title: A prospective study on changes in blood levels of cholecystokinin-8 and leptin in patients with refractory epilepsy treated with the ketogenic diet.
abstract: To evaluate the changes in serum CCK-8 and leptin levels in patients with refractory epilepsy treated with the ketogenic diet (KD).
  
  
  
  In this prospective study, patients aged between one and 40 years with refractory epilepsy were included. CCK-8 and leptin were measured in serum at baseline and after three and 12 months of treatment with the KD using an enzyme-linked Immunoabsorbant Assay. Seizure frequency and responsiveness were calculated.
  
  
  
  Fifty-four patients were included; 26 patients (48%) were still on the KD at 12 months. After three and 12 months, respectively, 39% and 26% were responders. CCK-8 values were statistically significantly increased at three months (p=0.005) and 12 months (p=0.012). In responders, at three months follow-up, this increase of CCK-8 was significant (p=0.020), whereas in the non-responders it was not (p=0.34). Leptin values were decreased at three and 12 months, the decrease at three months being statistically significant in post-pubertal men (p=0.028) and post-pubertal women (p=0.007).
  
  
  
  In responders to the KD, serum CCK-8 increased statistically significantly during treatment at three months. Serum leptin decreased statistically significantly at three months in men and in post-pubertal women. It is plausible that the increase of CCK-8 and the decrease of leptin contribute to the anti-convulsive effect of the KD.
authors: Department of Neurology, Academic Center for Epileptology Kempenhaeghe & Maastricht UMC+, Heeze, The Netherlands.
authors: Danielle A J E
authors: DA
authors: Lambrechts
authors: Department of Neurology, Maastricht University Medical Center, Maastricht, The Netherlands. Electronic address: evelynbrandtwouters@gmail.com.
authors: Evelyn
authors: E
authors: Brandt-Wouters
authors: Laboratory Clinical Chemistry and Pharmacology, Academic Center for Epileptology Kempenhaeghe & Maastricht UMC+, Heeze, The Netherlands.
authors: Pauline
authors: P
authors: Verschuure
authors: Research School of Mental Health & Neuroscience, Maastricht University, Maastricht, The Netherlands; Department of Neurology, Maastricht University Medical Center, Maastricht, The Netherlands; Center for Neurological Learning and Development Disabilities, Academic Center for Epileptology Kempenhaeghe & Maastricht UMC+, Heeze, The Netherlands.
authors: Hans S H
authors: HS
authors: Vles
authors: Department of Neurology, Academic Center for Epileptology Kempenhaeghe & Maastricht UMC+, Heeze, The Netherlands; Research School of Mental Health & Neuroscience, Maastricht University, Maastricht, The Netherlands; Department of Neurology, Maastricht University Medical Center, Maastricht, The Netherlands.
authors: Marian J M
authors: MJ
authors: Majoie
mesh_terms: D000293:Adolescent; D000328:Adult; D015415:Biomarkers / Q000097:blood; D002648:Child; D002675:Child, Preschool; D002766:Cholecystokinin / Q000097:blood*; D055423:Diet, Ketogenic; D000069279:Drug Resistant Epilepsy / Q000097:blood* / Q000178:diet therapy*; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D020738:Leptin / Q000097:blood*; D008297:Male; D010446:Peptide Fragments / Q000097:blood*; D011446:Prospective Studies; D012640:Seizures / Q000097:blood / Q000178:diet therapy; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D015415:Biomarkers; D020738:Leptin; D010446:Peptide Fragments; C410885:cholecystokinin 8; D002766:Cholecystokinin
keywords: Cholecystokinin-8; Ketogenic diet; Leptin; Mechanism of action; Refractory epilepsy