High Plasma Branched-Chain Amino Acids: Aromatic Amino Acids Ratio in Children on the Ketogenic Diet: A Mechanism in Controlling Epilepsy
Pipop Jirapinyo MD*, Pongkiat Kankirawatana MD**, Narumon Densupsoontorn MD**, Nuchnoi Thamonsiri BSc*, Renu Wongarn BA*
Affiliation : * Department of Pediatrics, Faculty of Medicine Siriraj Hospital, Mahidol University, ** Department of Pediatrics, The Children’s Hospital of Alabama, USA
Background : The authors proposed that ketogenic diets will produce an increase in the ratio of branched
chain amino acids (BCAAs) and aromatic amino acids (BCAAs) in plasma of children who are on the diets.
Subjects and Method : A sample of plasma amino acids sample before initiation of fasting and on day 10th of
the dietary treatment was obtained in patients with refractory epilepsy who were newly admitted for initia-
tion of ketogenic diet. Plasma amino acids were determined by high performance liquid chromatography
equipment.
Results : There are 20 patients with refractory epilepsy participating in this study. Outcomes of ketogenic
diet therapy were satisfactory. Nineteen cases out of 20 cases had a significantly higher ratio of plasma
BCAAs: ARAAs during ketogenic diets than before the diet (P < 0.001).
Conclusion : The ketogenic diets produced an increased ratio of plasma BCAAs: ARAAs. Whether the in-
creased ratio of plasma BCAAs: ARAAs plays an important role in controlling epilepsy is yet to be eluci-
dated.
Keywords : Ketogenic diet, Refractory epilepsy, Plasma amino acid, Branched chain amino acid, Aromatic amino acid.
