Disordered mineral metabolism produced by ketogenic diet therapy |
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Authors: | Theodore J Hahn Linda R Halstead Darryl C DeVivo |
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Institution: | (1) Division of Bone and Mineral Metabolism, The Jewish Hospital of St. Louis, 63110 St. Louis, Missouri, USA;(2) Departments of pediatrics, Neurology, and Neurosurgery, Washington University School of Medicine, 63110 St. Louis, Missouri, USA |
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Abstract: | Summary Vitamin D and mineral metabolism status was examined in five children maintained chronically on combined ketogenic diet-anticonvulsant
drug therapy (KG), and the results compared to those obtained in 18 patients treated with anticonvulsant drugs alone (AD)
and 15 normal controls. KG patients exhibited biochemical findings of vitamin D deficiency osteomalacia: decreased serum 25-hydroxyvitamin
D (25OHD) and calcium concentrations, elevated serum alkaline phosphatase and parathyroid hormone concentrations, decreased
urinary calcium and increased urinary hydroxyproline excretion, and decreased bone mass. Although the KG and AD groups demonstrated
similar reductions in serum 25OHD concentration, the KG patients exhibited a significantly greater reduction in bone mass.
In response to vitamin D supplementation (5000 IU/day), mean bone mass in the KG group increased by 8.1±0.9% (P<0.001) over a 12-month period. These results suggest that ketogenic diet and anticonvulsant drug therapy have additive deleterious
effects on bone mass and that these effects are partially reversible by vitamin D treatment. |
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Keywords: | Anticonvulsant Ketogenic diet Calcium Vitamin D Bone |
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