Rakitin Aleksei, Kõks Sulev, Haldre Sulev
Department of Neurology and Neurosurgery, University of Tartu, Tartu, Estonia; Neurology Clinic, Tartu University Hospital, Tartu, Estonia.
Department of Pathophysiology, University of Tartu, Tartu, Estonia; Centre of Translational Medicine, University of Tartu, Tartu, Estonia.
Seizure. 2016 May;38:11-6. doi: 10.1016/j.seizure.2016.03.008. Epub 2016 Mar 30.
The aim of this study was to compare the risk of metabolic syndrome (MS) and evaluate related factors for MS among people with epilepsy treated with valproate (VPA) or carbamazepine (CBZ).
A total of 213 adult patients with epilepsy treated with VPA (n=118) or CBZ (n=95) monotherapy were included in the study. Participants were evaluated for the presence of MS, diagnosed according to the National Cholesterol Education Program Adult Treatment Panel III criteria.
In the multiple logistic regression analysis, the risk of MS in CBZ- and VPA-treated patients was similar (odds ratio [OR]=0.99; 95% confidence interval [CI], 0.43-2.26; P=0.979). A lower proportion of CBZ-treated patients had abnormally low levels of high-density lipoprotein cholesterol (OR=0.10; 95% CI, 0.02-0.42; P=0.002), whereas a lower proportion of VPA-treated patients had abnormally high concentrations of fasting blood glucose (OR=0.30; 95% CI, 0.13-0.69; P=0.004). Females treated with VPA tended to have a higher risk of MS (OR=1.48; 95% CI, 0.50-4.41; P=0.485) compared to males (OR=0.74; 95% CI, 0.28-1.96; P=0.551), although this difference was not statistically significant.
Although the overall risk of MS was similar in patients with epilepsy who were treated with VPA or CBZ, the distribution of MS components differed between treatment groups. Patients treated with CBZ or VPA less frequently had decreased high-density lipoprotein cholesterol levels or increased blood glucose concentrations, respectively. Females on VPA treatment could be at higher risk of MS than males.
本研究旨在比较丙戊酸盐（VPA）或卡马西平（CBZ）治疗的癫痫患者代谢综合征（MS）的风险，并评估MS的相关因素。
本研究共纳入213例接受VPA（n = 118）或CBZ（n = 95）单药治疗的成年癫痫患者。根据美国国家胆固醇教育计划成人治疗小组第三次报告标准对参与者进行MS评估。
在多元逻辑回归分析中，CBZ和VPA治疗患者的MS风险相似（优势比[OR]=0.99；95%置信区间[CI]，0.43 - 2.26；P = 0.979）。接受CBZ治疗的患者中高密度脂蛋白胆固醇水平异常低的比例较低（OR = 0.10；95% CI，0.02 - 0.42；P = 0.002），而接受VPA治疗的患者中空腹血糖浓度异常高的比例较低（OR = 0.30；95% CI，0.13 - 0.69；P = 0.004）。与男性相比（OR = 0.74；95% CI，0.28 - 1.96；P = 0.551），接受VPA治疗的女性患MS的风险倾向于更高（OR = 1.48；95% CI，0.50 - 4.41；P = 0.485），尽管这种差异无统计学意义。
尽管接受VPA或CBZ治疗的癫痫患者MS的总体风险相似，但各治疗组MS组分的分布有所不同。接受CBZ或VPA治疗的患者分别较少出现高密度脂蛋白胆固醇水平降低或血糖浓度升高的情况。接受VPA治疗的女性患MS的风险可能高于男性。
