https://orcid.org/0000-0003-2803-7713
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Abstract
The use of the ketogenic diet (KD) as an adjuvant therapy in high-grade gliomas (HGG) is supported by preclinical studies, but clinical data on its effects on metabolism are currently lacking. In this study, we describe the effects of a KD on glucose profile, ketonemia, energy metabolism, and nutritional status, in adults affected by HGG. This was a single-arm prospective study. An isocaloric 3:1 KD was administered for 1 mo. Glucose profile was assessed by using fasting glycemia, insulin, and glycated hemoglobin. To evaluate ketonemia changes, a hand-held ketone meter was used from home. Energy metabolism was assessed by indirect calorimetry. Nutritional status was evaluated through changes in body composition and in lipid and hepatic profile. No changes in fasting glycemia were observed; however, insulinemia dropped to half of baseline levels. The KD shifted the metabolism, rising ketonemia and decreasing glucose oxidation rate to a quarter of the initial values. Moreover, the KD was generally safe. One-month intervention with the KD was able to act upon key metabolic substrates potentially involved in HGG metabolism. The lack of a significant reduction in fasting glycemia should be investigated in future studies.
Acknowledgments
We are thankful to our colleagues Stefano Ravasenghi, Franca Criscuoli, and Giovanni Fiorillo for the extra work required to perform the analysis included in this paper.
Disclosure Statement
No potential conflict of interest was reported by the authors.
Funding
The authors received no financial support for the research, authorship, and publication of this article.
Author’s Contributions
Conceptualization, S.B., E.L., and A.B.; methodology, S.B. and A.B.; formal analysis, A.F. and A.L.; investigation, R.D., C.L., and E.C.; data curation, R.D. and A.F.; writing-original draft preparation, A.F.; writing-review and editing, S.B., R.D., C.L., S.R., and G.Z.; project supervision, G.Z. and A.S.; project administration, R.D. and E.L.
Data Availability Statement
The data that support the findings of this study are available on request from the corresponding author A.F. The data are not publicly available due to them containing information that could compromise research participant privacy/consent.