Pengaruh Diet Ketogenik terhadap Ketebalan dan Elastisitas Arteri Karotis pada Pasien Epilepsi: A Systematic Review

Abstract

Background: Ketogenic diet is a high lipid, low carbohydrate, and adequate protein diet. It has long been used as a therapy in refractory epilepsy patients, but very little is known about the long-term effects. Objectives: This study was conducted to analyze the effect of a ketogenic diet on carotid artery thickness and elasticity in patients with epilepsy. Discussion: Literature searches were conducted through search engines such as PubMed, ScienceDirect, and Google Scholar, resulting in four studies that were eligible for inclusion and have passed the selection process based on PRISMA flowchart and JBI critical appraisal. These studies involved patients with refractory epilepsy (13 months to 31 years old), who were given ketogenic diet therapy for at least 6 months. Carotid artery elasticity decreased significantly on the ketogenic diet given for 12 months (p<0.001). However, it was not accompanied by a significant change in wall thickness, which was assessed through carotid intima-media thickness (CIMT). Most studies found an increased cardiovascular risk due to an increase in lipid profile and carotid artery stiffness. Conclusions: In conclusion, the ketogenic diet affects the carotid artery elasticity without changing the thickness, also increases lipid levels reversibly, and is thought to increase cardiovascular risk in patients with refractory epilepsy.