Farinelli Edoardo, Giampaoli David, Cenciarini Anja, Cercado Ephraim, Verrotti Alberto
Edoardo Farinelli, David Giampaoli, Anja Cenciarini, Alberto Verrotti, Department of Pediatrics, University of Perugia, 06100 Perugia, Italy.
World J Hepatol. 2015 May 28;7(9):1251-7. doi: 10.4254/wjh.v7.i9.1251.
Valproic acid (VPA) is one of the most prescribed drugs in children with newly diagnosed epilepsy. Weight gain and obesity have been observed as side effects of VPA. These are often linked with other metabolic disturbances such as development of insulin resistance, dyslipidemia, metabolic syndrome (MetS) and non-alcoholic fatty liver disease or nonalcoholic fatty liver disease (NAFLD). NAFLD refers to a group of liver disorders with marked hepatic steatosis. It is associated with an increased incidence of cardiovascular diseases and overall reduced life expectancy. NAFLD occurs in 20%-25% of the general population and it is known to be the most common cause of chronic liver disease. NAFLD therefore represents a major public health issue worldwide. This study reviews and summarizes relevant literature that supports the existence of an association between VPA therapy and the development of NAFLD in children. Long-term VPA-therapy appears to be associated with an increased risk of developing NAFLD. Further studies are needed to clarify the pathogenic mechanisms that lie behind this association and to standardize the options for the use of this drug in overweight patients and in those with risks for developing MetS and NAFLD.
丙戊酸（VPA）是新诊断癫痫患儿中最常使用的药物之一。体重增加和肥胖已被观察到是VPA的副作用。这些通常与其他代谢紊乱有关，如胰岛素抵抗的发展、血脂异常、代谢综合征（MetS）和非酒精性脂肪性肝病（NAFLD）。NAFLD是指一组以明显肝脂肪变性为特征的肝脏疾病。它与心血管疾病发病率增加和总体预期寿命降低有关。NAFLD在普通人群中的发生率为20%-25%，已知是慢性肝病的最常见原因。因此，NAFLD是全球一个主要的公共卫生问题。本研究回顾并总结了支持VPA治疗与儿童NAFLD发生之间存在关联的相关文献。长期VPA治疗似乎与发生NAFLD的风险增加有关。需要进一步研究来阐明这种关联背后的致病机制，并规范在超重患者以及有发生MetS和NAFLD风险的患者中使用该药物的选择。
