BACKGROUND Ketogenic diet therapies can improve seizure control in patients with drug-resistant epilepsy (DRE). The current study investigated whether dietary fat composition is associated with elevations in serum lipid levels in adults with epilepsy who began a modified Atkins diet (MAD). METHODS Adults with DRE were instructed to follow the MAD. Food records collected at baseline and follow-up were analyzed to extract median daily macro- and micronutrient composition. Total cholesterol (TC), low-density lipoprotein (LDL) cholesterol, triglyceride (TG), high-density lipoprotein (HDL) cholesterol, non-HDL and TC/HDL ratio were measured at baseline and follow-up. RESULTS Study participants initiating MAD showed higher fat intake at 1 month (p<0.001) and 2 months (p<0.001) and lower carbohydrate intake at 1 month (p<0.001) and 2 months (p<0.001) compared to baseline. Study participants also showed higher intake of cholesterol (p<0.001), saturated fatty acid (p<0.001) and monounsaturated fatty acid (p<0.001) over time. Following MAD initiation, study participants showed significant increases in levels of TC (p = 0.007), LDL (p<0.001), and non-HDL (p = 0.009) over time. Dietary intake variables, including cholesterol and fat subtypes, were significantly associated with difference in 1 month TC and LDL levels from baseline but not absolute 1 month lipid values. In a sub-analysis, participants with baseline dyslipidemia showed smaller changes in lipid values during diet use. CONCLUSIONS Adults with DRE starting MAD increased fat intake, particularly saturated and monounsaturated fat subtypes, and reduced carbohydrate intake. Changes in TC and LDL levels 1 month after MAD initiation are associated with dietary intake of cholesterol and fat.

中文翻译：

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采用改良阿特金斯饮食的成人癫痫患者空腹血脂水平升高的预测因素。

背景生酮饮食疗法可以改善耐药性癫痫（DRE）患者的癫痫发作控制。目前的研究调查了开始改良阿特金斯饮食（MAD）的癫痫成人患者的膳食脂肪成分是否与血清脂质水平升高相关。方法 患有 DRE 的成年人被指示遵循 MAD。对基线和随访时收集的食物记录进行分析，以提取每日大量和微量营养素成分中位数。在基线和随访时测量总胆固醇（TC）、低密度脂蛋白（LDL）胆固醇、甘油三酯（TG）、高密度脂蛋白（HDL）胆固醇、非HDL以及TC/HDL比率。结果 与基线相比，开始 MAD 的研究参与者在 1 个月 (p<0.001) 和 2 个月 (p<0.001) 时脂肪摄入量较高，而在 1 个月 (p<0.001) 和 2 个月 (p<0.001) 时碳水化合物摄入量较低。研究参与者还显示，随着时间的推移，胆固醇（p<0.001）、饱和脂肪酸（p<0.001）和单不饱和脂肪酸（p<0.001）的摄入量增加。MAD 开始后，研究参与者的 TC (p = 0.007)、LDL (p<0.001) 和非 HDL (p = 0.009) 水平随着时间的推移显着增加。膳食摄入变量（包括胆固醇和脂肪亚型）与 1 个月 TC 和 LDL 水平相对于基线的差异显着相关，但与 1 个月血脂绝对值无关。在一项子分析中，患有基线血脂异常的参与者在饮食期间表现出较小的血脂值变化。结论 开始 MAD 的 DRE 成人增加了脂肪摄入量，特别是饱和脂肪和单不饱和脂肪亚型，并减少了碳水化合物摄入量。MAD 开始后 1 个月，TC 和 LDL 水平的变化与饮食中胆固醇和脂肪的摄入有关。