Metabolic syndrome and obstructive sleep apnea syndrome among patients with epilepsy on monotherapy

Söylemez, Elif; Ozturk, Oya; Baslo, Sezin Alpaydın; Balçık, Zeynep Ezgi; Ataklı, Dilek

doi:10.1016/j.yebeh.2020.107296

“…The study found that the prevalence rate of MS in the epilepsy group was 25.5% (95% CI: 17.03%- 33.95%) as per NCEP ATP- III criteria and 23.5% (95% CI: 15.28%- 31.76%) as per IDF criteria. This finding is in line with similar studies conducted in Kigali Rwanda using ATP III (30.6%) [ 7 ], in Estonia using ATP-III (20.3%) [ 22 ], in India by ATP III criteria (29.5%) [ 23 ] and in Istanbul Turkey using IDF criteria (32.6%) [ 24 ]. Conversely, a higher rate of MS as compared to the finding of this study was reported among epileptic patients, 52.6% in South India using the AHA/NHLBI [ 8 ], 47.2% based on IDF Criteria, and 39.3% based on ATP-III criteria in Brazil [ 25 ], 43.5% in Italy using ATP-III [ 26 ] and 47.2% in West China based on AHA/NHLBI criteria [ 27 ].…”

Section: Discussionsupporting

confidence: 89%

“…Similarly, a higher prevalence rate of MS was estimated in epilepsy (23.5%) as compared to the control group (14.7%) using IDF criteria, but not statistically significant. Even though there are limitations in comparing our data with the previously similar published studies where the MS in epileptic patients was studied in non-comparative studies, few studies report a consistent result with our finding: a study conducted in Istanbul, Turkey (32.6% for epilepsy v s 12.0% for healthy controls) [ 24 ] and China (47.2% for epilepsy v s . 20.1% for controls) based on IDF criteria [ 27 ].…”

Section: Discussionsupporting

confidence: 87%

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

Kassaw

¹

,

Endale

²

,

Tesfa

³

et al. 2022

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Introduction Metabolic syndrome is a group of metabolic risk factors which are associated with an increased risk of cardiovascular disease and type2 diabetes. Nowadays, several studies have shown that the burden of metabolic syndrome is increasing among epileptic patients, and leads to MS-associated complications, including cardiovascular disease. However, getting published documents has been limited in Ethiopia and the study area. Therefore, we aimed to analyze the magnitude and associated factors of metabolic syndrome among epileptic patients in Dessie Comprehensive Specialized Hospital in compression with respective controls. Methods Hospital-based comparative cross-sectional study design was implemented from June 25 to August 20, 2021. A total of 204 participants with an equal number of cases and controls (n = 102 each) were included. The data was collected through face-to-face interviews and biochemical analyses such as fasting blood glucose and lipid profiles were done through the enzymatic technique. The magnitude of metabolic syndrome was determined using both National Cholesterol Education Program Adult Treatment Panel III and International Diabetes Federation definition criteria. The STATA version 14 was used for statistical data analysis, and a comparison of categorical and continuous variables was done with χ2 and an independent t-test, respectively. The multivariable binary logistic regression analysis was used to identify factors associated with metabolic syndrome, and variables having a P-value of <0.05 were considered statistically significant. Result The prevalence of metabolic syndrome among the epileptic group was (25.5% in National Cholesterol Education Program Adult Treatment Panel III and 23.5% in International Diabetes Federation criteria), whereas it was 13.7% in National Cholesterol Education Program Adult Treatment Panel III and 14.7% in International Diabetes Federation criteria among control groups. According to the International Diabetes Federation criteria, low physical activity (adjusted odds ratio = 4.73, 95% CI: 1.08–20.68), taking multiple antiepileptic drugs (adjusted odds ratio = 8.08, 95% CI: 1.52–42.74), having a total cholesterol level of ≥ 200 mg/dl (adjusted odds ratio = 5.81, 95%: 1.32–41.13) and body mass index (adjusted odds ratio = 1.57, 95% CI = 1.16–2.11) were significantly associated with metabolic syndrome among epileptic participants. Applying National Cholesterol Education Program Adult Treatment Panel III criteria, taking multiple antiepileptic drugs (adjusted odds ratio = 6.81, 95% CI: 1.29–35.92), having a total cholesterol level > 200 mg/dl (adjusted odds ratio = 7.37, 95% CI: 1.32–41.13) and body mass index (adjusted odds ratio = 1.53, 96% CI: 1.16–2.01) were also significantly associated. Conclusion The prevalence of metabolic syndrome among epileptic patients was higher than that of control groups and reaches statistically significant by National Cholesterol Education Program Adult Treatment Panel III. Being on multiple antiepileptic drugs, body mass index, having low physical activity and raised total cholesterol were significantly associated with metabolic syndrome among the epileptic group. Therefore, it is better to focus on controlling weight, having sufficient physical exercise, and regular monitoring of total cholesterol levels in epileptic patients.

