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卡马西平单药治疗的癫痫儿童中甲状腺功能障碍与低密度脂蛋白胆固醇升高相关:存在因果关系吗?

Thyroid dysfunction associated with increased low-density lipoprotein cholesterol in epileptic children treated with carbamazepine monotherapy: a causal relationship?

作者信息

Attilakos Achilleas, Garoufi Anastasia, Voudris Konstantinos, Mastroyianni Sotiria, Fotinou Aspasia, Papadimitriou Dimitrios T, Gavalakis Nikolaos, Prassouli Alexia, Katsarou Eustathia

机构信息

Second Department of Pediatrics, University of Athens, Panagiotis and Aglaia Kyriakou Children's Hospital Athens, 1 Dimitsanis Street, Marousi, 15125 Athens, Greece.

出版信息

Eur J Paediatr Neurol. 2007 Nov;11(6):358-61. doi: 10.1016/j.ejpn.2007.03.002. Epub 2007 Apr 10.

Abstract

OBJECTIVE

Lipid abnormalities and thyroid dysfunction have been reported in patients treated with antiepileptic drugs. The aim of this study was to evaluate prospectively the association between thyroid and lipid profile in children treated with carbamazepine (CBZ) monotherapy.

MATERIALS AND METHODS

Thyroid function was evaluated in 18 epileptic children, previously reported with CBZ-induced changes in serum lipid profile, before and at 6, 12 and 24 months of CBZ monotherapy.

RESULTS

All children had normal thyroid function before the initiation of CBZ treatment. During CBZ therapy thyroid dysfunction, with increased thyrotropin (TSH) and decreased thyroxine (T4), free thyroxine (FT4) and triiodothyronine (T3) was found, while, significant association was revealed between serum low-density lipoprotein cholesterol (LDL-C) and TSH levels at 6 (r=0.469; p=0.043) and 12 (r=0.730; p=0.001) months of treatment.

CONCLUSION

Lipid abnormalities may be associated with thyroid hormone disturbance in children treated with CBZ monotherapy. Since thyroid dysfunction and hypercholesterolemia are both associated with a higher atherosclerotic risk special attention and further studies are needed in epileptic patients treated with CBZ monotherapy.

摘要

目的

有报道称接受抗癫痫药物治疗的患者存在脂质异常和甲状腺功能障碍。本研究的目的是前瞻性评估接受卡马西平(CBZ)单药治疗的儿童甲状腺与血脂谱之间的关联。

材料与方法

对18名癫痫儿童进行甲状腺功能评估,这些儿童之前报告有CBZ引起的血清脂质谱变化,在CBZ单药治疗前以及治疗6、12和24个月时进行评估。

结果

所有儿童在开始CBZ治疗前甲状腺功能均正常。在CBZ治疗期间,发现甲状腺功能障碍,促甲状腺激素(TSH)升高,甲状腺素(T4)、游离甲状腺素(FT4)和三碘甲状腺原氨酸(T3)降低,同时,在治疗6个月(r = 0.469;p = 0.043)和12个月(r = 0.730;p = 0.001)时,血清低密度脂蛋白胆固醇(LDL-C)与TSH水平之间存在显著关联。

结论

接受CBZ单药治疗的儿童脂质异常可能与甲状腺激素紊乱有关。由于甲状腺功能障碍和高胆固醇血症均与较高的动脉粥样硬化风险相关,因此需要对接受CBZ单药治疗的癫痫患者给予特别关注并进行进一步研究。

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