title: Valproate, carnitine metabolism, and biochemical indicators of liver function. Collaborative Group for the Study of Epilepsy.
abstract: The effects of valproate (VPA) on carnitine and lipid metabolism and on liver function were assessed in 213 age- and sex-matched outpatients from five centers, with the following distribution: VPA monotherapy, 54; VPA polytherapy, 55; other monotherapies, 51; and untreated, 53. Mean total and free carnitine levels were significantly lower in patients with polytherapy; acylcarnitine was significantly higher for VPA monotherapy and the ratio of acyl- to free carnitine was significantly higher in all patients receiving VPA. Ammonia, uric acid, and bilirubin were the only tests selectively impaired with VPA. A significant correlation was found between serum ammonia and VPA dosage. Glucose, beta-lipoproteins, triglycerides, acetacetate, and beta-hydroxybutyrate were unchanged in the four groups. Sex and age appeared to interact with total and free carnitine values. Adverse drug reactions were apparently unrelated to carnitine metabolism impairment. Only a few patients had abnormal carnitine values. Our data support the assumption that carnitine deficiency and abnormal liver function due to VPA are mostly subclinical events.
authors.affiliation: Istituto di Ricerche Farmacologiche Mario Negri, Milan, Italy.
authors.forename: E
authors.initials: E
authors.lastname: Beghi
authors.forename: A
authors.initials: A
authors.lastname: Bizzi
authors.forename: A M
authors.initials: AM
authors.lastname: Codegoni
authors.forename: D
authors.initials: D
authors.lastname: Trevisan
authors.forename: W
authors.initials: W
authors.lastname: Torri
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D001671:Biochemistry / Q000379:methods; D002331:Carnitine / Q000097:blood / Q000378:metabolism*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D050356:Lipid Metabolism; D008099:Liver / Q000187:drug effects* / Q000502:physiology; D008111:Liver Function Tests; D008297:Male; D012737:Sex Factors; D014635:Valproic Acid / Q000494:pharmacology*
chemical_list: D014635:Valproic Acid; D002331:Carnitine