Medium‑chain triglyceride ketogenic diet alters hepatic mitochondrial complex I activity and induces CYP2E1 in rats
Ketogenic Research Hub Editorial Scientific oversight: Marco Medeot, Scientific Director
An 8‑week medium‑chain triglyceride ketogenic diet (MCT‑KD) in young and aged F344×BN rats reduced liver mitochondrial complex I activity and markedly increased hepatic CYP2E1 protein and activity, without detectable accumulation of methylglyoxal‑derived protein adducts.
Study and findings
The authors fed male Fisher 344 × Brown Norway F1 rats either a standard diet or an MCT‑based ketogenic diet for eight weeks. In young rats, the MCT‑KD lowered the activity of mitochondrial respiratory complex I in liver homogenates, while activities of complexes II, III, IV and citrate synthase (a marker of mitochondrial content) were unchanged. Hepatic CYP2E1 protein abundance and catalytic activity were strongly elevated in both young and aged groups, accompanied by an increase in the enzyme’s electron donor, P450 oxidoreductase (POR), especially in the young cohort. Despite the rise in the acetone‑CYP2E1 axis, levels of methylglyoxal‑derived protein adducts did not increase, even though expression of the detoxifying enzyme glyoxalase‑1 (GLO1) was reduced.
Clinical interpretation
These data indicate that prolonged consumption of an MCT‑KD triggers coordinated hepatic adaptations: a specific down‑regulation of complex I respiration and a robust induction of the CYP2E1‑POR system, which is known to generate reactive oxygen species during the metabolism of ketone bodies such as acetone. The lack of methylglyoxal‑protein adduct accumulation suggests that, at least in this rodent model, the up‑regulated CYP2E1 activity does not translate into measurable carbonyl stress under the experimental conditions. For clinicians considering MCT‑KD for metabolic or neurologic indications, the findings raise the possibility that hepatic xenobiotic metabolism may be altered, potentially affecting drug clearance that relies on CYP2E1, while mitochondrial complex I function could be modestly compromised.
Limitations and open questions
The study is limited to male F344×BN rats; sex‑specific responses were not examined. Only enzymatic activities and protein levels were measured; functional outcomes such as whole‑organism energy metabolism, oxidative damage markers beyond methylglyoxal adducts, or clinical endpoints were not assessed. The relevance of the observed complex I reduction to human liver physiology remains uncertain, as rodent and human mitochondrial regulation differ. Moreover, the impact of CYP2E1 induction on the pharmacokinetics of CYP2E1‑substrate drugs was not explored. Future investigations should address sex differences, dose‑response relationships of MCT‑KD, and whether similar hepatic adaptations occur in humans, ideally with concurrent assessment of drug metabolism and oxidative stress biomarkers.
Source
Ryan AS, Roberts RM, Stayer KM, Tomasevich AA, Misare KR, Hollis F, et al. The impact of medium chain triglyceride ketogenic diet on liver mitochondria and cytochrome P450 2E1. Arch Biochem Biophys. 2026;785:110978. doi: 10.1016/j.abb.2026.110978. PMID: 42617931.