Effects Of Antiepileptic Drugs For Serum Level Of Homocysteine In Epileptic Patients

Objectives:Using meta-analysis method to investigate the relationship between antiepileptic drugs and homocysteine levels in patients with epilepsy,to provide more rational choices for antiepileptic drugs and to clarify the long-term adverse effects of antiepileptic drugs on cardiovascular and cerebrovascular health and cognitive dysfunction.Strong clinical research evidence.Methods:Retrieved before March 2018,VIP,Wanfang Database,CNKI,and Cochrance Library,PubMed,Web of Science,Dutch Medical Abstracts(Databases such as EMBASE)were used to search for literature related to antiepileptic drugs and homocysteine in blood,and Newcastle-Ottawa scale was used to evaluate the quality of the selected literature.A study that met the requirements and provided an antiepileptic drug and blood homocysteine related effect amount was included in this meta-analysis.The extracted data was analyzed using Review Manager 5.3.5 software.Results:There were 32 observational studies were included.According to the control group,patients were divided into groups before and after use of anti-epileptic drugsl,and 2Meta analysis of anti-epileptic drugs and healthy controls showed overall anti-epileptic drugs.Elevated plasma homocysteine levels in epileptic patients(group 1 SMD=0.93?95%Cl:[0.66,1.20],P<0.00001;Group 2 SMD=0.92,95%CI:[0.62,1.22],P<0.000 01);Liver enzyme-induced antiepileptic drugs(Group 1MD=4.14.95%CI:[2.72,5.55],P<0.00001;Group 2MD=6.43,95%Cl:[4.65,8.21],P<0.000 01)The effect of homocysteine levels in blood of epilepsy patients was greater than non-hepatic enzyme-induced antiepileptic drugs(Group 1 MD=2.54,95%Cl:[0.66,4.43],P<0.00001;Group 2MD =2.30,95%Cl:[0.80,3.81],P<0.000 01).The subgroup analysis was performed according to the study area.The results showed that the blood homocysteine elevation was more pronounced in the East Asian and North American groups after the use of antiepileptic drugs than in the West Asian and South Asian populations.Review Manager 5.3.5 Software Statistics Software Sensitivity Analysis of the results showed that the stability was good.Funnel diagram method and Begg method were used to test the publication bias of meta-analysis.The results showed that the funnel diagram was basically symmetric,Pr>|Z|=0.091>0.05(not statistically significant),suggesting that there was no obvious publication bias in this study.Conclusions:Many anti-epileptic drugs have an effect on the metabolism of homocysteine in the blood of epilepsy patients,which can significantly increase homocysteine levels in epilepsy patients,and supplement folic acid,vitamin B12,and vitamin B6 to reduce homocysteine levels.May be beneficial to patients using antiepileptic drugs.