Evidence map›Paper›PMID 40217541›Full record

ArticleActa epileptologica2025

Exploring physiological beta-hydroxybutyrate level in children treated with the classical ketogenic diet for drug-resistant epilepsy.

Xiaoying Qiao, Zimeng Ye, Jialun Wen, Sufang Lin, Dezhi Cao, Li Chen, Dongfang Zou, Huafang Zou, Man Zhang, Zhibin Chen and 4 more

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Acta epileptologica, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Review
  2. Review
  3. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

14 authors.

Xiaoying QiaoDepartment of Neurology, Shenzhen Children's Hospital, Shenzhen, 518038, Guangdong, China.
Zimeng YeDepartment of Medicine (Austin Hospital), University of Melbourne, Melbourne, Victoria, 3084, Australia.
Jialun WenDepartment of Neurology, Shenzhen Children's Hospital, Shenzhen, 518038, Guangdong, China.
Sufang LinDepartment of Neurology, Shenzhen Children's Hospital, Shenzhen, 518038, Guangdong, China.
Dezhi CaoDepartment of Neurology, Shenzhen Children's Hospital, Shenzhen, 518038, Guangdong, China.
Li ChenDepartment of Neurology, Shenzhen Children's Hospital, Shenzhen, 518038, Guangdong, China.
Dongfang ZouDepartment of Neurology, Shenzhen Children's Hospital, Shenzhen, 518038, Guangdong, China.
Huafang ZouDepartment of Neurology, Shenzhen Children's Hospital, Shenzhen, 518038, Guangdong, China.
Man ZhangDepartment of Neurology, Shenzhen Children's Hospital, Shenzhen, 518038, Guangdong, China.
Zhibin ChenDepartment of Neurosciences, Central Clinical School, Alfred Hospital, Monash University, Melbourne, Victoria, 3004, Australia.
Patrick KwanDepartment of Neurosciences, Central Clinical School, Alfred Hospital, Monash University, Melbourne, Victoria, 3004, Australia.
Ingrid E SchefferDepartment of Medicine (Austin Hospital), University of Melbourne, Melbourne, Victoria, 3084, Australia.
Jiong QinDepartment of Pediatrics, Peking University People's Hospital, Beijing, 100000, China.
Jianxiang LiaoDepartment of Neurology, Shenzhen Children's Hospital, Shenzhen, 518038, Guangdong, China. epilepsycenter@vip.163.com.ORCID http://orcid.org/0000-0001-9769-3365

Funding

Basic Applied Basic Research Fund Committee of Guangdong Province 2020A1515110612Guangdong High level Hospital Construction Fund Guangdong High level Hospital Construction FundShenzhen KCXFZ20211020163549011 Shenzhen KCXFZ20211020163549011the Sanming Project of Medicine in Shenzhen No. SZSM202311028/201812005the Shenzhen Fund No. JCYJ20200109150818777the Shenzhen Fund for Guangdong Provincial Highlevel Clinical Key Specialties No. SZGSP012the Shenzhen Key Medical Discipline Construction Fund No. SZXK033
6 · The paper itself

Abstract

backgroundThe ketogenic diet (KD) therapy is a primary treatment for drug-resistant epilepsy, and beta-hydroxybutyrate (BHB) is the main ketone produced during KD. However, the pattern of increase in BHB levels is not well understood, and the reference range for BHB need to be defined. The aim of this study was to evaluate the BHB levels in the first three months, especially one week, after KD initiation, and to explore the physiological reference range for BHB.

methodsIn our study, a fasting initiation strategy was used for the majority of patients (252/300, 84%) who underwent fasting for 24-48 h, the rest fasted for at least 12 h. The concentration of blood BHB was measured four times a day during the first week, at one month and three months. Seizure frequency was recorded at one week, one month and three months. Responders were defined as those with a seizure reduction 50% or more compared to baseline. BHB levels were compared between responders and non-responders. The BHB levels of responders were used to calculate the reference range.

resultsA total of 300 patients were recruited, of whom 172 (57%) had accessible BHB data. BHB levels rapidly rose to 2.0 mmol/L at 19 h, peaked at 4.2 mmol/L at 43 h of therapy, and stabilized by three months. The reference range for BHB was 1.1 to 4.9 mmol/L.

conclusionsBHB levels increased rapidly following fasting, reaching the peak at day 2, stabilizing from the end of the first week through three months. The lower reference limit for BHB to ensure KD efficacy should be set at 1.1 mmol/L.

Indexed as

Beta-hydroxybutyrateChildrenEpilepsyKetogenic dietReference range

Identifiers

PMID40217541
PMCPMC11960278

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.