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Ketogenic Diet for Obesity Hypoventilation Syndrome

2019-10-04 08:31:43 | BioPortfolio

Summary

Obesity hypoventilation syndrome (OHS) causes hypercapnia (PaCO2>45) in subjects with obesity in the absence of lung disease, and is associated with respiratory failure, pulmonary hypertension, ICU admission, and death. Obesity is necessary, but not sufficient to cause OHS. Neuro-hormonal dysfunction is believed to impair respiratory CO2 sensitivity. In particular, leptin may play a role in OHS pathogenesis. In OHS, leptin levels are greatly elevated and correlate positively with PaCO2 independent of obesity or fat mass which suggests a linkage between defective central satiety and respiratory signaling.

Leptin resistance may be induced by carbohydrate-rich diets while very low carbohydrate "ketogenic" diets (KD) may enhance leptin sensitivity. The investigators hypothesize that a KD will correct hypoventilation in OHS patients, even in the absence of weight loss.

Description

Prolonged starvation ketosis increased ventilatory responses to inhaled CO2 in obese, mild OHS patients. The investigators anticipate that this phenomenon can be induced by high-fat, low carbohydrate KD instead of an extreme and protracted fast; correct hypoventilation rapidly, since "ketosis" and leptin responses occur within 1 week of a KD; and be feasibly administered to patients with severe OHS, normalizing patients' gas exchange during wakefulness and while asleep.

This is a pilot study to test these hypotheses in patients with OHS. The investigators will enroll patients with OHS, to examine the subacute effects of KD (12 days) on OHS respiratory and neuro-endocrine physiology.

Study Design

Conditions

Obesity Hypoventilation Syndrome

Intervention

Ketogenic Diet

Location

Johns Hopkins Bayview Medical Center
Baltimore
Maryland
United States
21224

Status

Recruiting

Source

Johns Hopkins University

Results (where available)

View Results

Links

Published on BioPortfolio: 2019-10-04T08:31:43-0400

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Medical and Biotech [MESH] Definitions

A course of food intake that is high in FATS and low in CARBOHYDRATES. This diet provides sufficient PROTEINS for growth but insufficient amount of carbohydrates for the energy needs of the body. A ketogenic diet generates 80-90% of caloric requirements from fats and the remainder from proteins.

A course of food intake that is high in FATS and low in CARBOHYDRATES. This diet provides sufficient PROTEINS for growth but insufficient amount of carbohydrates for the energy needs of the body. A ketogenic diet generates 80-90% of caloric requirements from fats and the remainder from proteins.

HYPOVENTILATION syndrome in very obese persons with excessive ADIPOSE TISSUE around the ABDOMEN and DIAPHRAGM. It is characterized by diminished to absent ventilatory chemoresponsiveness; chronic HYPOXIA; HYPERCAPNIA; POLYCYTHEMIA; and long periods of sleep during day and night (HYPERSOMNOLENCE). It is a condition often related to OBSTRUCTIVE SLEEP APNEA but can occur separately.

A condition of having excess fat in the abdomen. Abdominal obesity is typically defined as waist circumferences of 40 inches or more in men and 35 inches or more in women. Abdominal obesity raises the risk of developing disorders, such as diabetes, hypertension and METABOLIC SYNDROME X.

An autosomal recessive disorder characterized by RETINITIS PIGMENTOSA; POLYDACTYLY; OBESITY; MENTAL RETARDATION; hypogenitalism; renal dysplasia; and short stature. This syndrome has been distinguished as a separate entity from LAURENCE-MOON SYNDROME. (From J Med Genet 1997 Feb;34(2):92-8)

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