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Aim: To investigate biochemical cardiovascular risk factors and vascular endothelial function and structure in children with epilepsy on antiepileptic drugs (AEDs), particularly sodium valproate (VPA) and carbamazepine (CBZ).

Background: Individuals with epilepsy have increased risk factors for vascular disease, particularly lipid abnormalities and elevated total plasma homocyst(e)ine (tHcy). AED induced B-vitamin deficiencies have been suggested to contribute to this risk. Vitamin B supplementation has consequently been recommended for children on AEDs. Early vascular endothelial dysfunction and atherosclerosis are detectable by measuring flow-mediated dilation (FMD) and intima-media thickness (IMT).

Methods: Thirty children with epilepsy on AEDs (13.3±2.3 years, 14 male) and 30 controls (13.9±2.9 years, 14 male) were recruited. Fasting tHcy, folate, pyridoxal-5-phosphate (PLP), vitamin B12, glucose and lipids were measured. Vascular function and structure were assessed using FMD (brachial artery) and IMT (carotid/aortic arteries).

Results: No differences were found between children with epilepsy and controls for tHcy, folate, PLP, lipids, FMD, carotid or aortic IMT. Vitamin B12 levels were elevated and glucose reduced in children treated with VPA. Elevated total cholesterol, cholesterol/HDL ratio and triglycerides occurred in children treated with CBZ. Aortic IMT correlated with weight (r=0.75, p<0.001), BMI (r=0.54, p=0.01), and HDL cholesterol (r=-0.58, p=0.006).

Conclusion: We found no early changes in vascular function or structure in children on valproate or carbamazepine. We were also unable to confirm previous reports of tHcy abnormalities in this group. This may be due to higher B-vitamin intake, which compensates for loss of vitamins induced by this AED therapy. Vitamin supplementation in children with epilepsy on valproate and carbamazepine is not required in populations with adequate dietary intake of B vitamins.

Titel:	Vascular function and risk factors in children with epilepsy: associations with sodium valproate and carbamazepine.
Autor/in / Beteiligte Person:	Keenan, N ; Sadlier, LG ; Wiltshire, E
Link:	Zum Volltext
Zeitschrift:	Epilepsy research, Jg. 108 (2014-08-01), Heft 6, S. 1087
Veröffentlichung:	Amsterdam : Elsevier Science Publishers, c1987-, 2014
Medientyp:	academicJournal
ISSN:	1872-6844 (electronic)
DOI:	10.1016/j.eplepsyres.2014.04.006
Schlagwort:	Adolescent Anticonvulsants adverse effects Aorta diagnostic imaging Blood Glucose Brachial Artery diagnostic imaging Carbamazepine adverse effects Carotid Arteries diagnostic imaging Cholesterol blood Cholesterol, HDL blood Epilepsy diagnostic imaging Epilepsy drug therapy Female Folic Acid blood Homocysteine blood Humans Male Phosphoric Monoester Hydrolases blood Risk Factors Ultrasonography Valproic Acid adverse effects Vitamin B 12 blood Anticonvulsants therapeutic use Aorta physiopathology Brachial Artery physiopathology Carbamazepine therapeutic use Carotid Arteries physiopathology Epilepsy physiopathology Valproic Acid therapeutic use
Sonstiges:	Nachgewiesen in: MEDLINE Sprachen: English Publication Type: Journal Article; Research Support, Non-U.S. Gov't Language: English [Epilepsy Res] 2014 Aug; Vol. 108 (6), pp. 1087-94. <i>Date of Electronic Publication: </i>2014 May 14. MeSH Terms: Anticonvulsants / therapeutic use ; Aorta / physiopathology ; Brachial Artery / physiopathology ; Carbamazepine / therapeutic use ; Carotid Arteries / physiopathology ; Epilepsy / physiopathology ; Valproic Acid / *therapeutic use ; Adolescent ; Anticonvulsants / adverse effects ; Aorta / diagnostic imaging ; Blood Glucose ; Brachial Artery / diagnostic imaging ; Carbamazepine / adverse effects ; Carotid Arteries / diagnostic imaging ; Cholesterol / blood ; Cholesterol, HDL / blood ; Epilepsy / diagnostic imaging ; Epilepsy / drug therapy ; Female ; Folic Acid / blood ; Homocysteine / blood ; Humans ; Male ; Phosphoric Monoester Hydrolases / blood ; Risk Factors ; Ultrasonography ; Valproic Acid / adverse effects ; Vitamin B 12 / blood Comments: Comment in: Epilepsy Res. 2014 Dec;108(10):1960-1. (PMID: 25178671) ; Comment in: Epilepsy Res. 2014 Dec;108(10):1962. (PMID: 25449365) Contributed Indexing: Keywords: Anti-epileptic drug; Child; Epilepsy; Vascular function; Vitamin Substance Nomenclature: 0 (Anticonvulsants) ; 0 (Blood Glucose) ; 0 (Cholesterol, HDL) ; 0LVT1QZ0BA (Homocysteine) ; 33CM23913M (Carbamazepine) ; 614OI1Z5WI (Valproic Acid) ; 935E97BOY8 (Folic Acid) ; 97C5T2UQ7J (Cholesterol) ; EC 3.1.3.- (pyridoxal-5-phosphatase) ; EC 3.1.3.2 (Phosphoric Monoester Hydrolases) ; P6YC3EG204 (Vitamin B 12) Entry Date(s): Date Created: 20140605 Date Completed: 20150128 Latest Revision: 20220331 Update Code: 20231215

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Vascular function and risk factors in children with epilepsy: associations with sodium valproate and carbamazepine.