The effect of long-term valproic acid treatment in the level of total cholesterol among adult

Kusumastuti, Kurnia; Jaeri, Santoso

doi:10.4103/ijp.ijp_655_18

Cited by 8 publications

(10 citation statements)

References 9 publications

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“…A study by Kusumastuti K, employing logistic regression, made a similar discovery. Specifically, it was found that the risk of developing high total cholesterol levels in adult patients with VPA use for more than 12 months was 3.68 times lower than that with VPA use for less than 12 months ( Kusumastuti and Jaeri, 2020 ). In a meta-analysis conducted in 2022, researchers observed that long-term VPA treatment had the potential to reduce total cholesterol and low-density lipoprotein cholesterol levels.…”

Section: Discussionmentioning

confidence: 99%

Pre-treatment risk predictors of valproic acid-induced dyslipidemia in pediatric patients with epilepsy

Liang,

Lin,

Ning

et al. 2024

Front. Pharmacol.

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Background: Valproic acid (VPA) stands as one of the most frequently prescribed medications in children with newly diagnosed epilepsy. Despite its infrequent adverse effects within therapeutic range, prolonged VPA usage may result in metabolic disturbances including insulin resistance and dyslipidemia. These metabolic dysregulations in childhood are notably linked to heightened cardiovascular risk in adulthood. Therefore, identification and effective management of dyslipidemia in children hold paramount significance.Methods: In this retrospective cohort study, we explored the potential associations between physiological factors, medication situation, biochemical parameters before the first dose of VPA (baseline) and VPA-induced dyslipidemia (VID) in pediatric patients. Binary logistic regression was utilized to construct a predictive model for blood lipid disorders, aiming to identify independent pre-treatment risk factors. Additionally, The Receiver Operating Characteristic (ROC) curve was used to evaluate the performance of the model.Results: Through binary logistic regression analysis, we identified for the first time that direct bilirubin (DBIL) (odds ratios (OR) = 0.511, p = 0.01), duration of medication (OR = 0.357, p = 0.009), serum albumin (ALB) (OR = 0.913, p = 0.043), BMI (OR = 1.140, p = 0.045), and aspartate aminotransferase (AST) (OR = 1.038, p = 0.026) at baseline were independent risk factors for VID in pediatric patients with epilepsy. Notably, the predictive ability of DBIL (AUC = 0.690, p < 0.0001) surpassed that of other individual factors. Furthermore, when combined into a predictive model, incorporating all five risk factors, the predictive capacity significantly increased (AUC = 0.777, p < 0.0001), enabling the forecast of 77.7% of dyslipidemia events.Conclusion: DBIL emerges as the most potent predictor, and in conjunction with the other four factors, can effectively forecast VID in pediatric patients with epilepsy. This insight can guide the formulation of individualized strategies for the clinical administration of VPA in children.

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Section: Discussionmentioning

confidence: 99%

Pre-treatment risk predictors of valproic acid-induced dyslipidemia in pediatric patients with epilepsy

Liang,

Lin,

Ning

et al. 2024

Front. Pharmacol.

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“…The main route for VPA biotransformation is glucuronidation;the glucuronidase enzyme may be inhibited by VPA or its metabolites, leading to decreased synthesis of TC, LDL‐C, and HDL‐C. In addition, long‐term use of VPA can decrease the levels of total cholesterol, and this may be mediated by enhanced function of some organs/organelles, which contributes to improved cholesterol metabolism [26]. Aric et al .…”

Section: Discussionmentioning

confidence: 99%

“…The main route for VPA biotransformation is glucuronidation; the glucuronidase enzyme may be inhibited by VPA or its metabolites, leading to decreased synthesis of TC, LDL-C, and HDL-C. In addition, long-term use of VPA can decrease the levels of total cholesterol, and this may be mediated by enhanced function of some organs/organelles, which contributes to improved cholesterol metabolism [26] 3/b pathway, which is associated with increased cholesterol metabolism and the pathogenesis of atherosclerosis [27]. Furthermore, 70% of cholesterol is synthesised from acetyl-coenzyme A (CoA) in hepatocytes.…”

Section: Discussionmentioning

confidence: 99%

Effect of long‐term valproic acid therapy on lipid profiles in paediatric patients with epilepsy: a meta‐analysis

Guo¹,

Dong²,

Chen³

et al. 2022

Epileptic Disorders

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Objective. Despite the potential role of valproic acid (VPA) in weight gain, the effects of VPA therapy on lipid profiles remain unclear. This study aimed to review the influence of VPA therapy on serum lipid profiles in children with epilepsy.Methods. This meta-analysis was conducted on data from PubMed, Web of Science, Cochrane Library, and Embase databases. Case-controlled studies, which assessed the effects of VPA therapy on lipid profiles, were included. All outcomes were recorded as continuous variables, and the effect size was measured.Results. VPA therapy was associated with a significant reduction in total cholesterol (mean difference [MD]=-6.34, 95% confidence interval [CI]: -12.30, -0.37, p=0.04) and low-density lipoprotein cholesterol levels (MD = -7.75, 95% CI: -13.48, -2.0, p=0.008). No significant effects were observed regarding the levels of high-density lipoprotein cholesterol and triglycerides. Significance. In conclusion, this meta-analysis indicates that VPA therapy causes a decrease in the levels of total cholesterol and low-density lipoprotein cholesterol.

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“…Hyperlipidaemia increases cholesterol, triglycerides, or both 4 , and hypercholesterolemia is a significant factor in arteriosclerotic disease. 5 Cholesterol is a hydrophobic molecule that circulates through the bloodstream in proteins called lipoproteins. 6 Increased and imbalanced cholesterol in blood plasma has been associated with increased coronary heart disease up to 2.52 -3.20 at productive age.…”

Section: Introductionmentioning

confidence: 99%

Effect of Rosella (Hibiscus sabdariffa. L) Consumption on Total Cholesterol Levels

2023

TJNPR

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The effect of long-term valproic acid treatment in the level of total cholesterol among adult

Cited by 8 publications

References 9 publications

Pre-treatment risk predictors of valproic acid-induced dyslipidemia in pediatric patients with epilepsy

Pre-treatment risk predictors of valproic acid-induced dyslipidemia in pediatric patients with epilepsy

Effect of long‐term valproic acid therapy on lipid profiles in paediatric patients with epilepsy: a meta‐analysis

Effect of Rosella (Hibiscus sabdariffa. L) Consumption on Total Cholesterol Levels

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