Avaliação toxicológica subcrônica de dieta cetogênica à base de trienantina em ratos jovens.

Abstract

The classic ketogenic diet, rich in long chain triacylglycerols (LCT), is characterised by a high concentration of lipids and a low concentation of carbohydrates and proteins, promoting ketonemia and ketonuria, a property used in the treatment of disorders that affect cerebral metabolism and function, for example epilepsy resistant to medication. Medium chain triacylglycerols (MCT) are considered alternative substrates to LCT in the production of this diet, to promote a more rapid increase in the levels of the body´s blood ketones. Trienantin, a medium chain triacyglycerol from enantic fatty acid (7:0), has been used with success with children suffering hereditary metabolic syndromes, but has had few studies about its toxicological effects. The objective of this dissertation was to evaluate the toxicity of a subchronic consumption of a ketogenic diet with a trienantin base on young rats, and is submitted in the form of two articles. The first, under the name of: Substitution of LCT with MCT in nutritional therapy: an emphasis on ketogenic therapy presents a revision of the ketogenic diet, comparing the data of LCT and MCT in animal and clinical studies. The more rapid ketonemia promoted by MCT allows a lower quantity of lipids and a greater proportion of proteins and carbohydrates, enhancing the palatability of the diet. The effect of replacing LCT with MCT on physiological parameters, such as serum lipid profile, remains controversial and requires additional studies to comprehend the repercussions of this class of lipids on human health. The second article entitled: Toxicological evaluation of a subchronic ketogenic diet based upon trienantin in young rats deals with an experimental study of male Wistar rats in which 3 groups (n=10), named according to their received diet: Control (diet pattern AIN-93) KetoTAGC7 (ketogenic based upon AIN-93G: modified to contain 4% soy oil, 25.79% trienantin and 40% margarine) and Keto TAGsoy (ketogenic based upon soya: AIN-93G modified to contain 29.79% soya oil and 40% margarine). The proportion of lipid:carbohydrate+protein in the ketogenic diets was 3.5:1 (control diet, 1:11.8) and the experimental duration was 6 weeks. Triacylglycerols, total cholesterol, HDLc, VLDLc and LDLc, in addition tests for hepatic and renal function and injury, were performed from serum obtained, and samples of liver,stomach, kidney and small intestine were collected for histological analysis. It was verified that the energy value of the portions of rations ingested did not differ amongst the three groups during the experimental period, however the animals submitted to the ketogenic diets had ingested a similar quantity of rations within the group, but less than (p=0.005) the control group. The ketogenic diet promoted similar weight gain amongst the group and only the animals in group KetoTAGC7 exhibited weight gain less than that of the control group (p=0.004) between the second and fifth weeks of the experiment. At the end of the study, all groups presented equivalent weights. There were no significant viii differences between the three groups as to the lipid profile, serum glucose and of the markers for hepatic function and injury. Histological analysis of samples from the small intestine, stomach and kidney did not show any significant morphological alteration and the presence of lipid infiltration within hepatocytes was detected in the same manner amongst the three groups. A ketogenic diet with a trienantin base did not promote toxic effects, under the conditions of this study, indicating the possibility that MCT could be administered to patients suffering neurological and metabolic defects, as part of ketogenic diet.