Dürdane AKSOY, Volkan SOLMAZ, Betül ÇEVİK, Elmas PEKDAŞ, Semiha KURT

Serum Lipids and Thyroid Functions in Young Epileptic Patients Undergoing Monotherapy with Valproate or Levetiracetam

Valproat (VPA) gibi klasik antiepileptikler, kimi zaman ilaç değiştirmeyi gerektirecek yan etki profiline sahiplerdir. VPA' nın lipit profili ve tiroit fonksiyonları üzerine olumsuz etkileri iyi araştırılmıştır, levetirasetam (LEV) gibi yeni antiepileptiklerin etkileri ile ilgili çelişkili yayınlar vardır. Bu çalışmada VPA gibi iyi bilinen bir antiepileptikle yeni kuşak antiepileptiklerden LEV' in serum lipit profili ve tiroit fonksiyon testleri üzerine olan etkilerini genç hastalar üzerinde araştırdık. En az iki yıldır VPA (n=42) veya LEV (n=37) monoterapisi alan, 18-40 yaşlar arasında 79 epileptik hasta ve 58 sağlıklı birey çalışmaya alındı. Hipertansiyon, diyabet, tiroit fonksiyon bozukluğu olanlar, başka bir ilaç alan, sigara, alkol kullananlar çalışmaya dahil edilmediler. Hastaların açlık totalkolesterol, LDL-kolesterol, HDL-kolesterol, trigliserit düzeyleri ve tiroit fonksiyon testleri ölçüldü. Gruplar tanımlanan parametreler açısından karşılaştırıldılar. VPA, LEV ve kontrol grupları arasında total-kolesterol, LDL-kolesterol, HDL-kolesterol, serbestT3 değerleri açısından anlamlı bir fark olmamasına rağmen, trigliserit, tiroit-stimulan hormon (TSH) ve serbest-T4 değerleri açısından anlamlı fark vardı. VPA grubunun trigliserit düzeyleri LEV grubundan ve kontrol grubundan (p=0.0001) anlamlı şekilde yüksekti, LEV grubu ile kontrol grubu arasında anlamlı fark yoktu. VPA grubunun serbest-T4 değerleri LEV grubundan ve kontrol grubundan (p=0.020) anlamlı şekilde düşük, TSH değerleri ise anlamlı şekilde yüksekti. LEV ve kontrol grubu arasında serbestT4 ve TSH açısından anlamlı fark saptanmadı. Bu çalışmada uzun dönem kullanımda VPA' nın serum trigliserit düzeyleri tiroit fonksiyonları açısından olumsuz etkisi gözlenmiş, LEV' in ise bu parametrelere olumsuz etkisinin olmadığı sonucuna ulaşılmıştır

Anahtar Kelimeler:

Antiepileptik tedavi, valproat, levetirasetam, trigliserit, tiroit fonksiyon testleri

Serum Lipids and Thyroid Functions in Young Epileptic Patients Undergoing Monotherapy with Valproate or Levetiracetam

The negative side effects of classic antiepileptics, such as Valproate (VPA), often cause patients to discontinue their use. While the negative effects of VPA on lipid profile and thyroid functions have been well published, data regarding the side effects of new antiepileptics, such as levetiracetam (LEV), are not as conclusive. In this study, we investigated the effects of a well-known antiepileptic, VPA, and a new antiepileptic, LEV, on serum lipid levels and thyroid functions in young epileptic patients. Our study included 79 epileptic patients aged between 18-40 years who were undergoing VPA (n=42) or LEV (n=37) monotherapy for at least two years and 58 healthy subjects. Patients with hypertension, diabetes mellitus, thyroid dysfunction, smoking or alcohol addiction, and those who were being treated with any other drugs were excluded from the study. Fasting total cholesterol, LDL-cholesterol, HDL-cholesterol and triglyceride levels were measured for each patient and thyroid function tests were performed. The three groups were compared in terms of these aforementioned parameters. There were no statistical differences in the total cholesterol, LDL-cholesterol, HDL-cholesterol and free-T3 levels between the three groups. The triglyceride levels of the VPA group were significantly higher than those of the LEV and control groups (p=0.0001). While the free-T4 levels of the VPA group were significantly lower than those of the LEV and control groups (p=0.020), TSH levels were higher. The free-T4 and TSH levels did not differ significantly between the LEV and control groups. This study revealed that while the long term use of VPA negatively affected serum triglyceride levels and thyroid functions, LEV did not have any negative effects on these parameters.

Keywords:

Antiepileptic treatment, valproate, levetiracetam, triglycerides, thyroid function tests,

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