Long-term Follow-up of Effects on Insulin Resistance in Children with Epilepsy Before and After Ketogenic Diet: Prevalence and Risk Factors
Abstract number :
2.143
Submission category :
4. Clinical Epilepsy / 4C. Clinical Treatments
Year :
2022
Submission ID :
2204125
Source :
www.aesnet.org
Presentation date :
12/4/2022 12:00:00 PM
Published date :
Nov 22, 2022, 05:23 AM
Authors :
Yun-Jin Lee, MD – Pusan National University Children's Hospital; Juhyun Kong, MD – Pusan National University Children's Hospital; Sang Ook Nam, MD – Pusan National University Children's Hospital; Young Mi Kim, MD – Pusan National University Hospital
Rationale: To evaluate the incidence of insulin resistance (IR) and associated risk factors before and after the ketogenic diet (KD) in children with epilepsy.
Methods: This longitudinal cohort study analyzed data of children with epilepsy on KD. IR was assessed using the homeostasis model assessment of insulin resistance (HOMA-IR). The HOMA-IR values and associated laboratory tests were measured before the initiation of the KD (HOMA-IR-0), during the KD (HOMA-IR-1), and after KD termination (HOMA-IR-2).
Results: A total of 34 children were enrolled. The median age at the initiation of KD was 2.1±2.4 years, and the median follow-up duration was 3.5±1.4 years. The median HOMA-IR-0 (before the initiation of KD) was 1.3±0.3, which significantly increased to 2.2±0.5 at the last follow-up during the KD (HOMA-IR-1; ∆HOMA-IR-1= 0.9±0.3, p< 0.001). The median HOMA-IR-2 value decreased to 1.6±0.7, but was more than 2.0 in 4 patients (11.7%). The following factors were associated with patients with higher HOMA-IR-1 values (≥2.0): younger age at seizure onset (0.4±0.5 years, p< 0.001), at the initiation of antiepileptic drugs (AEDs; 0.4±0.6 years, p< 0.001), and at the initiation of KD (0.9±1.1 years, p< 0.001) and higher serum total cholesterol (245.0±20.1 mg/dL, p=0.001), low-density lipoprotein cholesterol (LDL-C, 103.0±6.7 mg/dL, p=0.003), and triglyceride (387.0±28.8 mg/dL, p< 0.001) levels. Multivariate regression analysis revealed that the age at seizure onset (p=0.002), at initiation of AEDs (p=0.021), and at initiation of KD (p=0.022) and serum levels of LDL-C (p=0.012) and triglycerides (p=0.026) were associated with a significantly high HOMA-IR-1 or HOMA-IR-2 values.
Clinical Epilepsy