Background: Very low-calorie ketogenic diet (VLCKD) is associated with improvement of metabolic and cardiovascular disorders. We aimed to evaluate the effects of VLCKD in patients with Cushing’s disease (CD) as adjunctive therapy to treatment for primary disease. Methods: We evaluated clinical, hormonal and metabolic parameters in 15 patients with CD and 15 controls at baseline and after 1 week and 3 weeks of VLCKD and further 2 weeks of low-carbohydrate ketogenic diet (LCKD). Results: After 5 weeks of diet a significant decrease in BMI (p=0.002), waist circumference (WC) (p=0.024), systolic (p=0.015) and diastolic blood pressure (p=0.005), ACTH (p=0.026), cortisone (p=0.025), total (p=0.006) and LDL cholesterol (p=0.017), triglycerides (p=0.016), alkaline phosphatase (p=0.008) and a significant increase in HDL cholesterol (p=0.017), vitamin D (p=0.015) and oral disposition index (Dio)(p=0.004) was observed in CD. A significant decrease in BMI (p=0.003), WC (p=0.002), systolic (p=0.025) and diastolic (p=0.007) blood pressure and total cholesterol (p=0.026) and increase in HDL cholesterol (p=0.001) and DIo (p<0.001) was observed in controls. Conclusions: The current study confirms that ketogenic diet is effective in improving metabolic disorders and shows that a nutritional approach may be combined with conventional CD therapy in order to improve metabolic and cardiovascular comorbidities.
