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丙戊酸盐治疗的癫痫儿童的血浆瘦素、神经肽Y、胃饥饿素和脂联素水平及颈动脉内膜中层厚度

Plasma leptin, neuropeptide Y, ghrelin, and adiponectin levels and carotid artery intima media thickness in epileptic children treated with valproate.

作者信息

Tokgoz Huseyin, Aydin Kursad, Oran Bulent, Kiyici Aysel

机构信息

Department of Pediatrics, Meram Faculty of Medicine, Konya University, 42080, Meram, Konya, Turkey.

出版信息

Childs Nerv Syst. 2012 Jul;28(7):1049-53. doi: 10.1007/s00381-012-1788-7. Epub 2012 May 30.

Abstract

BACKGROUND

Weight gain is a common side effect of valproate (VPA) treatment, although the mechanism is not clear. Abnormal weight gain and obesity are associated with dyslipidemia, hypertension, and atherosclerosis. Measurement of the common carotid artery intima media thickness (CAIMT) gives a picture of early arterial wall alterations and, currently, is considered a noninvasive marker of premature atherosclerosis. The aim of the present study was to evaluate plasma insulin, leptin, neuropeptide Y (NPY), ghrelin, and adiponectin levels in children with epilepsy treated with VPA and to evaluate these parameters for early atherosclerosis.

MATERIAL AND METHODS

Twenty prepubertal children with idiopathic epilepsy treated with VPA were enrolled in this study. Body mass index (BMI) and fasting insulin glucose ratio (FIGR) were calculated, and the plasma insulin, leptin, NPY, ghrelin, and adiponectin levels; the lipid profiles; and CAIMT were measured for all subjects before the treatment and after a follow-up period of 6 and 12 months.

RESULTS

When pretreatment values were compared with those at the end of 6 and 12 months, the mean BMI values, plasma insulin, leptin, NPY levels, and FIGR were increased, whereas the plasma ghrelin and adiponectin levels, lipid profiles, and CAIMT did not change significantly at the end of 6 and 12 months.

CONCLUSION

These results suggest that weight gain during VPA treatment may be related to increases in insulin, leptin, and NPY levels. Additionally, in this study, no increase in the risk for early atherosclerosis was determined by CAIMT in children with epilepsy treated with VPA.

摘要

背景

体重增加是丙戊酸盐(VPA)治疗常见的副作用,但其机制尚不清楚。异常体重增加和肥胖与血脂异常、高血压及动脉粥样硬化有关。测量颈总动脉内膜中层厚度(CAIMT)可反映早期动脉壁改变,目前被认为是过早发生动脉粥样硬化的一种非侵入性标志物。本研究旨在评估接受VPA治疗的癫痫患儿的血浆胰岛素、瘦素、神经肽Y(NPY)、胃饥饿素及脂联素水平,并评估这些参数与早期动脉粥样硬化的关系。

材料与方法

本研究纳入了20例接受VPA治疗的青春期前特发性癫痫患儿。计算所有受试者的体重指数(BMI)和空腹胰岛素血糖比值(FIGR),并在治疗前以及随访6个月和12个月后测量其血浆胰岛素、瘦素、NPY、胃饥饿素及脂联素水平、血脂谱和CAIMT。

结果

将治疗前的值与6个月和12个月结束时的值进行比较,平均BMI值、血浆胰岛素、瘦素、NPY水平及FIGR升高,而在6个月和12个月结束时,血浆胃饥饿素和脂联素水平、血脂谱及CAIMT无显著变化。

结论

这些结果表明,VPA治疗期间体重增加可能与胰岛素、瘦素和NPY水平升高有关。此外,在本研究中,接受VPA治疗的癫痫患儿的CAIMT未显示早期动脉粥样硬化风险增加。

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