The effects of valproate on serum leptin, insulin, and lipid levels in epileptic children.


Kilic H., Demirel A. , Uysal S.

Pediatrics international : official journal of the Japan Pediatric Society, 2021 (Journal Indexed in SCI) identifier identifier identifier

  • Publication Type: Article / Article
  • Volume:
  • Publication Date: 2021
  • Doi Number: 10.1111/ped.14674
  • Title of Journal : Pediatrics international : official journal of the Japan Pediatric Society
  • Keywords: anti-epileptic drug, cholesterol, epilepsy, leptin, valproate, ADD-ON TREATMENT, WEIGHT-GAIN, METABOLIC SYNDROME, ANTIEPILEPTIC DRUGS, ACID TREATMENT, DOUBLE-BLIND, MECHANISMS, SECRETION, RISK, ADIPONECTIN

Abstract

Background Weight gain is an important adverse effect of valproate (VPA) therapy. A number of mechanisms have been proposed for its pathophysiology. The aim of the present study is the evaluation of insulin, leptin and lipid levels in epileptic children on treatment with VPA. Methods Thirty epileptic children treated with VPA, and 20 age-sex-matched healthy children, were enrolled in this study. Blood samples were taken and the body mass index was calculated for all of the subjects. Serum insulin, leptin, and lipid levels were compared between the two groups. Results Leptin levels were significantly higher in the patient group (P = 0.009) whereas body mass index values were comparable. There was a positive correlation between leptin and body mass index among both patient (r = 0.464, P = 0.01) and control groups (r = 0.734, P = 0.0001). Total cholesterol and low-density lipoprotein (LDL) cholesterol levels were lower in VPA-treated epileptic children than the control group (P = 0.008; P = 0.003, respectively). No significant difference was determined in insulin levels between the two groups. A negative correlation was observed between plasma VPA level and total cholesterol and LDL cholesterol levels in the patient group (r = -0.380, P = 0.03, r = -0.474, P = 0.008, respectively). Conclusion This study demonstrated higher leptin levels in the patient group despite similar BMI values. Hence, it seems likely that VPA causes leptin resistance. Unlike other anti-epileptics, VPA does not produce an increase in serum cholesterol levels. On the contrary, lower levels of total and LDL cholesterol levels in VPA-receiving patients have been observed in our study.