinical and Experimental Pediatrics
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• 제55권9호
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• pp.316-321
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• 2012

The ketogenic diet has been widely used and proved to be effective for intractable epilepsy. Although the mechanisms underlying its antiepileptic effects remain to be proven, there are increasing experimental evidences for its neuroprotective effects along with many researches about expanding use of the diet in other neurologic disorders. The first success was reported in glucose transporter type 1 deficiency syndrome, in which the diet served as an alternative metabolic source. Many neurologic disorders share some of the common pathologic mechanisms such as mitochondrial dysfunction, altered neurotransmitter function and synaptic transmission, or abnormal regulation of reactive oxygen species, and the role of the ketogenic diet has been postulated in these mechanisms. In this article, we introduce an overview about the expanding use and emerging trials of the ketogenic diet in various neurologic disorders excluding intractable epilepsy and provide explanations of the mechanisms in that usage.

• Clinical and Experimental Pediatrics
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• 제48권2호
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• pp.204-207
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• 2005

저자들은 최근 난치성 간질 환자에서 많이 시도되고 있는 케톤 식이요법의 합병증으로 발생한 신장 결석 2례를 경험하여 문헌고찰과 함께 보고하는 바이다.

• Korean Journal of Acupuncture
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• 제36권4호
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• pp.274-280
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• 2019

Objectives : This preliminary study investigated the effect of acupuncture treatment on short-term ketogenic diet-induced weight loss and glucose intolerance in mice. Methods : Six-week old male C57BL/6J mice were randomly assigned to 3 groups: normal, KD, and KD+ACU. All the mice except normal group were fed with ketogenic diet formula for 7 weeks and mice in KD+ACU group received acupuncture treatment three times a week. Body weights were measured three times a week, and glucose level was measured on week 1,3,5, and 7. Ketone level was measured on week 3,5, and 7. Results : Ketogenic diet showed short-term weight loss effect, however, acupuncture treatment did not affect on the weight loss. Ketone level was increased in KD fed mice compared to normal diet fed mice and the level was decreased in KD+ACU group on week 3. However, the change was not significantly different compared to KD group on week 7. Glucose intolerance was improved in KD+ACU group compared to KD group. Conclusions : Acupuncture treatment was effective in relieving glucose intolerance, and the results suggest that combining acupuncture treatment with ketogenic diet may complement each therapeutic intervention by improving glucose intolerance but not effecting on weight loss. This study provides meaningful evidence as a preliminary study of acupuncture treatment on ketogenic diet.

• Asian Pacific Journal of Cancer Prevention
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• 제16권5호
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• pp.2061-2068
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• 2015

Background: Tumors are largely unable to metabolize ketone bodies for energy due to various deficiencies in one or both of the key mitochondrial enzymes, which may provide a rationale for therapeutic strategies that inhibit tumor growth by administration of a ketogenic diet with average protein but low in carbohydrates and high in fat. Materials and Methods: Thirty-six male BALB/C nude mice were injected subcutaneously with tumor cells of the colon cancer cell line HCT116. The animals were then randomly split into three feeding groups and fed either a ketogenic diet rich in omega-3 fatty acids and MCT (MKD group; n=12) or lard only (LKD group; n=12) or a standard diet (SD group; n=12) ad libitum. Experiments were ended upon attainment of the target tumor volume of $600mm^3$ to $700mm^3$. The three diets were compared for tumor growth and survival time (interval between tumor cell injection and attainment of target tumor volume). Results: The tumor growth in the MKD and LKD groups was significantly delayed compared to that in the SD group. Conclusions: Application of an unrestricted ketogenic diet delayed tumor growth in a mouse xenograft model. Further studies are needed to address the mechanism of this diet intervention and the impact on other tumor-relevant parameters such as invasion and metastasis.

