| Background and purposeEpilepsy is the paroxysmal brain dysfunction for the sake of Brain neuron populations'excessive discharge, and it is a chronic brain dysfunction syndrome. There are nearly 50,000,000 epileptic worldwide, and 9,000,000 in China. Epilepsy can be seen in all of the age grades. Up to now, long-term antiepileptic drugs (AEDs) therapy was the main method, especially some refractory epilepsy which needed lifetime medication and drug combination. Valproic acid is used popularly because of its broad anti-epilepsy spectrum and low price. Indubitably, most of the AEDs have side effects in varying degree. 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 example 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.Retrospective and cross-sectional study indicate that obesity can lead to insulin insistence, polycystic ovary syndrome, diabetes and cardiovascular disease. On the other hand, weight gain can affect the feature of the people with epilepsy and/or induce metabolic disease. Some studies say that weight gain can occur during treatment with VPA and should be of concern to the clinician because it can lead to many endocrinological problems such as insulin resistance and higher serum insulin. Many of these studies are retrospective studies, and most of the cases they choose are not first diagnosed. Retrospective study can not exclude the effect of long time therapy with VPA. Patients with newly diagnosed epilepsy were included in this study. For the further study, we make a study for a year on postpuberal female with epilepsy who do not have any anti-epilepsy drugs and body mass index (BMI)<25. 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 con'elation of weight gain and blood-fasting insulin level.MethodsSelect 30 cases of postpuberal female epilepsy outpatients with the treatment of magnesium Valproic acid extentab at the age 16-45 that come to our hospital during June 2009 to April 2010, and accept a regular and single drug (VPA) treatment more than 12 month. We measured the weight, height, the waistline, the hip circumstance, the blood-fasting sugar and the blood-fasting insulin level before Valproic acid treatment and after 3 months treatment and after 6 months treatment and 12 months treatmento At the same time, we measured the serum drug level after months treatment and after 6 months treatment and 12 months treatment. We calculated the BWI, the fat percentage and waist-to-hipratio, then we compared the BWI, the fat percentage, waistline, the hip circumference, waist-to-hipratio, the blood-fast sugar, the blood-fast insulin, the insulin insistence before and after 3 months treatment and after 6 months treatment and 12 months treatment, and find the correlation of weight gain and blood-fasting insulin level.Results1.26 Patients appearing weight gain after 12months treatment.17(56.67percent) of them weight gain are more than 4 kilograms.2. After 3 months and 6 months and 12 months treatment, the waistline is higher than before treatment; the same is hip circumference. 3. The waist-to-hipratio is not significantly different before and after treatment.4. After 3 months and 6 months and 12 months treatment, the BMI are all higher than before treatment.The same is fat percentage. They are all significantly different before and after treatment.5. The blood-fasting sugar level after 3 months treatment is lower than before treatment; the same is comparing blood-fasting sugar level after 6 months treatment and 12 months treatment. The blood-fasting sugar level after 6 months treatment is lower than after 3 months treatment, and the blood-fasting sugar level after 12 months treatment is lower than after 6 months treatment,but there are no statistically significant different.6. The blood-fasting insulin level after 3 months and 12 months treatment are higher than before treatment, but it is not significantly different. The blood-fasting insulin level after 6 months treatment is significantly higher than before treatment.7. The HOMA-IR after 6 months and 12 months treatment are higher than before treatment. And there are statistically significant different.8. Weight gain has no correlation with initial weight.9. Weight gain has no correlation with valporic acid dose.10. Weight gain has no correlation with serum valproic acid level.11. Whatever the weight gain or not, the blood-fasting insulin level has no difference before and after 12 months treatment.Conclusions1. Valproic acid induces conclusions weight gain and the increase of BMI.2. weight gain induced by valproic acid is mainly the increase of fat, and the fat is well-distributed.3. Valproic acid induced higher blood-fasting insulin level.4. Valproic acid induced blood-fasting sugar level increase after 3 months treatment.5. Weight gain induced by valproic acid has no correlation with initial weight, valproic acid dose and serum valproic acid level. |
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