| Background and PurposeIn 1964, valproic acid was first used in clinical, and then it was used for curing epilepsy all over the world. It was first used in our country in 1977. Though many new anti-epilepsy dugs were used in clinical, valproic acid is used popularly becase of its broad anti-epilepsy spectrum and low price.With the improvement of life level, the aim in international for epilepsy treatment is not only seizure free, but also improving the life level, so the side effects of valproic acid attract our attention, for examal weight gain. It is found that weight gain can induce many diseases including diabetes, polycystic ovary, cardio-cerebral vascular disease and so on. Weight gain can affect the feature of the people with epilepsy and affect their compliance for treatment.There are many studies on valproic acid and weight in internal and international in these years. Biton V, Martin CK, and Sherifa A found valproic acid can induce weight gain, but Caksen H and Espinosa PS found the weight has no change before and after treatment with valproic acid.Many people think serum insulin level has correlation with weight gain induced by valproic acid and make studies on this. Some people found higher serum insulin level inducesd weight gain, but some people thought weight gain induced higher serum insulin level. Many of these studies are retrospective studies, and most of the cases they choose are not first diagnosed. Retrospective study is easy to appear recall error and can not exclude the effect of initial weight, the food and exercise habit. If the case we choose is not the first diagnosed case, we can not exclude the effect of other drugs used before and the effect of chronic epilepsy seizures. Though there are some prosective studies, most of them are study on children. For the further study, we make a study for half a year on postpuberal female with epilepsy who do not have any anti-epilepsy drugs and body mass index(BMI) <25. What we study is the relationship of valproic acid and weight and the relationship of weight gain and blood-fastinginsulin level.MethodsWe chose the person meet the standard with the treatment of Magnesium Valproic acid extentab. We measured the height, the weight, the waistline, the hip circumference, the blood-fasting sugar and the blood-fasting insulin level before Valproic acid treatment and after 3 months treatment and after 6 months treatment, at the same time. We measured the serum drug level after 3 months treatment and after 6 months treatment. We calculated the BWI, fat percentage and waist-to-hipratio, then we compared the BMI, the fat percentage, the waistline, the hip circumference, the waist-to-hipratio, the blood-fasting sugar, the blood-fasting insulin before and after 3 months treatment and 6 months treatment, and find the correlation of weight gain and blood-fasting insulin level.Results1 There are 28 persons appearing weight gain after 6 months treatment, 16(53.33percent) of them weight gain are more than 4 kilogram, 9(30.00percent) of them fat percentage is more than 30 percent.2 After 3 months and 6 months treatment, The BMI are both higher than before treatment. The same is fat percentage.After 6 months treatment, the body mass index and fat percentage are both highter than after 3 months treatment.3 After 3 months and 6 months treatment, the waistline is higher than before treatment; the same is hip circumference; but the waist-to-hipratio is not signifanantly different before and after treatment.4 The blood-fasting sugar level after 3 months treatment is lower than before treatment; the same is compareing blood-fasting sugar level after 6 months treatment and before treatment. The blood-fasting sugar level after 6 months treatment is lower than after 3 months treatment, but it is not signifancantly different.5 The blood-fasting insulin level after 3 months treatment is lower than before treatment, but it is not signifancantly different; the same is comparing before and after6 months treatment. The blood-fasting insulin level after 6 months treatment is signifancantly higher than after 3 months treatment.6 The HOMA-IR after 3 months treatment is lower than before treatment. The HOMA-IR after 6 months treatment is lower than before treatment, but it is not signifancantly different. The HOMA-IR after 6 months treatment is signifancantly higher than after 3 months treatment.7 Weight gain has no correlstion with initial weight, valproic acid dose, serum valproic acid level.8 Whatever the weight gain or not, the blood-fasting insulin level has no diffirent before and after 6 months treatment.Conclusions1 Valproic acid induces continuous weight gain.2 Weight gain induced by Valproic acid is mainly the increase of fat, and the fat is well-distributed.3 Weight gain induced by Valproic acid has no correlstion with initial weight, valproic acid dose and serum valproic acid level.4 Valproic acid induces blood-fasting sugar level decrease.5 Valproic acid induces blood-fasting insulin level increase after 3 months treatment. |
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