Frequency of metabolic syndrome and insulin resistance in epileptic patients treated with sodium valproate or carbamazepine monotherapy: A Case-Control Study 

Abstract

Background Metabolic syndrome (MetS) represents a collection of metabolic risk factors such as obesity, dyslipidemia, hyperglycemia, and hypertension. Medications can increase the incidence rate of MetS and insulin resistance (IR). Objective This study aims to evaluate the effects of Carbamazepine (CBZ) or Valproate (VPA) as monotherapy on the development of MetS and IR in the adult Iranian epileptic patients. Methods In this observational analytic case-control study, 80 epileptic patients were treated with VPA (40 patients) or CBZ (40 patients) monotherapies for more than 6 months and 45 age and sex matched controls were included. MetS was assessed based on International Diabetes Federation (IDF) and National Cholesterol Education Program (NCEP) criteria. Results In the multiple regression analysis, in VPA-treated patients the risk of MetS (by IDF criteria) was increased 19 times higher than controls (OR = 19.20; 95% CI = 2.62-140.23, P = 0. 004) and risk of IR (by HOMA and QUICKI) was increased 15 and 9 times more than controls (OR = 14.83; 95% CI = 3.03–72.56, P = 0.001) and (OR = 9.13; 95% CI = 2.55–32.65, P = 0.001) respectively. Increase in waist, DBP, and insulin level were also showed as important factors in risk of MetS. In CBZ therapy, the risk of MetS (by IDF) depressed by 17% less than controls and the risk of IR (by HOMA) increased 7 times more than controls. Conclusion Treatment with VPA can increase the likelihood of developing MetS and IR while, CBZ therapy could decrease the risk of MetS and increase risk of IR in the epileptic patients in Iran compared to the general population.

Metabolic syndrome and its associated factors among epileptic patients at Dessie Comprehensive Specialized Hospital, Northeast Ethiopia; a hospital-based comparative cross-sectional study

“…Likewise, BMI was significantly associated with MS in both the IDF and ATP-III criteria. This is consistent with the studies conducted in Estonia [ 22 ], Iran [ 45 ] and Japan [ 38 ]. The result could be explained in light of the contribution of increased body weight to central obesity, which leads to the accumulation of fat in the body.…”

Assessment of circulating miRNA-218, miRNA-222, and miRNA-146 as biomarkers of polycystic ovary syndrome in epileptic patients receiving valproic acid

“…In addition, PCOS has been associated with co-morbidities, such as type 2 diabetes, dyslipidemia, hyperinsulinemia, insulin resistance, obesity, infertility, and galactorrhea 31 . A study on Finnish women demonstrated that approximately 60% of individuals who received VPA exhibited biochemical and clinical changes related to PCOS 32 . One common side effect of PCOS is weight gain that could result from mitochondrial inhibition in response to oxidative metabolites 33 .…”

The bidirectional association of nonalcoholic fatty liver disease with depression, bipolar disorder, and schizophrenia

“…9,[27][28][29] Parenthetically, the relationship between valproate use and risk of NAFLD is not established, although several studies report such an association. 30,31 Moreover, the included studies remained limited in discerning the difference between the association of BD-I and BD-II with NAFLD, respectively.…”