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Open Access 01-12-2024 | Acne Inversa | Research

Very low-calorie ketogenic diet (VLCKD) in the management of hidradenitis suppurativa (Acne Inversa): an effective and safe tool for improvement of the clinical severity of disease. Results of a pilot study

Authors: Ludovica Verde, Sara Cacciapuoti, Giuseppina Caiazzo, Matteo Megna, Fabrizio Martora, Annarita Cavaliere, Maria Mattera, Maria Maisto, Gian Carlo Tenore, Annamaria Colao, Silvia Savastano, Giovanna Muscogiuri, Luigi Barrea

Published in: Journal of Translational Medicine | Issue 1/2024

Abstract

Background

Hidradenitis suppurativa (HS), an inflammatory-based dermatological condition often associated with obesity, poses significant challenges in management. The very low-calorie ketogenic diet (VLCKD) has shown efficacy in addressing obesity, related metabolic disorders, and reducing chronic inflammation. However, its effects on HS remain underexplored. In this prospective pilot study, we aimed to investigate the impact of a 28-day active phase of VLCKD on HS in a sample of treatment-naive women with HS and excess weight.

Methods

Twelve women with HS and overweight or obesity (BMI 27.03 to 50.14 kg/m²), aged 21 to 54 years, meeting inclusion/exclusion criteria and agreeing to adhere to VLCKD, were included. Baseline lifestyle habits were assessed. The Sartorius score was used to evaluate the clinical severity of HS. Anthropometric parameters (waist circumference, weight, height, and body mass index), body composition via bioelectrical impedance analysis, levels of trimethylamine N-oxide (TMAO), oxidized low-density lipoprotein (oxLDL), and derivatives of reactive oxygen metabolites (dROMs) were assessed at baseline and after 28 days of the active phase of VLCKD.

Results

VLCKD led to general improvements in anthropometric parameters and body composition. Notably, a significant reduction in the Sartorius score was observed after the intervention (Δ%: − 24.37 ± 16.64, p < 0.001). This reduction coincided with significant decreases in TMAO (p < 0.001), dROMs (p = 0.001), and oxLDL (p < 0.001) levels. Changes in the Sartorius score exhibited positive correlations with changes in TMAO (p < 0.001), dROMs (p < 0.001), and oxLDL (p = 0.002).

Conclusion

The 28-day active phase of VLCKD demonstrated notable improvements in HS severity and associated metabolic markers, highlighting the potential utility of VLCKD in managing HS and its association with metabolic derangements in women with overweight or obesity.

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Title: Very low-calorie ketogenic diet (VLCKD) in the management of hidradenitis suppurativa (Acne Inversa): an effective and safe tool for improvement of the clinical severity of disease. Results of a pilot study
Authors: Ludovica Verde
Sara Cacciapuoti
Giuseppina Caiazzo
Matteo Megna
Fabrizio Martora
Annarita Cavaliere
Maria Mattera
Maria Maisto
Gian Carlo Tenore
Annamaria Colao
Silvia Savastano
Giovanna Muscogiuri
Luigi Barrea
Publication date: 01-12-2024
Publisher: BioMed Central
Keywords: Acne Inversa
Obesity
Obesity
Published in: Journal of Translational Medicine / Issue 1/2024
Electronic ISSN: 1479-5876
DOI: https://doi.org/10.1186/s12967-024-04853-0

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