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丙戊酸钠和卡马西平治疗的两组癫痫患者胰岛素抵抗的研究

The Investigation of Insulin Resistance in Two Groups of Epileptic Patients Treated with Sodium Valproate and Carbamazepine.

作者信息

Najafi Mohammad Reza, Bazooyar Bahareh, Zare Mohammad, Aghaghazvini Mohammad Reza, Ansari Behnaz, Rajaei Ali, Dashti Masoumeh

机构信息

Department of Neurology, Isfahan Neurosciences Research Center, Alzahra Hospital, Isfahan University of Medical Sciences, Isfahan, Iran.

Department of Internal Medicine, Babol University of Medical Sciences, Babol, Iran.

出版信息

Adv Biomed Res. 2017 Mar 7;6:25. doi: 10.4103/2277-9175.201689. eCollection 2017.

Abstract

BACKGROUND

Valproic acid (VPA) is a widely used broad-spectrum antiepileptic drug for therapy of generalized and focal epilepsies. Cross-sectional studies have suggested that valproate treatment may be associated with hyperinsulinemia. We decided to investigate hyperinsulinemia as a health-threatening side effect of VPA in Iranian epileptic patients.

MATERIALS AND METHODS

Body mass index (BMI), lipid profile, fasting serum insulin, fasting blood glucose (FBS), and homeostatic model assessment-insulin resistance (HOMA-IR) were measured in 30 VPA-treated epileptic patients and 30 controls (CBZ-treated). The Chi-square test, -test, and Pearson correlation test were used.

RESULTS

BMI was higher in VPA group than in control group (25.7 ± 3.5 > 21.7 ± 4.1) (0.000 < 0.05). Prevalence of obesity was 16.6% in VPA group that was almost the same and even lower than general Iranian population. Serum triglyceride (TG) (150 ± 77.2) was higher than CBZ group (114 ± 35.2) ( = 0.023 < 0.05). However, serum high-density lipoprotein level was lower in VPA group than controls (45.2 ± 11.7 < 54.4 ± 13.9) ( = 0.008 < 0.05). Serum insulin, FBS, HOMA-IR, cholesterol, and low-density lipoprotein did not demonstrate statistically significant differences between the two groups ( > 0.05).

CONCLUSION

Despite the majority of previous studies that are against VPA and according to our study, VPA could be prescribed safely and it may not cause IR and its complications.

摘要

背景

丙戊酸(VPA)是一种广泛使用的广谱抗癫痫药物,用于治疗全身性和局灶性癫痫。横断面研究表明,丙戊酸盐治疗可能与高胰岛素血症有关。我们决定调查高胰岛素血症作为VPA在伊朗癫痫患者中一种威胁健康的副作用。

材料与方法

对30例接受VPA治疗的癫痫患者和30例对照组(接受卡马西平治疗)测量体重指数(BMI)、血脂谱、空腹血清胰岛素、空腹血糖(FBS)和稳态模型评估胰岛素抵抗(HOMA-IR)。使用卡方检验、t检验和Pearson相关检验。

结果

VPA组的BMI高于对照组(25.7±3.5>21.7±4.1)(P=0.000<0.05)。VPA组肥胖患病率为16.6%,几乎与伊朗普通人群相同,甚至更低。血清甘油三酯(TG)(150±77.2)高于卡马西平组(114±35.2)(P=0.023<0.05)。然而,VPA组血清高密度脂蛋白水平低于对照组(45.2±11.7<54.4±13.9)(P=0.008<0.05)。两组之间血清胰岛素、FBS、HOMA-IR、胆固醇和低密度脂蛋白无统计学显著差异(P>0.05)。

结论

尽管大多数先前的研究反对使用VPA,但根据我们的研究,VPA可以安全使用,并且可能不会引起胰岛素抵抗及其并发症。

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