Saleh Dina Ahmed Amin, Ismail Mona Ahmed, Ibrahim Ayman Mohamed
Department of Pediatrics, Faculty of Medicine, Ain Shams University, Cairo, Egypt.
Pak J Biol Sci. 2012 Jan 15;15(2):68-77. doi: 10.3923/pjbs.2012.68.77.
This study explores the occurrence of Non-alcoholic Fatty Liver Disease (NAFLD), Insulin Resistance (IR), dyslipidemia and atherogenic ratios in epileptic children and adolescents receiving Valproic Acid (VPA), Carbamazepine (CBZ) or both (combination therapy) compared to healthy controls. Abdominal Computerized Tomography (CT), measurements of serum fasting insulin, glucose, serum lipids and liver enzymes were performed in VPA (n = 14), CBZ (n = 14) or both (n = 10) treated non-diabetic non-obese epileptic patients compared to healthy controls (n = 10). Abdominal CT demonstrated characteristics of fatty liver disease in 42.8% of VPA, in 21.4% of CBZ, in 60% of combination therapy treated patients and none of the healthy controls. All of them were overweight and 53.3% had IR. In conclusion VPA therapy was associated with increased risk of IR and NAFLD, while CBZ therapy was associated with dyslipidemia and combination therapy was associated with all these risks.
本研究探讨了与健康对照组相比，接受丙戊酸（VPA）、卡马西平（CBZ）或两者联合治疗（联合疗法）的癫痫儿童和青少年中，非酒精性脂肪性肝病（NAFLD）、胰岛素抵抗（IR）、血脂异常和致动脉粥样化比率的发生情况。对14例接受VPA治疗、14例接受CBZ治疗或10例接受联合治疗的非糖尿病、非肥胖癫痫患者，以及10例健康对照者进行了腹部计算机断层扫描（CT）、空腹血清胰岛素、血糖、血脂和肝酶的检测。腹部CT显示，接受VPA治疗的患者中有42.8%、接受CBZ治疗的患者中有21.4%、接受联合治疗的患者中有60%出现了脂肪性肝病的特征，而健康对照组中无一例出现。所有患者均超重，53.3%有胰岛素抵抗。总之，VPA治疗与胰岛素抵抗和NAFLD风险增加相关，而CBZ治疗与血脂异常相关，联合治疗则与所有这些风险相关。
