Valproat ve karbamazepin tedavisinin serum leptin, insülin, lipid profili, C-reaktif protein düzeyleri ile vücut ağırlığı üzerine etkisi

Amaç: Valproat (VPA) ve Karbamazepin (KBZ) tedavisinin leptin, insülin, lipid profili, C-reaktif protein(CRP), C-peptid ve vücut ağırlığı üzerine etkisinin araştırılması amaçlandı.Yöntem: Yaşları 1.5-15 arasında olan, 29’u VPA (GRUP I), 21’i KBZ (GRUP II) tedavisi alan epileptik olguile 35 sağlıklı kontrol olgusu (GRUP III) çalışmaya alındı.Bulgular: Vücut kitle indeksi (VKİ) persantiline göre GRUP I’deki olguların % 6.9 (2 olgu) ve GRUP II’dekiolguların ise % 19 (4 olgu) fazla kilolu ve obezdi. GRUP II’de GRUP I’e göre lipid profilinden sadece serumLDL-K ve TK düzeylerinde anlamlı oranda bir yükseklik mevcuttu (p0.05). Serum leptin, CRP ve insülin düzeylerinin VPA ve KBZkullanımına bağlı vücut ağırlığı artışında ise anlamlı bir etkisi yoktu.Sonuç: VPA ve KBZ’e bağlı tartı artışı etyolojisinde suçlanan serum leptin, insülin ve lipid yüksekliği arasındaanlamlı bir ilişki saptanmamıştır. Antiepileptiklere bağlı vücut ağırlığı artışı ve obesite etyopatogenezininaydınlatılması için obesitede etkili kalıtım, sosyoekonomik faktörler, beslenme alışkanlığı, çevresel faktörler veaile eğitimi gibi multifaktöriyel etkileşimlerin göz önünde bulundurulduğu yeni çalışmalara ihtiyaç vardır.

The effects of valproate and carbamazepine intake on serum leptin, insulin, lipid profiles, C-reactive protein levels and weight

Objectives: This study aims to evaluate the effects of valproate (VPA) and carbamazepine (CBZ) intake onserum leptin, insulin, lipid profiles, C-reactive protein (CRP) levels, C-peptid and weight.Patients and methods: Twenty-nine using VPA (Group I), and 21 patients using CBZ (Group II) aged 1.5-15years and 35 healthy children (Group III) were included.Results: The rates of weight intake according to body mass index percentile increaase were 6.9 %, (2 cases) inthe Group I and 19 % (4 cases) in the Group II. In Group II, levels of only LDL-K and TK were significantlyhigher than in Group I, but increasing of these lipids were not statistically significant compared with the controlgroup. However, no significant effect of serum levels of leptin, insulin, lipid profile, CRP, and C-peptide wereobserved on weight intake.Conclusion: The etiology of weight gain due to VPA and CBZ intake was not associated with hyperleptinemia,hyperinsulinemia and hyperlipidemia. Multifactorial associations among heredity, socioeconomic factors,dietary habits, enviromental factors and family education should be taken into consideration in the etiology ofweight gain secondary to antiepileptics. Further new studies about this subject should be performed.

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