Iwaki Hirotaka, Jin Kazutaka, Fujikawa Mayu, Nakasato Nobukazu, Kaneko Sunao
Department of Epileptology, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan; North Tohoku Epilepsy Center, Minato Hospital, Hachinohe, Aomori, Japan.
Department of Epileptology, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan.
Epilepsy Behav. 2018 Jun;83:87-91. doi: 10.1016/j.yebeh.2018.03.010. Epub 2018 Apr 14.
Intellectual disability (ID) is associated with weight gain caused by antiepileptic drugs such as valproic acid. The present study analyzed the relationship between ID and weight loss caused by topiramate (TPM).
Seventy-eight patients with epilepsy (35 women, aged 18 to 70years) were enrolled in this prospective study. Body weight was measured before and 1, 6, 12, and 18months after initiation of TPM treatment. Both patients and caregivers were provided information about TPM-related weight loss. The patients were divided into the group with no or mild ID (intelligence quotient >50) and the group with moderate to profound ID (intelligence quotient ≤50).
Body weight of both groups significantly decreased until 6months but stabilized after 12months. Weight loss at 6, 12, and 18months was significantly greater in the group with no or mild ID than in the group with moderate to profound ID. Body weight change at 18months was correlated with intellectual levels (β=0.274, p=0.011) and baseline body mass index (β=-0.322, p=0.002) by multiple linear regression analysis.
The present study suggests that the pattern of weight loss during TPM administration differs according to intellectual levels. Patients with ID maintained their body weight. Weight loss due to TPM might be weakened by caregiver control of food intake or inactivity.
智力残疾（ID）与丙戊酸等抗癫痫药物导致的体重增加有关。本研究分析了ID与托吡酯（TPM）导致的体重减轻之间的关系。
本前瞻性研究纳入了78例癫痫患者（35名女性，年龄18至70岁）。在开始TPM治疗前以及治疗后1、6、12和18个月测量体重。向患者及其护理人员提供了有关TPM相关体重减轻的信息。患者被分为无或轻度ID组（智商>50）和中度至重度ID组（智商≤50）。
两组患者的体重在6个月前均显著下降，但在12个月后稳定。无或轻度ID组在6、12和18个月时的体重减轻明显大于中度至重度ID组。通过多元线性回归分析，18个月时的体重变化与智力水平（β=0.274，p=0.011）和基线体重指数（β=-0.322，p=0.002）相关。
本研究表明，TPM给药期间的体重减轻模式因智力水平而异。ID患者维持了体重。TPM导致的体重减轻可能会因护理人员对食物摄入或不活动的控制而减弱。
