Body mass index and some biochemical parameters among valproate treated male epileptic patients

Abstract

Objective: To assess the effect of continuous valproate monotherapy (VPA) on body mass index (BMI), serum leptin, malondialdehyde (MDA) and lipid profile in male epileptic children and adult patients in comparison to healthy male controls. Subjects, materials and methods: A case-control study design was adopted. Samples from 44 male patients (22 less than 18 years old, and 22 over than 18 years old), with primary generalized epilepsy, on continuous VPA monotherapy, for at least six months before participation in the study, were collected over the period from October 2009 to March 2010. Forty-four apparently healthy male volunteers (22 less than 18 years old, and 22 over than 18 years old) without previous history of epilepsy were recruited as controls. Serum levels of leptin, and lipid profile indices were estimated using commercially available kits and a manually prepared reagent for MDA assay. (BMI) was calculated as weight in kilograms divided by the squared height in meters. Results: The results revealed that epileptic children and epileptic adults receiving continuous VPA monotherapy had a significantly higher BMI (p<0.001), serum leptin, serum MDA and atherogenic index (AI) and a significantly lower (p<0.001) serum high density lipoprotein cholesterol (HDL-c) as compared to their matched control subjects. The results also revealed insignificant difference in serum total cholesterol (TC), triglycerides (TGs) and low density lipoprotein cholesterol (LDL-c) between epileptic children and epileptic adults on VPA and their matched control subjects. Serum leptin was positively correlated with body mass index standard deviation score (BMI SDS) of epileptic children (r=0.542; P<0.001) and duration of using VPA (r=0.215; P<0.001) in epileptic children. The results showed insignificant difference in serum TC, TGs and LDL-c between epileptic adults on VPA and control subjects. This study also revealed that the increase in serum leptin was significantly higher (p<0.001) in epileptic adults receiving continuous VPA monotherapy than in epileptic children. Conclusion: Continuous VPA monotherapy was associated with higher BMI and serum leptin and an increase in the oxidative stress marker MDA in both male epileptic children and adults. There was no effect of VPA use on lipid profile indices in both epileptic children and adults except significant decrease in serum HDL-c and significant increase in AI.