Effect Of Valproic Acid On Carotid Artery Intima-media Thickness In Epileptic Patients

Objective:To investigate the influence of the carotid artery intima-media thickness(CA-IMT) in epileptic patients with valproate (VPA).Methods:Thirty patients under long-term VPA monotherapy and Thirty-three healthy age-and sex-matched control subjects received measurement of IMT at the common carotid artery by B-mode ultrasonography in both sides and the level of Total cholesterol,Triglycerides,High-density lipoproteins cholesterol,Low-density lipoproteins cholestero,and so on.Subsequently,multivariable and univariable regression analysis were adopted to screen the risk factors for IMT(such as during,administration time).Results:1. Compared to control group, the IMT of common carotid artery on either side[Left,0.486±0.087 versus 0.378±0.063, P<0.001],[Right,0.501±0.087 versus 0.397±0.056, P<0.001] or the mean CA-IMT[0.493±0.080 versus 0.393±0.052, P<0.001] was significantly increased in epilepsy group (P<0.001).Multiple stepwise regression analysis further revealed that there was also a significant positive correlation between the mean CA-IMT and duration of epilepsy/VPA therapy.When epileptic patients were divided into two groups according to the duration of epilepsy(≤3 years;>3 years), significantly higher CA-IMT were found in >3 years group[0.544≤0.071 versus 0.448≤0.058,P<0.001]. While grouped according to the duration of VPA treatment(≤1 years;>1 years),the CA-IMT were higher in >1 years than≤1 years group[0.509±0.091 versus 0.472±0.060,P>0.05],but no differences were observed.2.The levels of TG[1.37±0.33 versus 1.04±0.38,P<0.01],TC/HDL-c[3.83±0.89 versus 3.05±0.50,P<0.001] and LDL-c/HDL-c[2.21±0.82 versus 1.84±0.48,P<0.05] in epilepsy group were significantly higher than the control group,the levels of HDL[1.17±0.30 versus 1.34±0.23,P<0.05] was decreased,while there was no significant differences in the levels of TC [4.25±0.62 versus 4.03±0.54,P>0.05] and LDL-c[2.42±0:64 versus 2.41±0.55,P>0.05].Conclusion:Epileptic patients with VPA have increased vulnerability to develop increased CA-IMT.