Bone Phenotype in Pediatric Patients with Epilepsy on the Ketogenic Diet
Abstract number :
3.368
Submission category :
10. Dietary Therapies (Ketogenic, Atkins, etc.)
Year :
2019
Submission ID :
2422261
Source :
www.aesnet.org
Presentation date :
12/9/2019 1:55:12 PM
Published date :
Nov 25, 2019, 12:14 PM
Authors :
Sharon Whiting, University of Ottawa; Sarah Healy, Children's Hospital of Eastern Ontario; Leanne Ward, Children's Hospital of Eastern Ontario; Karine Khatchadourian, Children's Hospital of Eastern Ontario
Rationale: Even though the ketogenic diet (KD) has been used to effectively treat intractable epilepsy in children for decades, little is known about the long-term effects of the KD on bone health. Some research has suggested that the KD may lead to loss of bone mineral content (BMC) in children; particularly in those who are younger and non-ambulatory and in those with low BMI. Although research in other populations has suggested that low BMC may be secondary to reduced lean muscle mass (LBM), no known research has looked at this in children with epilepsy on the KD. Methods: In order to better understand bone health in children on the KD, a retrospective study of 15 children, aged 4 to 11 (M=7.58, 9 males, 6 females), who were being treated by the KD and who were being followed in a bone health clinic, was conducted. Results: On average, participants were on the KD for 4.44 years (.92 - 9.83 years) before being seen by the bone health clinic. Four patients had pathologic fractures: two with 1 long bone fracture, one with long bone and multiple vertebral fractures, and one with 2 long bone fractures. The two latter patients required bisphosphonate therapy and were non ambulatory children. Analysis at first bone health visit showed on average, low total BMC (Z-score= -1.47) and low LBM for height (Z score= -2.08). Correlation analyses found that LBM (r=.886, p< .001), age (r=.721, p= .005), and ambulatory status (r=.559, p= .047) were significantly correlated with later BMC values. Regression analyses found that LBM at first visit was a significant predictor of BMC at both the second (R= .886, R2adj= .766, F(1,12)= 40.20, p<.001) and third (R= .754, R2adj= .507, F(1,8)= 9.22, p<.019) follow-up visits. Conclusions: The results of this study highlight the importance of continuously monitoring bone health in this population, particularly in children who are younger and non-ambulatory. Furthermore, this study suggests that low bone content in this population may be secondary to low lean tissue mass; with lack of muscle development secondarily affecting bone strength. Funding: This study was funded by the Ontario Brain Institute.
Dietary Therapies