Effect of a Very-Low-Calorie Ketogenic Diet on Circulating Myokine Levels Compared with the Effect of Bariatric Surgery or a Low-Calorie Diet in Patients with Obesity

Nutrients. 2019 Oct 4;11(10):2368. doi: 10.3390/nu11102368.


: The preservation of muscle mass and muscle function after weight loss therapy is currently a considerable challenge in the fight against obesity. Muscle mass secretes proteins called myokines that have relevant functions in the regulation of metabolism and health. This study was aimed to evaluate whether a very low-calorie ketogenic (VLCK) diet may modulate myokine levels, in addition to changes in body composition, compared to a standard, balanced low-calorie (LC) diet or bariatric surgery in patients with obesity. Body composition, ketosis, insulin sensitivity and myokines were evaluated in 79 patients with overweight/obesity after a therapy to lose weight with a VLCK diet, a LC diet or bariatric surgery. The follow-up was 6 months. The weight loss therapies induced changes in myokine levels in association with changes in body composition and biochemical parameters. The effects on circulating myokine levels compared to those at baseline were stronger after the VLCK diet than LC diet or bariatric surgery. Differences reached statistical significance for IL-8, MMP2 and irisin. In conclusion, nutritional interventions or bariatric surgery to lose weight induces changes in circulating myokine levels, being this effect potentially most notable after following a VLCK diet.

Keywords: PnK method; bariatric surgery; body composition; fat free mass; ketogenic diet; low-calorie diet; obesity; protein diet; very low-energy diet.

Publication types

  • Comparative Study
  • Multicenter Study

MeSH terms

  • Adiposity
  • Bariatric Surgery* / adverse effects
  • Biomarkers / blood
  • Caloric Restriction* / adverse effects
  • Case-Control Studies
  • Diet, Ketogenic* / adverse effects
  • Female
  • Fibronectins / blood*
  • Humans
  • Interleukin-8 / blood*
  • Male
  • Matrix Metalloproteinase 2 / blood*
  • Muscle, Skeletal / metabolism*
  • Obesity / blood
  • Obesity / diagnosis
  • Obesity / physiopathology
  • Obesity / therapy*
  • Spain
  • Time Factors
  • Treatment Outcome
  • Weight Loss


  • Biomarkers
  • CXCL8 protein, human
  • FNDC5 protein, human
  • Fibronectins
  • Interleukin-8
  • MMP2 protein, human
  • Matrix Metalloproteinase 2