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[接受丙戊酸单药治疗的癫痫患儿的肥胖及代谢综合征患病率]

[The prevalence of obesity and metabolic syndrome in paediatric patients with epilepsy treated in monotherapy with valproic acid].

作者信息

Carmona-Vazquez C R, Ruiz-Garcia M, Pena-Landin D M, Diaz-Garcia L, Greenawalt S R

机构信息

Instituto Nacional de Pediatria, Mexico DF, Mexico.

出版信息

Rev Neurol. 2015 Sep 1;61(5):193-201.

Abstract

INTRODUCTION

Valproic acid (VPA) is a useful antiepileptic drug for controlling different types of epilepsy. It has several side effects and is associated to increased body weight, as well as metabolic and endocrine disorders, including metabolic syndrome.

AIM

To determine the prevalence of obesity and metabolic syndrome among paediatric patients with epilepsy treated in monotherapy with VPA.

PATIENTS AND METHODS

The study was cross-sectional, observational and analytical. A sample of patients treated with VPA between 2010-2014 were studied and the body mass index (BMI), abdominal perimeter, arterial blood pressure, glucose, triglycerides and high density lipoproteins (HDL) were studied in search of obesity and metabolic syndrome. Obesity was defined as a BMI above the 95th percentile, and metabolic syndrome was considered if at least three of the following criteria were fulfilled: abdominal perimeter above the 90th percentile, systolic arterial pressure above the 90th percentile, triglycerides above 110 mg/dL and HDL below 40 mg/dL.

RESULTS

A total of 47 patients with a mean age of 10.1 ± 4 years were studied; 51.06% were males. Eight (17%) of them developed obesity and, of those, two (25%) had metabolic syndrome. Three patients went on to become overweight (6%). Statistically significant differences were observed in the mean age in comparison to the BMI groups, where the obese patients were adolescents (ANOVA, p = 0.0001) and those who took more VPA per day were the obese (ANOVA, p = 0.024).

CONCLUSIONS

Patients treated with VPA who become obese may go on to develop metabolic syndrome. They require careful monitoring and, if they are seen to put on weight, withdrawal of the drug should be considered.

摘要

引言

丙戊酸(VPA)是一种用于控制不同类型癫痫的有效抗癫痫药物。它有多种副作用,与体重增加以及包括代谢综合征在内的代谢和内分泌紊乱有关。

目的

确定接受VPA单药治疗的癫痫患儿中肥胖和代谢综合征的患病率。

患者与方法

本研究为横断面、观察性和分析性研究。对2010年至2014年期间接受VPA治疗的患者样本进行研究,测定体重指数(BMI)、腹围、动脉血压、血糖、甘油三酯和高密度脂蛋白(HDL),以查找肥胖和代谢综合征。肥胖定义为BMI高于第95百分位数,如果满足以下至少三项标准,则考虑为代谢综合征:腹围高于第90百分位数、收缩压高于第90百分位数、甘油三酯高于110mg/dL且HDL低于40mg/dL。

结果

共研究了47例平均年龄为10.1±4岁的患者;其中51.06%为男性。其中8例(17%)出现肥胖,其中2例(25%)患有代谢综合征。3例患者超重(6%)。与BMI组相比,平均年龄存在统计学显著差异,肥胖患者为青少年(方差分析,p = 0.0001),且每天服用VPA较多的患者为肥胖患者(方差分析,p = 0.024)。

结论

接受VPA治疗且肥胖的患者可能会发展为代谢综合征。他们需要仔细监测,如果发现体重增加,应考虑停药。

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