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与使用丙戊酸治疗的癫痫患者代谢综合征相关的生化紊乱。

Biochemical derangements related to metabolic syndrome in epileptic patients on treatment with valproic acid.

机构信息

Department of Biochemistry, JIPMER, Puducherry, 605006, India.

Department of Biochemistry, JIPMER, Puducherry, 605006, India.

出版信息

Seizure. 2018 Aug;60:57-60. doi: 10.1016/j.seizure.2018.06.003. Epub 2018 Jun 5.

Abstract

PURPOSE

Evaluation of biochemical derangements related to metabolic syndrome in epileptic patients on treatment with Valproic acid.

METHODS

This study consisted of two groups of 42 patients. Group I - Newly diagnosed patients with epileptic seizures untreated with any Anti-epileptic drugs (AEDs). Group II - Patients on treatment with Valproic acid for more than one year. Age and gender matched patients of 18-40 years were recruited. Patients who were diabetic, hypertensive, smokers, alcoholics, with persistent infection, head injuries, pregnancy and lactation were excluded from the study. Biochemical parameters, fasting blood glucose, lipid profile, Malondialdehyde (MDA), Total Antioxidant Status (TAS), MDA/TAS ratio, leptin, adiponectin, fasting insulin, high sensitive c-reactive protein (hsCRP), Homeostatic model assessment of insulin resistance (HOMA-IR) and leptin/adiponectin ratio were estimated.

RESULTS

There was a decrease in Total cholesterol and Low Density Lipoprotein- cholesterol levels among the VPA-treated epileptic patients in comparison to newly diagnosed patients. BMI did not differ between the untreated and treated patients. There were no significant difference in the levels of hsCRP, leptin and TAS between the newly diagnosed and VPA-treated patients. Increased insulin as well as HOMA-IR levels and decreased adiponectin levels were found in VPA treated subjects when compared to the newly diagnosed patients. Oxidative stress parameters (MDA, MDA/TAS ratio) were elevated in VPA treated subjects when compared to newly diagnosed patients.

CONCLUSION

VPA treatment increased the risk factors for the development of metabolic syndrome such as hyperinsulinemia, insulin resistance and oxidative stress. However VPA treatment corrected the dyslipidemia of epileptic patients.

摘要

目的

评估接受丙戊酸治疗的癫痫患者代谢综合征相关的生化紊乱。

方法

本研究包括两组 42 名患者。组 I - 新诊断的癫痫发作患者,未接受任何抗癫痫药物(AEDs)治疗。组 II - 接受丙戊酸治疗一年以上的患者。招募年龄和性别匹配的 18-40 岁患者。排除患有糖尿病、高血压、吸烟者、酗酒者、持续性感染、头部受伤、怀孕和哺乳期的患者。评估生化参数、空腹血糖、血脂谱、丙二醛(MDA)、总抗氧化状态(TAS)、MDA/TAS 比值、瘦素、脂联素、空腹胰岛素、高敏 C 反应蛋白(hsCRP)、稳态模型评估的胰岛素抵抗(HOMA-IR)和瘦素/脂联素比值。

结果

与新诊断的患者相比,接受丙戊酸治疗的癫痫患者的总胆固醇和低密度脂蛋白胆固醇水平降低。未治疗和治疗患者的 BMI 没有差异。新诊断和丙戊酸治疗患者之间的 hsCRP、瘦素和 TAS 水平没有显著差异。与新诊断的患者相比,接受丙戊酸治疗的患者胰岛素水平升高,HOMA-IR 水平升高,脂联素水平降低。与新诊断的患者相比,接受丙戊酸治疗的患者的氧化应激参数(MDA、MDA/TAS 比值)升高。

结论

丙戊酸治疗增加了代谢综合征的发展风险因素,如高胰岛素血症、胰岛素抵抗和氧化应激。然而,丙戊酸治疗纠正了癫痫患者的血脂异常。

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