Ogunjimi Luqman, Joseph Yaria, Akinyinka Alabi, Aderonke Aderinola, Bamidele Osalusi, Bolanle Falujo, Abdullahi Murtala, Olaide Dada, Mariam Oyebowale, Ibironke Oyenuga, Fehintola Fatai, Adesola Ogunniyi
Department of Pharmacology and Therapeutics, Obafemi Awolowo College of Health Sciences, Olabisi Onabanjo University, Remo Campus, Sagamu Ogun State, Nigeria.
Department of Medicine, University College Hospital, Ibadan, Oyo State, Nigeria.
Heliyon. 2023 Sep 13;9(9):e20098. doi: 10.1016/j.heliyon.2023.e20098. eCollection 2023 Sep.
This study is aimed at comparing differential effect of Levetiracetam (LTC) monotherapy and Carbamazepine (CZP) monotherapy in W omen with epilepsy (WWE) on gonadal hormone.
87 WWE were recruited comprising randomly of 46 and 41 on CZP and LTC group respectively with diagnosis and classification based on International League Against Epilepsy (ILAE). Reproductive hormones (Luteinizing Hormone (LH), Follicle stimulating hormone, progesterone, estradiol and testosterone) were assayed. National Hospital Seizure Severity Scale (NHSS) and Zung self-reporting depression scale (ZSRDS) were used to assess the seizure severity and the mood respectively. Data was analyzed using Statistical Package for Social Sciences (SPSS) version 20. The Chi-square test was used to compare categorical variables while Student's t-test or its non-parametric equivalent where appropriate were used to compare continuous variables.
Clinical characteristics were comparable in both groups except for ZSRDS (p = 0.048), NHSS (p = 0.012) and hip circumference (p = 0.037). The CZP group had a higher ASEX score and proportion of WWE with clinically significant sexual dysfunction (p < 0.001). WWE on LTC had similar hormonal profiles with those on CZP except for a higher median serum testosterone level (p = 0.004), and lower median serum LH (p = 0.006). Age was negatively associated with serum testosterone level for the 25th, 50th, and 75th quartile. However, the differential effect for AED type was only significant for the 25th quartile; with higher values in LTC.
The therapeutics implication of lower LH and testosterone levels in the LTC group compared to CZP group need to be explored.
本研究旨在比较左乙拉西坦（LTC）单药治疗和卡马西平（CZP）单药治疗对癫痫女性（WWE）性腺激素的不同影响。
招募了87例WWE，分别随机分为CZP组46例和LTC组41例，根据国际抗癫痫联盟（ILAE）进行诊断和分类。检测生殖激素（促黄体生成素（LH）、卵泡刺激素、孕酮、雌二醇和睾酮）。采用国家医院癫痫发作严重程度量表（NHSS）和zung自评抑郁量表（ZSRDS）分别评估癫痫发作严重程度和情绪。使用社会科学统计软件包（SPSS）20版进行数据分析。卡方检验用于比较分类变量，而学生t检验或其非参数等效检验在适当情况下用于比较连续变量。
除ZSRDS（p = 0.048）、NHSS（p = 0.012）和臀围（p = 0.037）外，两组临床特征具有可比性。CZP组有更高的ASEX评分和具有临床显著性性功能障碍的WWE比例（p < 0.001）。LTC治疗的WWE与CZP治疗的WWE激素谱相似，但血清睾酮中位数水平较高（p = 0.004），血清LH中位数水平较低（p = 0.006）。年龄与第25、50和75四分位数的血清睾酮水平呈负相关。然而，AED类型的差异效应仅在第25四分位数时有显著性；LTC组的值更高。
与CZP组相比，LTC组LH和睾酮水平较低的治疗意义有待探索。