• Journal of Nutrition and Health
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• 제56권4호
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• pp.349-360
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• 2023

Purpose: Ketogenic diets (KDs) have anti-obesity effects that may be related to glucose control and the gut microbiota. This paper hypothesizes that KD reduces body weight and changes the insulin sensitivity and gut microbiota composition in a mouse model of diet-induced obesity. Methods: In this study, C57BL/6 male mice were assigned randomly to 3 groups. The assigned diets were provided to the control and high-fat (HF) diet groups for 14 weeks. The KD group was given a HF diet for 8 weeks to induce obesity, followed by feeding the KD for the next 6 weeks. Results: After the treatment period, the KD group exhibited a 35.82% decrease in body weight gain compared to the HF group. In addition, the KD group demonstrated enhanced glucose control, as shown by the lower levels of serum fasting glucose, serum fasting insulin, and the homeostatic model assessment of insulin resistance, compared to the HF group. An analysis of the gut microbiota using 16S ribosomal RNA sequencing revealed a significant decrease in the proportion of Firmicutes when the KD was administered. In addition, feeding the KD reduced the overall alpha-diversity measures and caused a notable separation of microbial composition compared to the HF diet group. The KD also led to a decrease in the relative abundance of specific species, such as Acetatifactor_muris, Ligilactobacillus_apodemi, and Muribaculum_intestinale, compared with the HF group. These species were positively correlated with the body weight, whereas the abundant species in the KD group (Kineothrix_alysoides and Saccharofermentans_acetigenes) showed a negative correlation with body weight. Conclusion: The current study presents supporting evidence that KD reduced the body weight and altered the insulin sensitivity and gut microbiota composition in a mouse model of diet-induced obesity.

• Childhood Kidney Diseases
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• 제23권1호
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• pp.48-52
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• 2019

The ketogenic diet (KD) has been used as an effective antiepileptic therapy for intractable childhood epilepsy. However, various adverse effects have been reported with use of the KD. We report a case of a child who developed acute tubular necrosis subsequent to therapy with KD. A 5-year-old girl had myoclonic epilepsy with developmental delay. She was under the treatment with antiepileptic drugs since the age of 3 months and on the KD during the past 18 months. Proteinuria persisted intermittently with the initiation of the KD and subsequently increased in the past 2 months. She was admitted with intermittent mild fever, vomiting, and lethargy for the past 3-4 weeks. At the time of admission, she presented with hypertriglyceridemia, heavy proteinuria, renal Fanconi syndrome, and acute kidney injury. Renal sonography showed a marked increase in the size and parenchymal echogenicity of both kidneys. A renal biopsy revealed acute tubular necrosis accompanied by early interstitial fibrosis. After the withdrawal of the KD and supportive therapy, without changing other anticonvulsants and their dosages, improvement of renal function was observed. Proteinuria had disappeared after 1 month and kidney size returned to normal after 8 months. It is hypothesized that the KD can induce and/or aggravate the renal tubulointerstitial injury in some patients who are under the treatment with anticonvulsants.

• Journal of Genetic Medicine
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• 제18권2호
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• pp.137-141
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• 2021

Genetic causes of developmental and epileptic encephalopathy (DEE) have been rapidly uncovered from mid-2010s. The mutations of gene enconding calcium channel, voltage-dependent, P/Q type, alpha 1A subunit (CACNA1A) are recently detected in DEE, which gene is already known well in familial hemiplegic migrine type 1 or episodic ataxia type 2. Ketogenic diet therapy (KDT) is effective in some DEE, which data is short in CACNA1A encephalopathy. A 3-month-old male with global developmental delay and multidrug-resistant focal seizures was diagnosed as epilepsy of infancy with migrating focal seizures (EIMFS). Brain magnetic resonance imaging and metabolic screening were all normal. Whole exome sequencing revealed two variants of CACNA1A: c.899A>C, and c.2808del that is from his mother. His seizures disappeared within 3 days whenever on KDT, which recurred without it. To our knowledge, this rare case of EIMFS with novel mutations of CACNA1A, is the first report in CACNA1A encephalopathy becoming seizure-free on KDT.