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“…According to the preliminary epidemiological survey of OSAS in China, the prevalence rate is about 4% [ 7 ]. Based on the population of 1.3 billion in China, there are at least 52 million OSAS patients [ 8 ].…”

Section: Introductionmentioning

confidence: 99%

Association of Obstructive Sleep Apnea Syndrome (OSA/OSAHS) with Coronary Atherosclerosis Risk: Systematic Review and Meta-Analysis

Chen

¹

,

Zou

²

,

Wang

³

2022

Computational and Mathematical Methods in Medicine

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Objective. Obstructive sleep apnea syndrome (OSA) is the most common type of sleep disorders. This study aimed to systematically review the correlation between OSA and the risk of coronary atherosclerosis. Methods. Literature on case-control studies on the relationship between coronary heart disease (CHD) and sleep apnea syndrome was collected and collated, and the incidence of SAS in CHD and non-CHD patients was observed and compared. RevMan 5.2 analysis software and Stata12SE analysis software were used for heterogeneity test and combination analysis of the included studies. The results were expressed with odds ratio (OR), 95% confidence intervals (CI) were calculated, and publication bias and sensitivity tests were evaluated. Results. There was a statistical difference in OSA associated with the risk of coronary atherosclerosis between the experimental group and the control group [ OR = 1.38 , 95% CI (1.18, 1.62), P < 0.0001 , I 2 = 0 % , Z = 3.93 ]. OSA associated with vascular endothelial injury [ OR = 3.59 , 95% CI (3.00, 4.29), P < 0.00001 , I 2 = 90 % , Z = 14.09 ]. OSA is associated with vascular oxidation emergency [ OR = 2.19 , 95% CI (2.05, 2.33), P < 0.00001 , I 2 = 94 % , Z = 23.40 ]; OSA is associated with chronic vascular inflammation [ OR = 1.70 , 95% CI (1.39, 2.07), P < 0.00001 , I 2 = 16 % , Z = 5.18 ]. Conclusion. The incidence of obstructive sleep apnea in patients with CHD was higher than that in non-CHD patients, and obstructive sleep apnea was a risk factor for CHD.

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“…OSA appears likely to promote seizure occurrence in elderly patients [39], in particular nocturnal GTCS, while continuous positive airway pressure (CPAP) treatment is associated with reduced seizure frequency [40]. Several factors might contribute to an increased prevalence of OSA in epilepsy, including a higher rate of metabolic syndrome favored by reduced exercise and weight-gaining ASMs such as valproate [41]. Vagus nerve stimulation (VNS) also appears to trigger or aggravate OSA in 28-57% of patients [42][43][44], possibly through a stimulation-induced left vocal cord adduction [43].…”

Section: Description Of Findingsmentioning

confidence: 99%

Expert Opinion: Managing sleep disturbances in people with epilepsy

Nobili

¹

,

Beniczky

²

,

Eriksson

³

et al. 2021

Epilepsy & Behavior

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Poor sleep and daytime sleepiness are common in people with epilepsy. Sleep disorders can disrupt seizure control and in turn sleep and vigilance problems can be exacerbated by seizures and by antiepileptic treatments. Nevertheless, these aspects are frequently overlooked in clinical practice and a clear agreement on the evidence-based guidelines for managing common sleep disorders in people with epilepsy is lacking. Recently, recommendations to standardize the diagnostic pathway for evaluating patients with sleep-related epilepsies and comorbid sleep disorders have been presented. To build on these, we adopted the Delphi method to establish a consensus within a group of experts and we provide practical recommendations for identifying and managing poor night-time sleep and daytime sleepiness in people with epilepsy. We recommend that a comprehensive clinical history of sleep habits and sleep hygiene should be always obtained from all people with epilepsy and their bed partners. A psychoeducational approach to inform patients about habits or practices that may negatively influence their sleep or their vigilance levels should be used, and strategies for avoiding these should be applied. In case of a suspected comorbid sleep disorder an appropriate diagnostic investigation should be performed. Moreover, the possible presence of sleep fragmentation induced by sleep-related seizures should be ruled out. Finally, the dose and timing of antiepileptic medications and other co-medications should be optimized to improve nocturnal sleep and avoid daytime sedation.

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Metabolic syndrome and obstructive sleep apnea syndrome among patients with epilepsy on monotherapy

Cited by 6 publications

References 74 publications

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

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

Association of Obstructive Sleep Apnea Syndrome (OSA/OSAHS) with Coronary Atherosclerosis Risk: Systematic Review and Meta-Analysis

Expert Opinion: Managing sleep disturbances in people with epilepsy

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