Fasting serum insulin and lipid levels in men with epilepsy.
BACKGROUND
Previous studies suggest that obese women taking valproate (VPA) for epilepsy are insulin resistant.


OBJECTIVE
To assess the effects of antiepileptic drugs on serum insulin and lipid levels in men with epilepsy.


METHODS
Body mass index (BMI) and fasting serum concentrations of insulin and lipids were measured in 102 men with epilepsy who were treated with VPA, carbamazepine (CBZ), or oxcarbazepine (OXC) monotherapy. Thirty-two healthy men served as control subjects.


RESULTS
Obesity was not more common among VPA-treated men than among other men with epilepsy or the control subjects. However, the obese VPA-treated men had higher serum insulin levels (p < 0.001) than the obese control subjects despite similar BMI. CBZ and OXC did not have any significant effect on any of the measurements. Fasting serum insulin concentrations above the normal range were observed in seven obese VPA-treated patients (35%) but in only one obese control subject (5%). Five obese VPA-treated patients (25%) and one obese control subject (5%) had serum triglyceride levels above the normal range, and a low high-density lipoprotein/total cholesterol ratio was observed in two obese VPA-treated patients (10%).


CONCLUSIONS
Obese valproate-treated men have high serum insulin levels, indicating insulin resistance. Moreover, some of the valproate-treated men cluster cardiovascular risk factors such as obesity, hyperinsulinemia, and elevated serum triglyceride concentrations. CBZ and OXC do not seem to have any significant effects on serum insulin or lipid levels in men with epilepsy.
Pylvänen
V
V
Department of Neurology, University of Oulu, Finland. virpi.pylvanen@oulu.fi
Knip
M
M
Pakarinen
A J
AJ
Turkka
J
J
Kotila
M
M
Rättyä
J
J
Myllylä
V V
VV
Isojärvi
J I T
JI
D000293:Adolescent; D000328:Adult; D000927:Anticonvulsants / Q000009:adverse effects / Q000627:therapeutic use; D015992:Body Mass Index; D002220:Carbamazepine / Q000031:analogs & derivatives* / Q000627:therapeutic use; D004827:Epilepsy / Q000097:blood* / Q000150:complications / Q000188:drug therapy; D005215:Fasting / Q000097:blood*; D006801:Humans; D006946:Hyperinsulinism / Q000097:blood / Q000150:complications; D007328:Insulin / Q000097:blood*; D007333:Insulin Resistance; D008055:Lipids / Q000097:blood*; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000097:blood / Q000150:complications; D000078330:Oxcarbazepine; D012016:Reference Values; D012307:Risk Factors; D014280:Triglycerides / Q000097:blood; D014635:Valproic Acid / Q000009:adverse effects / Q000627:therapeutic use
D000927:Anticonvulsants; D007328:Insulin; D008055:Lipids; D014280:Triglycerides; D002220:Carbamazepine; D014635:Valproic Acid; D000078330:Oxcarbazepine