Third Department of Pediatrics, National and Kapodistrian University of Athens, "Attikon" Hospital, Athens, Greece.
Third Department of Pediatrics, National and Kapodistrian University of Athens, "Attikon" Hospital, Athens, Greece.
Epilepsy Res. 2019 Sep;155:106162. doi: 10.1016/j.eplepsyres.2019.106162. Epub 2019 Jul 4.
Long-term treatment with some older antiepileptic drugs may lead to dyslipidemia or thyroid disturbances. The effect of levetiracetam (LEV), a newer broad spectrum antiepileptic agent, on cardiovascular risk factors is not yet sufficiently investigated. The purpose of this study was to investigate prospectively the effect of LEV monotherapy on serum lipid profile and thyroid hormones levels in children with epilepsy. The study population consisted of 39 children (21 females, 18 males, mean age 6.8 ± 4,1 years, range 2-15 years) that were treated for new-onset epilepsy with LEV monotherapy. Serum total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), triglycerides (TGs), apolipoprotein A-I (apo A-I), apolipoprotein B (apo B), lipoprotein (a) [Lp(a)], thyroxine (T4), free thyroxine (FT4) and thyrotropin (TSH), were evaluated before and at 6 and 12 (n = 28) months of LEV monotherapy. TGs were significantly decreased at 6 and 12 months of LEV treatment (p = 0.026 and p = 0.001, respectively). TGs/HDL-C ratio was significantly decreased at 6 and 12 months of LEV treatment (p = 0.024 and p = 0.003, respectively), while LDL-C/HDL-C ratio was significantly decreased at 12 months of LEV treatment (p = 0.025). There were no significant alterations in the other parameters during the study. In conclusion, long-term LEV monotherapy does not cause adverse alterations on thyroid hormones and serum lipids in children with epilepsy. More studies are needed to clarify whether LEV monotherapy have a favourable effect on serum lipids and whether LEV may be considered as a safer alternative drug for the prevention of antiepileptic drug-induced cardiovascular complications in adult life.
长期使用某些较老的抗癫痫药物可能导致血脂异常或甲状腺功能紊乱。新型广谱抗癫痫药物左乙拉西坦 (LEV) 对心血管危险因素的影响尚未得到充分研究。本研究旨在前瞻性研究 LEV 单药治疗对癫痫儿童血清脂质谱和甲状腺激素水平的影响。研究人群由 39 名儿童（21 名女性，18 名男性，平均年龄 6.8±4.1 岁，范围 2-15 岁）组成，他们因新诊断的癫痫接受 LEV 单药治疗。血清总胆固醇（TC）、高密度脂蛋白胆固醇（HDL-C）、低密度脂蛋白胆固醇（LDL-C）、甘油三酯（TGs）、载脂蛋白 A-I（apo A-I）、载脂蛋白 B（apo B）、脂蛋白（a）[Lp(a)]、甲状腺素（T4）、游离甲状腺素（FT4）和促甲状腺激素（TSH）在 LEV 单药治疗前和 6 个月及 12 个月（n=28）进行评估。在 LEV 治疗 6 个月和 12 个月时，TG 显著降低（p=0.026 和 p=0.001）。在 LEV 治疗 6 个月和 12 个月时，TG/HDL-C 比值显著降低（p=0.024 和 p=0.003），而 LDL-C/HDL-C 比值在 LEV 治疗 12 个月时显著降低（p=0.025）。在研究期间，其他参数没有显著变化。总之，长期 LEV 单药治疗不会导致癫痫儿童甲状腺激素和血清脂质发生不良变化。需要进一步研究以明确 LEV 单药治疗是否对血清脂质有有利影响，以及 LEV 是否可被视为预防成年期抗癫痫药物引起的心血管并发症的更安全替代药物。
