Pengaruh Diet Ketogenik terhadap Ketebalan dan Elastisitas Arteri Karotis pada Pasien Epilepsi: A Systematic Review
Downloads
Latar Belakang: Diet ketogenik merupakan diet tinggi lemak, rendah karbohidrat, dan cukup protein. Diet ini sudah lama digunakan sebagai terapi pada pasien epilepsi refrakter, namun belum banyak studi mengenai efek jangka panjang diet ini.
Tujuan: Penelitian ini dilakukan untuk menganalisis pengaruh diet ketogenik terhadap ketebalan dan elastisitas arteri karotis penderita epilepsi.
Ulasan: Pencarian literatur dilakukan melalui search engine berupa Pubmed, ScienceDirect, dan Google Scholar. Empat artikel penelitian memenuhi kriteria inklusi, kemudian dilakukan tinjauan sistematis menggunakan diagram alir PRISMA dan JBI critical appraisal. Keempat penelitian terpilih melibatkan pasien epilepsi refrakter dari kelompok usia anak dan dewasa muda (13 bulan - 31 tahun) yang diintervensi dengan pemberian terapi diet ketogenik selama minimal 6 bulan. Elastisitas arteri karotis menurun secara signifikan pada pemberian diet ketogenik selama 12 bulan (p<0,001). Namun, penurunan elastisitas arteri karotis tidak diikuti dengan adanya perubahan yang signifikan pada ketebalan dinding arteri karotis, yang dinilai menggunakan carotid intima media thickness (CIMT). Sebagian besar studi menemukan adanya peningkatan risiko kardiovaskular oleh karena adanya peningkatan profil lipid dan kekakuan arteri karotis.
Kesimpulan: Secara kesimpulan, diet ketogenik mempengaruhi elastisitas arteri karotis tanpa mengubah ketebalannya. Diet ketogenik juga meningkatkan kadar lipid secara reversible dan diduga dapat meningkatkan risiko kardiovaskular pada pasien epilepsi refrakter.
Scheffer, I. E. et al. Classification of the epilepsies: Position paper of the Commission for Classification and Terminology. Epilepsia 58, (2017).
Joudi Mashhad, M., Harati, H., Parooie, F. & Salarzaei, M. Epilepsy surgery for refractory seizures: a systematic review and meta-analysis in different complications. The Egyptian Journal of Neurology, Psychiatry and Neurosurgery 56, (2020).
Engel, J. Approaches to refractory epilepsy. Annals of Indian Academy of Neurology 17, (2014).
D'Andrea Meira, I. et al. Ketogenic Diet and Epilepsy: What We Know So Far. Frontiers in Neuroscience 13, (2019).
Coppola, G. et al. The impact of the ketogenic diet on arterial morphology and endothelial function in children and young adults with epilepsy: A case–control study. Seizure 23, (2014).
Williams, T. J. & Cervenka, M. C. The role for ketogenic diets in epilepsy and status epilepticus in adults. Clinical Neurophysiology Practice 2, (2017).
El-Rashidy, O. F. et al. Modified Atkins diet vs classic ketogenic formula in intractable epilepsy. Acta Neurologica Scandinavica 128, (2013).
Batch, J. T., Lamsal, S. P., Adkins, M., Sultan, S. & Ramirez, M. N. Advantages and Disadvantages of the Ketogenic Diet: A Review Article. Cureus (2020) doi:10.7759/cureus.9639.
í˜ygarden, H. Carotid Intima"Media Thickness and Prediction of Cardiovascular Disease. Journal of the American Heart Association 6, (2017).
Kapetanakis, M., Liuba, P., Odermarsky, M., Lundgren, J. & Hallböök, T. Effects of ketogenic diet on vascular function. European Journal of Paediatric Neurology 18, (2014).
Doksöz, Ö. et al. The Short-Term Effects of Ketogenic Diet on Cardiac Ventricular Functions in Epileptic Children. Pediatric Neurology 53, (2015).
Özdemir, R. et al. The Effect of the Ketogenic Diet on the Vascular Structure and Functions in Children with Intractable Epilepsy. Pediatric Neurology 56, (2016).
Huang, X. et al. Evaluation of carotid plaque echogenicity based on the integral of the cumulative probability distribution using gray-scale ultrasound images. PLOS ONE 12, (2017).
Swink, T., Vining, E. & Freeman, J. The ketogenic diet: 1997. Adv Pediatr 44, 297–329 (1997).
Livingston, S., Pauli, L. L. & Pruce, I. Ketogenic diet in the treatment of childhood epilepsy. Developmental Medicine and Child Neurology 19, 833–834 (1977).
Patel, A., Pyzik, P. L., Turner, Z., Rubenstein, J. E. & Kossoff, E. H. Long-term outcomes of children treated with the ketogenic diet in the past. Epilepsia 51, (2010).
Urbina, E. M. et al. Noninvasive Assessment of Subclinical Atherosclerosis in Children and Adolescents. Hypertension 54, (2009).
Dayimu, A. et al. Trajectories of Lipids Profile and Incident Cardiovascular Disease Risk: A Longitudinal Cohort Study. Journal of the American Heart Association 8, (2019).
Pletcher, M. J., Vittinghoff, E., Thanataveerat, A., Bibbins-Domingo, K. & Moran, A. E. Young Adult Exposure to Cardiovascular Risk Factors and Risk of Events Later in Life: The Framingham Offspring Study. PLOS ONE 11, (2016).
Nocella, C. et al. Extra Virgin Olive Oil and Cardiovascular Diseases: Benefits for Human Health. Endocrine, Metabolic & Immune Disorders - Drug Targets 18, (2017).
Borén, J. et al. Low-density lipoproteins cause atherosclerotic cardiovascular disease: pathophysiological, genetic, and therapeutic insights: a consensus statement from the European Atherosclerosis Society Consensus Panel. European Heart Journal 41, (2020).
Ohwada, T. et al. Apolipoprotein B correlates with intra-plaque necrotic core volume in stable coronary artery disease. PLOS ONE 14, (2019).
Iannuzzi, A. et al. Stiffness of the aortic wall in hypercholesterolemic children. Metabolism 48, (1999).
Kwiterovich, J. P. O. Effect of a High-Fat Ketogenic Diet on Plasma Levels of Lipids, Lipoproteins, and Apolipoproteins in Children. JAMA 290, (2003).
Nizamuddin, J., Turner, Z., Rubenstein, J. E., Pyzik, P. L. & Kossoff, E. H. Management and Risk Factors for Dyslipidemia with the Ketogenic Diet. Journal of Child Neurology 23, (2008).
Copyright (c) 2022 Amerta Nutrition
This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.
AMERTA NUTR by Unair is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.
1. The journal allows the author to hold the copyright of the article without restrictions.
2. The journal allows the author(s) to retain publishing rights without restrictions
3. The legal formal aspect of journal publication accessibility refers to Creative Commons Attribution Share-Alike (CC BY-SA).
4. The Creative Commons Attribution Share-Alike (CC BY-SA) license allows re-distribution and re-use of a licensed work on the conditions that the creator is appropriately credited and that any derivative work is made available under "the same, similar or a compatible license”. Other than the conditions mentioned above, the editorial board is not responsible for copyright violation.
