Kakunje Anil, Prabhu Ashwini, Karkal Ravichandra, Pookoth K Rahyanath, Kumar Parmod, Gupta Nitin, Priya Es Sindhu, Nishad Pma
Department of Psychiatry, Yenepoya Medical College, Yenepoya Deemed to be University, Mangalore, Karnataka, India.
Division of Cancer Research and Therapeutics, Yenepoya Research Center, Yenepoya Deemed to be University, Mangalore, Karnataka, India.
Indian J Psychiatry. 2025 Sep;67(9):894-899. doi: 10.4103/indianjpsychiatry_1152_24. Epub 2025 Sep 16.
Valproic acid (VPA) is the medication prescribed for the treatment of bipolar disorder, epilepsy, and migraine. It is reported that the VPA treatment leads to biotin deficiency due to the low serum biotinidase activity. Alopecia or hair loss is another common side effect of valproate administration.
The study aims to investigate hair loss complaint in people, who are on Valproate and find the association between valproate levels, serum biotinidase activity and hair loss in persons treated with valproate.
This two years cross sectional comparative study involving 150 participants was performed at department of Psychiatry of a tertiary care teaching hospital. The study group had 75 persons taking Valproate compared with 75 persons in the control group. Blood samples were collected for estimation of serum VPA levels and serum biotinidase activity. Quantification of alopecia biomarker Interleukin (IL)-2 was estimated. Data was analyzed by using student T test, Pearson's correlation, and Mann Whitney test.
The study group comprised of 40 males and 35 females with a mean age of 42.04 (±12.85) years. The control group had 39 males and 36 females with a mean age of 38.38 (±14.42) years. Hair loss was reported in 18 (24%) persons of study cohort compared to 2 (2.66%) among the control group. There was a statistically significant difference between biotinidase levels across the participants with hair loss complaint and those without hair loss complaint. (Mean rank of participants with hair loss complaint = 43.30, mean rank of participants without hair loss complaint = 80.45, U = 656.000, ≤ 0.001). There was a statistically significant difference between the distribution of across the study and control groups. (Mean rank of study group = 57.73, mean rank of control group = 83.27, U = 3,395.00, = 0.025).
It can be concluded that there is an association between Valproate levels, biotinidase activity and hair loss.
丙戊酸（VPA）是用于治疗双相情感障碍、癫痫和偏头痛的药物。据报道，由于血清生物素酶活性低，VPA治疗会导致生物素缺乏。脱发是丙戊酸盐给药的另一种常见副作用。
本研究旨在调查服用丙戊酸盐的人群中的脱发情况，并找出丙戊酸盐水平、血清生物素酶活性与接受丙戊酸盐治疗者脱发之间的关联。
这项为期两年的横断面比较研究在一家三级护理教学医院的精神科进行，涉及150名参与者。研究组有75人服用丙戊酸盐，对照组有75人。采集血样以评估血清VPA水平和血清生物素酶活性。对脱发生物标志物白细胞介素（IL）-2进行定量评估。数据采用学生t检验、Pearson相关性分析和Mann Whitney检验进行分析。
研究组包括40名男性和35名女性，平均年龄为42.04（±12.85）岁。对照组有39名男性和36名女性，平均年龄为38.38（±14.42）岁。研究队列中有18人（24%）报告有脱发，而对照组中有2人（2.66%）报告有脱发。有脱发主诉的参与者和无脱发主诉的参与者之间的生物素酶水平存在统计学显著差异。（有脱发主诉的参与者平均秩次 = 43.30，无脱发主诉的参与者平均秩次 = 80.45，U = 656.000，P≤0.001）。研究组和对照组之间的分布存在统计学显著差异。（研究组平均秩次 = 57.73，对照组平均秩次 = 83.27，U = 3395.00，P = 0.025）。
可以得出结论，丙戊酸盐水平、生物素酶活性与脱发之间存在关联。
