The Effect of the Ketogenic Diet on Adiponectin, Omentin and Vaspin in Children with Drug-Resistant Epilepsy.

BACKGROUND: Changes in adipokine secretion may be involved in the anti-epileptic effect of a ketogenic diet (KD) in drug-resistant epilepsy (DRE). OBJECTIVES: The assessment of the influence of KD on serum adiponectin, omentin-1, and vaspin in children with DRE. METHODS: Anthropometric measurements (weight, height, BMI, and waist-to-hip circumference ratio) were performed in 72 children aged 3-9 years, divided into 3 groups: 24 children with DRE treated with KD, 26-treated with valproic acid (VPA), and a control group of 22 children. Biochemical tests included fasting glucose, insulin, beta-hydroxybutyric acid, lipid profile, aminotransferases activities, and blood gasometry. Serum levels of adiponectin, omentin-1 and vaspin were assayed using commercially available ELISA tests. RESULTS: Serum levels of adiponectin and omentin-1 in the KD group were significantly higher and vaspin-lower in comparison to patients receiving VPA and the control group. In all examined children, serum adiponectin and omentin-1 correlated negatively with WHR and serum triglycerides, insulin, fasting glucose, and HOMA-IR. Vaspin levels correlated negatively with serum triglycerides and positively with body weight, BMI, fasting glucose, insulin, and HOMA-IR. CONCLUSION: One of the potential mechanisms of KD in children with drug-resistant epilepsy may be a modulation of metabolically beneficial and anti-inflammatory adipokine levels.

The effect of the ketogenic diet on leptin, chemerin and resistin levels in children with epilepsy.

OBJECTIVES: Recently, inflammation have been proposed as one of the mechanisms underlying the patology of drug-resistant epilepsy (DRE). Ketogenic diet (KD) is one of the therapeutic methods used in DRE. There are some data that adipokines may modulate inflammatory processes and their concentrations are influenced by KD. Therefore, the aim of this study was to evaluate the influence of KD on serum leptin, chemerin and resistin in children with DRE. DESIGN: A cross-sectional observational study performed on 72 subjects aged 3-9 years, divided into 3 groups: 24 children with DRE treated with KD, 26 treated with valproic acid (VPA), and a control group of 22 children. MATERIAL AND METHODS: Anthropometric measurements (weight, heigth, BMI, waist to hip circumerences ratio) were performed in all participants. Biochemical tests included serum fasting glucose, insulin, beta-hydroxybutyric acid, lipid profile, alanine aminotransferase and aspartate aminotransferase activities and blood gasometry. Serum levels of leptin, chemerin and resistin were assayed using commercially available ELISA tests. RESULTS: Serum levels of leptin and chemerin in the KD group were significantly lower and resistin - higher in comparison to patients receiving VPA and the control group. In children treated with the KD, leptin concentrations correlate with insulin levels and HOMA-IR scores. Chemerin levels in this group, in contrast, show negative correlation with body mass and height expressed as standard deviation scores from the mean for age and sex. CONCLUSIONS: Modification of pro-inflammatory adipocytokine levels is potentially one of the mechanisms of anticonvulsant effects of KD in children with refractory epilepsy.

Serum adiponectin levels in adolescents and young adults with growth hormone deficiency.

INTRODUCTION: Adiponectin (APN) is adipose tissue-derived hormone influencing energy metabolism. Growth hormone deficiency (GHD) may contribute to the development of disturbances in the hormonal function of adipose tissue (AT), and many disorders observed in untreated patients with GHD coincides with these contributed to low serum APN levels. OBJECTIVES: The assessment of serum adiponectin levels in adolescents and young adults with severe or partial GHD and analysis of relationships between serum APN and GH/IGF-1 axis function impairment as well as cardiometabolic risk factors. DESIGN AND SETTING: Based on the results of insulin tolerance test (ITT) patients were qualified for one of the following groups: 1) severe GHD - SGHD (26 patients; 8 women and 18 men); 2) partial GHD - PGHD (22 patients, 7 women and 15 men); 3) normal GH status - NGHS (28 patients, 9 women and 19 men). The fourth examined group consisted of healthy individuals - H (46 participants; 15 women, 31 men). Anthropometric measurements (height, weight, BMI), analysis of body composition and serum glucose, lipids, insulin, IGF-1 and APN assays were performed in all participants. RESULTS: There were no significant differences in the concentrations of APN between groups. After calculation of the total APN content in extracellular fluids per unit of fat tissue mass (TAPN/FM), these values were significantly lower in the SGHD (p<0.001) and correlated with the degree of impairment of the GH/IGF-1 axis functioning. In patients with GHD positive correlations between APN and serum HDL cholesterol (r=0.39, p<0.05) have been demonstrated. In the subjects with normal GH secretion serum APN correlated positively with serum HDL cholesterol (r=0.28; p<0.05), and negatively with fasting blood glucose (r=-0.31; p<0.05). CONCLUSIONS: Severe, but not partial growth hormone deficiency impairs adiponectin production in the adipose tissue that is compensated by the increase of fat mass. The degree of GH/IGF-1 axis disruption is related to the TAPN/FM. This parameter may be potentially useful in diagnosing severe growth hormone deficiency in the adults.

Serum alpha-klotho concentrations in girls with anorexia nervosa.

BACKGROUND: Soluble α-klotho may influence energy homeostasis. It also plays a role in calcium-phosphate and vitamin D3 metabolism regulation. Two so far published studies have demonstrated that serum α-klotho levels in patients with AN are decreased, but their relationships with BMI and metabolic disturbances in these patients remain unclear. OBJECTIVES: The aim of the study was to assess the association between serum soluble α-klotho levels and glucose, calcium-phosphorus and vitamin D3 metabolism in girls with acute AN. METHODS: Serum soluble α-klotho concentrations were evaluated using commercially available ELISA kit in 31 Polish girls with restrictive AN and 29 healthy controls (C). Moreover, anthropometric measurements (weight, height, BMI) and laboratory assays (serum fasting glucose, insulin, HOMA-IR, total calcium, phosphorus as well as 25-hydroxy vitamin D3 and calcitriol) were performed. RESULTS: The mean serum α-klotho concentrations in the AN group were significantly lower than in the C group even after adjustment for BMI. Significant correlations between serum α-klotho and body mass (r=0.54; p=0.009), BMI (r=0.48; p=0.02), serum calcitriol (r=0.48; p=0.03), insulin (r=0.49; p=0.008) and HOMA-IR (r=0.54; p=0.006) were observed in the AN, but not in healthy controls. CONCLUSIONS: Serum α-klotho concentrations in female adolescents with AN are decreased in comparison with normal weight girls and strongly associated with their nutritional status, insulin sensitivity and active vitamin D3 levels.