Nafiye Polat Çiçek1, Tülay Kamaşak2, Mine Serin3, Aysenur Okten4, Ahmet Alver5, Ali Cansu6. 1. Education and Research Hospital of Çorum, Çorum, Turkey. Electronic address: nafiyepolat@ktu.edu.tr. 2. Karadeniz Tecnical University, Depertment of Pediatric Neurology, Trabzon, Turkey. Electronic address: tkamasak@ktuedu.tr. 3. Ege University Pediatric Neurology, İzmir, Turkey. Electronic address: hepsenmine@ege.edu.tr. 4. Karadeniz Tecnical University, Pediatric Endocrinology, Trabzon, Turkey. Electronic address: aysenur@ktu.edu.tr. 5. Karadeniz Technical University, Medical Biochemistry, Trabzon, Turkey. Electronic address: alver@ktu.edu.tr. 6. Karadeniz Technical University, Pediatric Neurology, Trabzon, Turkey. Electronic address: acansu@ktu.edu.tr.
Abstract
PURPOSE: Although some drugs used in the treatment of epilepsy are known to affect body weight, the hormonal factors responsible have not been sufficiently described. The purpose of this study was to compare insulin, leptin, neuropeptide Y and ghrelin levels in children with epilepsy receiving monotherapy with topiramate (TPM) and valproic acid (VPA), the drugs whose effects on body weight have been most discussed, with those of a control group. METHOD: 48 patients (25 VPA, 23 TPM) aged between 6 and 15.5 years, presenting to the Karadeniz Technical University Medical Faculty Pediatric Neurology Clinic, diagnosed with idiopathic epilepsy or location-related idiopathic epilepsy, and receiving VPA or TPM monotherapy for at least 6 months were included in the study. Twenty-five healthy subjects with similar demographic characteristics were enrolled as the control group. Blood samples were collected from the patient and control groups after fasting for at least 10-12 h and again 1 and 2 h postprandially. Body mass index (BMI) values were calculated for all cases. VPA levels, glucose, insulin, leptin, neuropeptide Y and ghrelin were investigated in all three separate blood samples. RESULTS: Age, height, weight and BMI were similar between the patient and control groups. Significant weight gain was observed throughout treatment in the VPA group compared to the TPM group. High fasting and postprandial insulin levels were observed in the VPA group. VPA group leptin and neuropeptide Y (NPY) levels were also higher than in the TPM and control groups. No significant difference was determined in ghrelin levels in the patient groups compared to the controls. CONCLUSION: Low blood sugar not being observed, even though insulin levels are high, after fasting and in the postprandial period in epileptic children receiving VPA is indicative of insulin resistance. The elevation in leptin and neuropeptide Y levels observed in the VPA group also suggest this.
PURPOSE: Although some drugs used in the treatment of epilepsy are known to affect body weight, the hormonal factors responsible have not been sufficiently described. The purpose of this study was to compare insulin, leptin, neuropeptide Y and ghrelin levels in children with epilepsy receiving monotherapy with topiramate (TPM) and valproic acid (VPA), the drugs whose effects on body weight have been most discussed, with those of a control group. METHOD: 48 patients (25 VPA, 23 TPM) aged between 6 and 15.5 years, presenting to the Karadeniz Technical University Medical Faculty Pediatric Neurology Clinic, diagnosed with idiopathic epilepsy or location-related idiopathic epilepsy, and receiving VPA or TPM monotherapy for at least 6 months were included in the study. Twenty-five healthy subjects with similar demographic characteristics were enrolled as the control group. Blood samples were collected from the patient and control groups after fasting for at least 10-12 h and again 1 and 2 h postprandially. Body mass index (BMI) values were calculated for all cases. VPA levels, glucose, insulin, leptin, neuropeptide Y and ghrelin were investigated in all three separate blood samples. RESULTS: Age, height, weight and BMI were similar between the patient and control groups. Significant weight gain was observed throughout treatment in the VPA group compared to the TPM group. High fasting and postprandial insulin levels were observed in the VPA group. VPA group leptin and neuropeptide Y (NPY) levels were also higher than in the TPM and control groups. No significant difference was determined in ghrelin levels in the patient groups compared to the controls. CONCLUSION: Low blood sugar not being observed, even though insulin levels are high, after fasting and in the postprandial period in epilepticchildren receiving VPA is indicative of insulin resistance. The elevation in leptin and neuropeptide Y levels observed in the VPA group also suggest this.
Authors: Muhammad T Alrifai; Noura A Alsubaie; Albatool M Abodarahem; Shadan B Alomran; Maryam N Alboqami; Raghad T Alsadun; Yusra Sajid Chachar; Mohammed A Alqassim; Mohamed K Abdelkabir Journal: Cureus Date: 2022-08-28