The Influence of Ketogenic Diet on Liver Function in Children and Adolescents with Intractable Epilepsy

Background: High-fat content and carbohydrate restriction of the ketogenic diet (KD) increases the workload of some organs, especially the liver. Moreover, most of the antiepileptic drugs (AEDs) are metabolized in the liver; therefore, the function of the liver could be influenced during the treatment with KD. This study was undertaken to investigate the influence of the ketogenic diet on liver function. Methods: A prospective, open-label study was carried out. A total of 28 patients with intractable epilepsy initiated the diet. All patients were children and adolescentswhodid not respond to at least 2 AEDs. Liver function tests including Alanine aminotransferase (ALT), Aspartate aminotransferase (AST), and alkaline phosphatase (ALP) were analyzed before and after 3 months on the KD. Results: Fourteen patients with the median age of 4.12 (2.31 - 9.70) years completed the study. The serum levels of ALP and AST did not differ significantly before and after 3 months on the diet (P value 0.05). There was a significant difference in the serum level of ALT before and after 3 months of treatment (13 vrs 20, P = 0.014). Conclusions: Albeit, it seems that KD did not have any influence on the serum levels of AST and ALP; however, it had a significant effect on the serum level of ALT. More investigations with a larger sample size and longer follow-up duration are needed to approve abovementioned results.