Evidence map›Paper›PMID 41408292›Full record

ArticleJournal of translational medicine2025

Very low energy ketogenic therapy: an anti-inflammatory medical nutritional approach for MASLD in obesity.

Luigi Barrea, Ludovica Verde, Martina Galasso, Silvia Savastano, Annamaria Colao, Giovanna Muscogiuri

Abstract read
In one paragraph

Article in Journal of translational medicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing 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

2 citing papers in PubMed.

  1. Article
  2. 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

6 authors.

Luigi Barrea *Facoltà di Scienze Umane della Formazione e dello Sport, Università Telematica Pegaso, Via Porzio, Centro Direzionale, isola F2, 80143, Naples, Italy.
Ludovica Verde *Department of Public Health, University of Naples Federico II, Via Sergio Pansini 5, 80131, Naples, Italy.
Martina GalassoCentro Italiano per la cura e il Benessere del paziente con Obesità (C.I.B.O), Unità di Endocrinologia, Diabetologia e Andrologia, Dipartimento di Medicina Clinica e Chirurgia, Università degli Studi di Napoli Federico II, Via Sergio Pansini 5, 80131, Naples, Italy.
Silvia SavastanoCentro Italiano per la cura e il Benessere del paziente con Obesità (C.I.B.O), Unità di Endocrinologia, Diabetologia e Andrologia, Dipartimento di Medicina Clinica e Chirurgia, Università degli Studi di Napoli Federico II, Via Sergio Pansini 5, 80131, Naples, Italy.
Annamaria ColaoCentro Italiano per la cura e il Benessere del paziente con Obesità (C.I.B.O), Unità di Endocrinologia, Diabetologia e Andrologia, Dipartimento di Medicina Clinica e Chirurgia, Università degli Studi di Napoli Federico II, Via Sergio Pansini 5, 80131, Naples, Italy.
Giovanna MuscogiuriCentro Italiano per la cura e il Benessere del paziente con Obesità (C.I.B.O), Unità di Endocrinologia, Diabetologia e Andrologia, Dipartimento di Medicina Clinica e Chirurgia, Università degli Studi di Napoli Federico II, Via Sergio Pansini 5, 80131, Naples, Italy. giovanna.muscogiuri@unina.it.ORCID 0000-0002-8809-4931

Funding

Ministero dell'Istruzione, dell'Università e della Ricerca n.2022BASPYN
6 · The paper itself

Abstract

backgroundChronic inflammation, oxidative stress, and high CRP are linked to metabolic dysfunction-associated steatotic liver disease (MASLD); Very low energy ketogenic therapy (VLEKT) shows anti-inflammatory effects in obesity. The primary aim was to evaluate the effects of ketogenic phase of VLEKT on MASLD and the secondary aim was to identify the underlying mechanisms in women with obesity.

methodsThis prospective outpatient study included 80 women with obesity (mean age 39.25 ± 4.89 years; BMI 37.27 ± 4.58 kg/m2) and MASLD (FLI ≥ 60) who followed ketogenic phase of VLEKT (< 800 kcal/day, with macronutrient composition comprising 13% carbohydrates, 43% proteins and 44% fats at the University Hospital Federico II of Naples. Assessments at baseline and after ketogenic phase of VLEKT included anthropometric measurements, body composition (via bioelectrical impedance analysis), biochemical analyses, high-sensitivity C-reactive protein (hs-CRP) levels and the Fatty Liver Index (FLI).

resultsAfter ketogenic phase, significant reductions were observed in BMI, waist circumference, fat mass, total and LDL cholesterol, triglycerides, gamma-glutamyl transferase (γGT), aspartate aminotransferase (AST), alanine aminotransferase (ALT), fasting plasma glucose and Hs-CRP levels (p < 0.001, for all). Weight loss (%Δ weight) showed significant positive correlations with %Δ fat mass (p < 0.001), %Δ total cholesterol (p < 0.001), %Δ LDL cholesterol (p < 0.001), and %Δ γGT (p < 0.001), while %Δ HDL cholesterol showed a significant negative correlation (p < 0.001). Multiple regression analysis identified %Δ hs-CRP as the main predictor of MASLD improvement, explaining 65.9% of the variance (p < 0.001).

conclusionsMASLD improved post-ketogenic-phase of VLEKT in women with obesity, primarily via reduced chronic inflammation.

Indexed as

Anti-Inflammatory AgentsDiet, KetogenicFatty LiverObesityAdultBody CompositionC-Reactive ProteinFemaleHumansInflammationMiddle AgedAnti-Inflammatory AgentsC-Reactive ProteinHigh sensitivity C reactive protein levelsMASLDObesityPhase angleVery low-energy ketogenic therapyVLEKT

Identifiers

PMID41408292
PMCPMC12709836

What OpenQuestion holds

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Registered trials

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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.