Valproic acid therapy decreases serum 25-hydroxyvitamin D level in female infants and toddlers with epilepsy— a pilot longitudinal study

Qiu, Jiamin; Guo, Hongli; Li, Ling; Xu, Ze-Yue; Xu, Zejun; Xia, Jing; Hu, Yahui; Wen, Xiaoyi; Chen, Feng; Lu, Xiaopeng

doi:10.7555/jbr.34.20200057

Cited by 9 publications

(4 citation statements)

References 28 publications

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“…The effect of sex on serum VitD is still controversial. Some reports (34,39,(42)(43)(44)(45) concluded that the serum 25-OH-VitD levels in males were significantly higher than those in females, but there didn't exist any correlation for both sexes in other studies (21,36,(46)(47)(48). In our retrospective study, notably, the effect of sex differences did occur in the two study groups observed, and it was more pronounced in the cohort group.…”

Section: Discussionmentioning

confidence: 99%

Association between serum vitamin D status and the anti-seizure treatment in Chinese children with epilepsy

Dong

Guo

et al. 2022

Front. Nutr.

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ObjectiveTo compare the serum 25-OH-VitD levels, the major marker of vitamin D (VitD) status, between healthy children and children with epilepsy before initiation of and during anti-seizure medications (ASMs) treatment and to evaluate the potential influence factors on 25-OH-VitD levels. Another major aim was to assess the potential role of VitD supplementation.MethodsFor comparison, we finally enrolled and collected data from 6,338 healthy children presenting to Health Care Department and 648 children visiting primary care pediatricians with symptoms of epilepsy in Children’s Hospital of Nanjing Medical University from January 2019 to June 2021. The demographic and biochemical characteristics of each child were extracted from the hospital information system.ResultsSerum 25-OH-VitD levels in 648 children with epilepsy were significantly lower than those of 6,338 healthy children (P < 0.0001), and the percentage of VitD insufficiency and deficiency status in pediatric patients was 49.19%. Of note, the serum 25-OH-VitD levels in children with newly diagnosed epilepsy before receiving any ASMs treatment were also significantly lower than those in healthy controls. Interestingly, ASMs therapy, alone or in combination, did not consistently reduce baseline serum VitD levels in children with epilepsy. The lower serum VitD levels in pediatric patients than those in healthy children might be related to the disease itself, rather than the ASMs treatment. As expected, VitD supplementation substantially increased the serum 25-OH-VitD levels (P < 0.0001). More critically, children with epilepsy receiving VitD supplementation achieved good seizure control in our study.SignificanceIn this retrospective study, the childhood epilepsy before initiation of and during ASMs treatment decreased the serum 25-OH-VitD concentrations, suggesting a clear association between epileptic disease and the risk of VitD deficiency. ASMs coadministration and long-term valproic acid treatment did not worse VitD-deficiency status, but in the small group receiving VitD supplementation, there was a significant improvement in reduction of seizure frequency. Therefore, pediatric clinicians are urged to raise public awareness of epilepsy-associated VitD deficiency.

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Section: Discussionmentioning

confidence: 99%

Association between serum vitamin D status and the anti-seizure treatment in Chinese children with epilepsy

Dong

Guo

et al. 2022

Front. Nutr.

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“…Studies have shown that VPA monotherapy has a negative effect on vitamin D levels, and VPA-induced vitamin D deficiency does not depend on the region of residence of patients [103,[197][198][199]. The level of vitamin D 3 decreases with an increase in BMI in patients taking long-term VPA.…”

Section: Amylasementioning

confidence: 99%

Valproate-Induced Metabolic Syndrome

Shnayder,

Grechkina,

Trefilova

et al. 2023

Biomedicines

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Valproic acid (VPA) and its salts (sodium calcium magnesium and orotic) are psychotropic drugs that are widely used in neurology and psychiatry. The long-term use of VPA increases the risk of developing adverse drug reactions (ADRs), among which metabolic syndrome (MetS) plays a special role. MetS belongs to a cluster of metabolic conditions such as abdominal obesity, high blood pressure, high blood glucose, high serum triglycerides, and low serum high-density lipoprotein. Valproate-induced MetS (VPA-MetS) is a common ADR that needs an updated multidisciplinary approach to its prevention and diagnosis. In this review, we consider the results of studies of blood (serum and plasma) and the urinary biomarkers of VPA-MetS. These metabolic biomarkers may provide the key to the development of a new multidisciplinary personalized strategy for the prevention and diagnosis of VPA-MetS in patients with neurological diseases, psychiatric disorders, and addiction diseases.

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“…Lower vitamin D levels, along with other deficiencies have been associated with valproate therapy (Cheung et al, 2016). The role of valproate in Vitamin D deficiency has been documented (Menon & Harinarayan, 2010;Nicolaidou et al, 2006;Qiu et al, 2020), possibly contributing to hair abnormalities.…”

Section: Vitamin D Deficiencymentioning

confidence: 99%

Valproate‐associated hair abnormalities: Pathophysiology and management strategies

Praharaj

Munoli

Udupa

et al. 2021

Human Psychopharmacology

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Objective: To review the literature on valproate-associated hair abnormalities and the available treatment options. Methods:We searched PubMed and Google Scholar with keywords including "valproate", "valproic acid", "hair", "alopecia", and "effluvium," supplemented with hand search from cross-references. We included all types of studies including case reports in this review. Results: The pathophysiology of hair loss includes telogen effluvium, biotin, mineral deficiency, and possibly hyperandrogenism. Diagnosis is based on history of hair loss or abnormalities following valproate treatment, and is confirmed by use of simple clinical tests such as pull test and modified wash test. Treatment involves reassurance and advice on hair care, and if possible drug discontinuation or dose reduction. Medications such as biotin and other vitamins with minerals supplementation is effective for most individuals with hair loss. Other treatment options are agomelatine, topical valproate or minoxidil, though these lack evidence. Conclusion: Hair abnormalities with valproate are common, benign adverse effects, and management includes general measures and specific treatment options.

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Valproic acid therapy decreases serum 25-hydroxyvitamin D level in female infants and toddlers with epilepsy— a pilot longitudinal study

Cited by 9 publications

References 28 publications

Association between serum vitamin D status and the anti-seizure treatment in Chinese children with epilepsy

Association between serum vitamin D status and the anti-seizure treatment in Chinese children with epilepsy

Valproate-Induced Metabolic Syndrome

Valproate‐associated hair abnormalities: Pathophysiology and management strategies

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