• Clinical and Experimental Pediatrics
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• 제56권8호
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• pp.327-331
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• 2013

The ketogenic diet (KD) is an established, effective, nonpharmacologic treatment for children with pharmacoresistant epilepsy. Although the KD is the most well-established dietary therapy for epilepsy, it is too restrictive and is associated with serious complications; therefore, alternative lower-fat diets, including a modified Atkins diet and low-glycemic index diet, have been developed. Recent ongoing clinical evidence suggests that other dietary therapies have an efficacy almost comparable to that of the KD. In addition, a diet rich in polyunsaturated fatty acids appears to increase the efficacy of diet therapy and reduce the complications of a high-fat diet. Here, we review the systematic information about lower-fat diets and better-quality dietary therapies and the current clinical status of each of these dietary approaches.

• Clinical and Experimental Pediatrics
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• 제49권2호
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• pp.187-191
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• 2006

목 적 : MCD는 항경련제에 반응하지 않는 난치성 간질의 중요한 원인으로 수술적 치료의 대상으로 고려되어지지만, 병변의 범위나 분포에 따라 제한적이고 치료효과에 있어서도 차이가 보고되고 있다. 케톤생성 식이요법은 최근까지 대부분의 연구들에서 뛰어난 간질 억제효과를 보고하고 있으나, MCD 병변을 보이는 난치성 간질을 대상으로 시행한 케톤생성 식이요법의 치료 효과에 대한 보고는 국내외적으로 지금까지 없는 상태로, 본 연구에서는 이 환자군들에 대해 간질 수술보다 덜 침습적인 치료법인 케톤생성 식이요법의 간질 억제효과를 알아보고자 하였다. 방 법 : 1998년 이후 난치성 간질로 케톤생성 식이요법을 시행하였던 소아 환아들 중 뇌 MRI상 MCD 소견을 보이는 30명을 대상으로 후향적 의무기록 고찰과 분석을 시행하였으며, 케톤 생성 식이요법 시행 후 경련의 감소효과를 분석하였다. 결 과 : 전체 대상 30명 환아들의 남녀비는 1 : 1.1이었고, 경련을 처음 시작한 연령은 평균 $2.0{\pm}2.9$세, 케톤생성 식이요법을 시작한 평균 연령은 $5.4{\pm}4.6$세, 케톤생성 식이요법을 시작할 때까지의 경련 지속기간은 평균 $3.5{\pm}3.3$년, 환아들의 추적 관찰기간은 평균 $29.0{\pm}21.0$개월이었다. MCD의 종류는 대뇌 피질 이형성증(cortical dysplasia)이 24명(80.0%)으로 가장 많았고, MCD의 분포는 일측 대뇌 반구에만 있는 경우가 23명(76.7%), 양측 대뇌 반구 모두에 병변이 있는 경우가 7명(23.3%)이었다. 케톤생성 식이요법에 의한 경련의 감소 정도는 전체 30명의 환아 중 9명(30.0%)에서 경련이 완전히 소실되었으며, 50% 이상 경련이 감소된 경우는 14명(46.7%)이었는데, 경련을 처음 시작한 연령이나 케톤생성 식이요법을 시작할 때까지의 경련 지속기간은 경련의 감소효과와 통계학적 유의성이 없었고, 케톤생성 식이요법을 시작한 나이가 어릴수록, 케톤생성 식이요법의 기간이 길수록 경련의 감소효과가 높은 경향을 나타내었으나 통계적 유의성은 없었으며, MCD의 분포에 따른 특별한 연관관계는 없었다. 결 론 : 케톤생성 식이요법이 MCD 소견을 동반하고 있어 수술적 치료가 고려되어지는 난치성 소아 간질 환아에서도 간질 수술의 여러 가지 제한적인 측면과 침습성을 고려해 볼 때 효과적인 치료 결과를 기대할 수 있을 것으로 판단되며, 아직까지 국내외적으로 MCD를 동반한 난치성 소아 간질 환아에 대한 케톤생성 식이요법의 효과에 대한 자료가 미미한 상태이므로 전향적인 대규모의 비교 연구 및 분석이 필요할 것으로 사료된다.