title: Serum levels of interleukin-6 and dehydroepiandrosterone sulphate in response to either fasting or a ketogenic diet in rheumatoid arthritis patients.
abstract: OBJECTIVE
  To investigate the effects of either a 7-day fast or a 7-day ketogenic diet upon serum interleukin-6 (IL-6) and dehydroepiandrosterone sulphate (DHEAS) in RA patients.
  
  
  METHODS
  We measured serum concentrations of DHEAS and IL-6 in 23 RA patients with active disease, 10 of whom followed a 7-day sub-total fast and 13 of whom consumed a ketogenic diet (isoenergetic, carbohydrate < 40 g/day) for 7 days. Clinical and laboratory variables were measured at baseline, on day 7 and after re-feeding on day 21. Correlation analyses were used to assess the associations between serum IL-6, DHEAS and disease activity variables at each timepoint.
  
  
  RESULTS
  Fasting, but not the ketogenic diet, decreased serum IL-6 concentrations by 37% (p < 0.03) and improved disease activity at day 7. Both fasting and the ketogenic diet increased serum DHEAS levels by 34% as compared with baseline (both p < 0.006). Levels of IL-6, but not DHEAS, correlated with several disease activity variables.
  
  
  CONCLUSIONS
  Both fasting and a ketogenic diet significantly increased serum DHEAS concentrations in RA patients. Only fasting significantly decreased serum IL-6 levels and improved disease activity. As the increases in serum DHEAS were similar in response to both fasting and a ketogenic diet, it is unlikely that the fall in serum IL-6 or clinical improvements after fasting were directly related to increases in serum DHEAS. The fasting-induced fall in serum IL-6 may underlie the fall in CRP and ESR observed in RA patients in response to a 7-day fast.
authors.affiliation: Centre for Rheumatic Diseases, National Hospital, Oslo, Norway. david.fraser@klinmed.uio.no
authors.forename: D A
authors.initials: DA
authors.lastname: Fraser
authors.forename: J
authors.initials: J
authors.lastname: Thoen
authors.forename: O
authors.initials: O
authors.lastname: Djøseland
authors.forename: O
authors.initials: O
authors.lastname: Førre
authors.forename: J
authors.initials: J
authors.lastname: Kjeldsen-Kragh
mesh_terms: D000328:Adult; D000368:Aged; D001172:Arthritis, Rheumatoid / Q000097:blood* / Q000178:diet therapy* / Q000276:immunology; D001799:Blood Sedimentation; D002097:C-Reactive Protein / Q000378:metabolism; D019314:Dehydroepiandrosterone Sulfate / Q000097:blood*; D004041:Dietary Fats / Q000008:administration & dosage*; D005215:Fasting / Q000502:physiology*; D005260:Female; D006801:Humans; D015850:Interleukin-6 / Q000097:blood*; D007662:Ketosis / Q000097:blood; D008297:Male; D008875:Middle Aged
chemical_list: D004041:Dietary Fats; D015850:Interleukin-6; D019314:Dehydroepiandrosterone Sulfate; D002097:C-Reactive Protein