title: The impact of the ketogenic diet on arterial morphology and endothelial function in children and young adults with epilepsy: a case-control study.
abstract: OBJECTIVE
  The present study aimed to assess the impact of the ketogenic diet on arterial morphology and endothelial function of the big vessels of the neck and on cardiac diastolic function, in a cohort of epileptic children and young adults treated with the ketogenic diet.
  
  
  METHODS
  Patients were recruited based on the following inclusion criteria: (1) patients who were or had been on the ketogenic diet for a time period of at least six months. Each patient underwent measurement of carotid intima media thickness, carotid artery stiffness, echocardiography, and diastolic function assessment. Patients with drug resistant epilepsy, matched for number, age and sex and never treated with ketogenic diet, were recruited as controls.
  
  
  RESULTS
  The population study was composed by 43 epilepsy patients (23 males), aged between 19 months and 31 years (mean 11 years). Twenty-three patients were or had been treated with ketogenic diet, and 20 had never been on it (control group). Subjects treated with the ketogenic diet had higher arterial stiffness parameters, including AIx and β-index and higher serum levels of cholesterol or triglycerides compared to those who had never been on the diet (control group) (p<0.001).
  
  
  CONCLUSIONS
  Arterial stiffness is increased in children and young adults treated with the ketogenic diet, before the increase of the intima media thickness. This supports that arterial stiffness is an early marker of vascular damage.
authors.affiliation: Child and Adolescent Neuropsychiatry, Medical School, University of Salerno, Italy. Electronic address: gcoppola@unisa.it.
authors.forename: Giangennaro
authors.initials: G
authors.lastname: Coppola
authors.affiliation: Cardiology Department, Second University of Naples, Ospedale dei Colli, Naples, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Natale
authors.affiliation: Child and Adolescent Neuropsychiatry, Medical School, University of Salerno, Italy.
authors.forename: Annarita
authors.initials: A
authors.lastname: Torino
authors.affiliation: Department of Biochemistry & Biophysics "F. Cedrangolo", Second University of Naples, Italy.
authors.forename: Rosanna
authors.initials: R
authors.lastname: Capasso
authors.affiliation: Child and Adolescent Neuropsychiatry, Medical School, University of Salerno, Italy.
authors.forename: Alfredo
authors.initials: A
authors.lastname: D'Aniello
authors.affiliation: Child and Adolescent Neuropsychiatry, Medical School, University of Salerno, Italy.
authors.forename: Erica
authors.initials: E
authors.lastname: Pironti
authors.affiliation: Child and Adolescent Neuropsychiatry, Medical School, University of Salerno, Italy.
authors.forename: Elena
authors.initials: E
authors.lastname: Santoro
authors.affiliation: Cardiology Department, Second University of Naples, Ospedale dei Colli, Naples, Italy.
authors.forename: Raffaele
authors.initials: R
authors.lastname: Calabrò
authors.affiliation: Alberto Verrotti, Department of Pediatrics, University of Perugia, Italy.
authors.forename: Alberto
authors.initials: A
authors.lastname: Verrotti
mesh_terms: D000293:Adolescent; D000328:Adult; D000927:Anticonvulsants / Q000627:therapeutic use; D001794:Blood Pressure / Q000187:drug effects / Q000502:physiology*; D002339:Carotid Arteries / Q000000981:diagnostic imaging* / Q000187:drug effects; D059168:Carotid Intima-Media Thickness; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D002784:Cholesterol / Q000097:blood; D015331:Cohort Studies; D055423:Diet, Ketogenic / Q000009:adverse effects*; D004452:Echocardiography; D004827:Epilepsy / Q000178:diet therapy* / Q000188:drug therapy / Q000473:pathology; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D014280:Triglycerides / Q000097:blood; D017539:Tunica Intima / Q000187:drug effects / Q000473:pathology*; D059289:Vascular Stiffness / Q000502:physiology; D055815:Young Adult
chemical_list: D000927:Anticonvulsants; D014280:Triglycerides; D002784:Cholesterol
keywords: Arterial morphology; Carotid artery stiffness; Endothelial function; Ketogenic diet