Increased high-density lipoprotein cholesterol in patients with epilepsy treated with carbamazepine: a gender-related study.
OBJECTIVE
Long-term treatment with carbamazepine (CBZ) may alter serum lipoprotein concentrations. Gender-related examinations, however, are rare and inconsistent in their results.


METHODS
To examine possible sex differences, serum lipoproteins were analyzed in 127 clinic outpatients (56 women and 71 men) with epilepsies with focal or secondarily generalized tonic-clonic seizures (or both) treated with a CBZ monotherapy. Results were compared with a control group of 177 blood donors (67 women and 110 men) matched for age and weight.


RESULTS
Total cholesterol, low-density lipoprotein (LDL) cholesterol and high-density lipoprotein (HDL) cholesterol were higher in both male and female patients treated with CBZ compared with controls. The known sex difference in serum lipoprotein concentrations (i.e., higher LDL cholesterol and triglycerides but lower HDL cholesterol in men) was confirmed in controls and patients treated with CBZ, with the exception of LDL cholesterol. The HDL as well as the LDL differences were significantly more pronounced in women treated with CBZ than in men when compared with their controls. These results were independent of the dose of CBZ and plasma concentrations. Lathosterol, a cholesterol precursor, and its ratio to cholesterol, an indicator of cholesterol synthesis, were not different, when compared between gender and different HDL groups.


CONCLUSIONS
The observed increase in HDL cholesterol in patients with CBZ, especially in women, might correlate with the previously reported diminished rate of death from coronary heart disease in patients with epilepsy as HDL exerts an antiatherogenic effect.
Sudhop
T
T
Department of Clinical Pharmacology, University of Bonn, Germany.
Bauer
J
J
Elger
C E
CE
von Bergmann
K
K
D000328:Adult; D000367:Age Factors; D000553:Ambulatory Care; D000927:Anticonvulsants / Q000493:pharmacokinetics / Q000494:pharmacology / Q000627:therapeutic use*; D001782:Blood Donors / Q000706:statistics & numerical data; D001835:Body Weight; D002220:Carbamazepine / Q000493:pharmacokinetics / Q000494:pharmacology / Q000627:therapeutic use*; D002784:Cholesterol / Q000097:blood; D008076:Cholesterol, HDL / Q000097:blood*; D008078:Cholesterol, LDL / Q000097:blood; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D004827:Epilepsy / Q000097:blood* / Q000188:drug therapy*; D005260:Female; D006801:Humans; D007536:Isomerism; D008297:Male; D012737:Sex Factors; D013268:Stimulation, Chemical; D014280:Triglycerides / Q000097:blood
D000927:Anticonvulsants; D008076:Cholesterol, HDL; D008078:Cholesterol, LDL; D014280:Triglycerides; D002220:Carbamazepine; C001521:lathosterol; D002784:Cholesterol