Çocukluk Çağı Epilepsisinde Valproat Tedavisi Beslenme Durumunu ve Biyokimyasal Parametreleri Etkiler mi?

Amaç: Valproik asit, çeşitli nörolojik ve nöropsikiyatrik bozuklukların tedavisi için yaygın olarak reçete edilmektedir. Bu çalışmada epilepsili çocuklarda ağırlık artışına etkisi olduğu düşünülen valproik asit tedavisinin beslenme durumu ve bazı biyokimyasal faktörler üzerine etkisinin belirlenmesi amaçlanmıştır. Gereç ve Yöntemler: Çalışmaya epilepsi tanısı ile valproik asit monoterapisi alan 30 çocuk ve ergen dahil edildi. VPA tedavisinden önce ve 12 ay sonra seçilen biyokimyasal parametreler hasta dosyalarından geriye dönük olarak kaydedildi. Etken madde dozu 11-40 mg/kg/gün arasında değişmektedir. Valproik asit plazma seviyeleri, çalışma boyunca terapötik sınırlar içinde tutulmuştur. Hastaların antropometrik ölçümleri 1-5 yaş arası çocuklar için WHO Anthro programına ve 5-18 yaş arası çocuklar için WHO Anthro-Plus programı ile hesaplanmıştır. Bulgular: Hastaların epilepsi yaşı 48,85±38,16 ay olarak belirlenmiş olup hastalar ortalama 18,95±6,02 aydır 25,00±10,75 mg/kg/gün valproik asit tedavisi almaktadırlar. Tedavi öncesi ve sonrası açlık VAS skorları açısından fark bulunmazken, iştah VAS skoru artmış, tokluk VAS skoru ise azalmıştır (p<0.05). Tedavi sonrası hastaların yaşa göre BKİ z skorları, açlık insülini, HDL kolesterol ve trigliserit seviyelerinin arttığı saptanmıştır (p<0.05). Sonuç: VPA tedavisi alan çocuklarda büyüme ve ağırlık takibi için multidisipliner ekipte bir diyetisyenin bulunmasının önemli olduğu düşünülmüştür.

Anahtar Kelimeler:

epilepsi, açlık, beslenme durumu, Obezite

Does Valproate Treatment in Childhood Epilepsy Affect Nutritional Status and Biochemical Parameters?

Objective: Valproic acid is widely prescribed for the treatment of various neurological and neuropsychiatric disorders. This study aimed to determine the effect of valproic acid therapy, which is thought to have weight gain effect on nutritional status and some biochemical factors in children with epilepsy. Material and Methods: The study included 30 children and adolescents who received valproic acid monotherapy because of the diagnosis of epilepsy. Selected biochemical parameters before and 12 months after treatment were recorded retrospectively from the patient files. Valproic acid doses ranged from 11-40 mg/kg/day and plasma levels were maintained within the therapeutic limits throughout the study. The anthropometric measurements of the patients were recorded in the WHO Anthro program for children aged 1-5 years and the WHO Anthro-Plus program for children aged 5-18 years. Results: The epilepsy age of the patients was determined as 48.85±38.16 months; and they have been receiving valproic acid therapy at a dose of 25.00±10.75 mg/kg/day for 18.95±6.02 months. While no difference was found in terms of hunger VAS scores before and after treatment, VAS scores of appetite increased and satiety decreased (p<0.05). BMI-SDs, fasting insulin, HDL cholesterol and triglyceride levels increased after treatment (p<0.05). Conclusion: For this reason, it was thought that it is important to include a dietitian in multidisiplinary team for growth and weight monitoring in children receiving VPA therapy.

Keywords:

epilepsy, hunger, nutritional status, obesity,

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