University of Health, Bakirkoy Prof. Dr. Mazhar Osman Training and Research Hospital for Psychiatric, Neurologic and Neurosurgical Diseases, Istanbul, Turkey.
University of Health, Bakirkoy Prof. Dr. Mazhar Osman Training and Research Hospital for Psychiatric, Neurologic and Neurosurgical Diseases, Istanbul, Turkey.
Epilepsy Behav. 2020 Oct;111:107296. doi: 10.1016/j.yebeh.2020.107296. Epub 2020 Aug 6.
The study aimed to determine the frequency of metabolic syndrome (MetS) and obstructive sleep apnea syndrome (OSAS) in patients with epilepsy receiving monotherapy and the relationship between these syndromes and antiepileptic drugs (AEDs).
Two hundred and ninety-seven patients with epilepsy between the ages of 18-65 years receiving monotherapy for at least one year and 50 healthy participants were enrolled. Body mass indices and waist circumferences were measured. Serum fasting glucose levels, high-density lipoprotein (HDL), low density lipoprotein (LDL), total cholesterol (TC), triglyceride, and serum AED concentrations were noted. The frequency of MetS in patients with epilepsy was calculated. The snoring, tiredness, observed apnea, high blood pressure, body mass index, age, neck circumference, and male gender (STOP-Bang) questionnaire was used to determine the risk of OSAS. The relationship between these two syndromes and seizure type, disease duration, AED dosage, and treatment duration was analyzed.
Metabolic syndrome was more frequent in patients with epilepsy compared with healthy participants (32.6% vs. 12.0%), and it was diagnosed in 37.8% of patients receiving valproic acid (VPA), 36.1% of patients receiving carbamazepine (CBZ), 34.9% of patients receiving oxcarbazepine (OXC), and 30.5% of patients on levetiracetam (LEV). There was a positive correlation between VPA treatment duration and MetS existence (p < 0.05). However, MetS frequency did not change because of seizure type, disease duration, or AED dosages in patients with epilepsy receiving monotherapy. The risk for OSAS was higher in patients with epilepsy compared with healthy participants (24.6% vs. 12%), and it was calculated high in 27.7% of patients receiving CBZ, 32.2% of patients receiving LEV, and 30.2% of patients receiving OXC. The OSAS risk was higher in patients who have focal seizures than generalized seizures (p = 0.044). There was no relationship between OSAS risk and duration of epilepsy, duration of treatment, drug doses, and serum drug levels (p > 0.05).
Higher frequency of MetS and OSAS risk should be kept in mind on clinical follow-up of patients with epilepsy receiving monotherapy.
本研究旨在确定接受单药治疗的癫痫患者中代谢综合征（MetS）和阻塞性睡眠呼吸暂停综合征（OSAS）的频率，以及这些综合征与抗癫痫药物（AEDs）之间的关系。
纳入 297 名年龄在 18-65 岁之间、接受单药治疗至少 1 年的癫痫患者和 50 名健康参与者。测量体重指数和腰围。记录血清空腹血糖水平、高密度脂蛋白（HDL）、低密度脂蛋白（LDL）、总胆固醇（TC）、甘油三酯和血清 AED 浓度。计算癫痫患者 MetS 的频率。使用打鼾、疲劳、观察到的呼吸暂停、高血压、体重指数、年龄、颈围和男性（STOP-Bang）问卷来确定 OSAS 的风险。分析这两种综合征与癫痫发作类型、疾病持续时间、AED 剂量和治疗持续时间之间的关系。
与健康参与者相比，癫痫患者的代谢综合征更为常见（32.6%比 12.0%），接受丙戊酸（VPA）治疗的患者中有 37.8%、接受卡马西平（CBZ）治疗的患者中有 36.1%、接受奥卡西平（OXC）治疗的患者中有 34.9%、接受左乙拉西坦（LEV）治疗的患者中有 30.5%被诊断为代谢综合征。VPA 治疗持续时间与 MetS 存在呈正相关（p<0.05）。然而，在接受单药治疗的癫痫患者中，由于癫痫发作类型、疾病持续时间或 AED 剂量，代谢综合征的频率并没有改变。与健康参与者相比，癫痫患者发生 OSAS 的风险更高（24.6%比 12%），接受 CBZ 治疗的患者中有 27.7%、接受 LEV 治疗的患者中有 32.2%、接受 OXC 治疗的患者中有 30.2%被认为存在 OSAS 高风险。局灶性发作患者的 OSAS 风险高于全身性发作患者（p=0.044）。OSAS 风险与癫痫发作持续时间、治疗持续时间、药物剂量和血清药物水平之间无相关性（p>0.05）。
在接受单药治疗的癫痫患者的临床随访中，应注意代谢综合征和 OSAS 风险的发生频率更高。
