Mahdavi Atena, Naeini Amirmansour Alavi, Najafi Mohammadreza, Ghazvini Mohammadreza, Maracy Mohammadreza
Department of Community Nutrition, School of Nutrition and Food Sciences, Isfahan University of Medical Sciences, Isfahan, Iran.
Department of Neurology, Faculty of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.
Int J Prev Med. 2019 Mar 5;10:32. doi: 10.4103/ijpvm.IJPVM_71_18. eCollection 2019.
Antiepileptic drugs (AEDs) may lead to an increase in the plasma concentration of homocysteine. There is limited information, especially from Iran, regarding the risk in patients who are treated with levetiracetam as a new type of AED. The aim of the present study was to investigate the effect of levetiracetam on plasma homocysteine, vitamin B12, and folate levels in adult patients with epilepsy.
We conducted a case-control study and enrolled adult patients with epilepsy who had received monotherapy with levetiracetam for at least 6 months at some time prior to the study. homocysteine serum, vitamin B12, and folate were measured, and folate and vitamin B12 intake was determined by the food frequency questionnaire (FFQ).
Thirty-three patients on levetiracetam and 35 control subjects aged between 18 and 60 years were enrolled. No statistically significant differences in the means of the serum markers of vitamin B12, FA, and homocysteine levels were found between the two groups. In the first model, i.e., the crude model, no significant differences were observed in the serum concentrations of homocysteine, vitamin B12, and folate. In the second model, education was considered, and body mass index and folate intake was controlled with no significant difference being observed in the mean homocysteine serum level.
Treatment with levetiracetam in patients with epilepsy has no effect on the serum levels concentrations of homocysteine, vitamin B12, and folate. This medication is suggested for patients who use AEDs on a long-term basis and at high dosages.
抗癫痫药物（AEDs）可能导致血浆同型半胱氨酸浓度升高。关于新型AEDs左乙拉西坦治疗患者的风险，相关信息有限，尤其是来自伊朗的信息。本研究的目的是调查左乙拉西坦对成年癫痫患者血浆同型半胱氨酸、维生素B12和叶酸水平的影响。
我们进行了一项病例对照研究，纳入了在研究前曾在某个时间接受过至少6个月左乙拉西坦单药治疗的成年癫痫患者。检测血清同型半胱氨酸、维生素B12和叶酸水平，并通过食物频率问卷（FFQ）确定叶酸和维生素B12的摄入量。
纳入了33例接受左乙拉西坦治疗的患者和35例年龄在18至60岁之间的对照受试者。两组之间维生素B12、叶酸和同型半胱氨酸水平的血清标志物均值无统计学显著差异。在第一个模型即粗模型中，同型半胱氨酸、维生素B12和叶酸的血清浓度无显著差异。在第二个模型中，考虑了教育程度，并控制了体重指数和叶酸摄入量，同型半胱氨酸血清平均水平无显著差异。
癫痫患者使用左乙拉西坦治疗对同型半胱氨酸、维生素B12和叶酸的血清浓度水平无影响。对于长期高剂量使用AEDs的患者，建议使用这种药物。
