title: Effect of valproic acid treatment on body composition, leptin and the soluble leptin receptor in epileptic children.
abstract: OBJECTIVE
  The aim of the study was to determine the influence of valproic acid (VPA) treatment on leptin, the soluble leptin receptor (sOB-R), the sOB-R/leptin ratio, body composition and insulin resistance in epileptic children.
  
  
  METHODS
  A cross-sectional cohort study was conducted at the Medical University Innsbruck, Austria. Children >6 years with idiopathic epilepsy and antiepileptic drug therapy since at least six months were eligible. Leptin concentration, the sOB-R, the sOB-R/leptin ratio, body composition and glucose homeostasis were determined.
  
  
  RESULTS
  87 children (median [range] age 12.8 years [6.0-18.6]) were on treatment with VPA, 55 (12.3 years [6.4-18.3]) on other AEDs, comprising the non-VPA group. VPA-treated children had higher leptin concentrations, body-mass-index standard-deviation score (SDS), body fat (each p<0.001), serum insulin concentrations (p=0.014) and homeostasis model assessment (HOMA) index (p=0.009), as well as a lower sOB-R/leptin ratio (p<0.001) when compared to the non-VPA group. Overweight VPA-treated children showed lower sOB-R concentrations and a lower sOB-R/leptin ratio (each p<0.001) as well as higher body fat and leptin levels (each p<0.001) compared to lean VPA-treated children.
  
  
  CONCLUSIONS
  VPA monotherapy was associated with higher body weight, body fat and serum leptin concentrations as well as impaired glucose homeostasis. Low sOB-R concentrations and a low sOB-R/leptin ratio in overweight VPA-treated patients might contribute to disturbances in glucose homeostasis and to the development of the metabolic syndrome in these children later in life.
authors.affiliation: Department of Pediatrics IV, Division of Neuropediatrics, Medical University Innsbruck, Anichstrasse 35, 6020 Innsbruck, Austria. Markus_Rauchenzauner@hotmail.com
authors.forename: M
authors.initials: M
authors.lastname: Rauchenzauner
authors.forename: E
authors.initials: E
authors.lastname: Haberlandt
authors.forename: S
authors.initials: S
authors.lastname: Scholl-Bürgi
authors.forename: D
authors.initials: D
authors.lastname: Karall
authors.forename: E
authors.initials: E
authors.lastname: Schoenherr
authors.forename: T
authors.initials: T
authors.lastname: Tatarczyk
authors.forename: J
authors.initials: J
authors.lastname: Engl
authors.forename: M
authors.initials: M
authors.lastname: Laimer
authors.forename: G
authors.initials: G
authors.lastname: Luef
authors.forename: C F
authors.initials: CF
authors.lastname: Ebenbichler
mesh_terms: D000293:Adolescent; D000885:Anthropology, Physical / Q000379:methods; D000927:Anticonvulsants / Q000494:pharmacology* / Q000627:therapeutic use; D001823:Body Composition / Q000187:drug effects*; D015992:Body Mass Index; D002648:Child; D003430:Cross-Sectional Studies; D004305:Dose-Response Relationship, Drug; D004827:Epilepsy / Q000188:drug therapy / Q000378:metabolism*; D005260:Female; D006801:Humans; D020738:Leptin / Q000097:blood*; D008297:Male; D054411:Receptors, Leptin / Q000097:blood*; D012737:Sex Factors; D014635:Valproic Acid / Q000494:pharmacology* / Q000627:therapeutic use
chemical_list: D000927:Anticonvulsants; D020738:Leptin; D054411:Receptors, Leptin; D014635:Valproic Acid