title: Circulating levels of allopregnanolone, a neuroactive steroid, and leptin during treatment with valproic acid in children with epilepsy.
abstract: Weight gain is a well-known unwanted effect of valproic acid (VPA) therapy. Studies on VPA-associated changes of homeostatic hormones remain limited and controversial. Allopregnanolone (AP) is a circulating neuroactive steroid involved in modulation of behavioral activities whose serum levels are increased in obese children. The aim of the present study was to determine whether VPA therapy affects leptin and AP circulating levels in prepubertal girls with epilepsy. One-hundred and one patients were divided into four groups: epileptic patients with VPA-associated obesity (n = 21); lean epileptic patients under VPA therapy (n = 35); healthy obese children (n = 23), and healthy lean children (n = 22). Patients with VPA-associated obesity had significantly enhanced blood concentrations of AP (p = 0.001) and leptin (p = 0.007) than lean subjects. There were no differences in leptin and AP plasma levels between patients with VPA-associated obesity and obese controls (p = 0.45 and p = 0.10, respectively), as there were no differences between lean patients under VPA therapy and lean healthy controls (p = 0.06). In patients under VPA therapy, both plasma leptin and AP levels were significantly correlated with BMI (r = 0.074, p = 0.02, and r = 0.084, p = 0.01, respectively). Plasma leptin concentrations were not correlated with AP levels (r = 0.023, p = 0.13). In conclusion, a correlation between obesity and neuroactive steroids was shown. It remains to be established whether the increased circulating level of AP is a secondary effect of anxiolytic-sedative processes occurring in subjects with obesity-related emotional and behavioral anomalies, or plays a central role in determining abnormal eating behaviors.
authors.affiliation: Department of Pediatrics, Obstetrics, Gynecology and Reproductive Medicine, Pediatric Neurology Section, University of Siena, Siena, Italy. grosso@unisi.it
authors.forename: Salvatore
authors.initials: S
authors.lastname: Grosso
authors.forename: Stefano
authors.initials: S
authors.lastname: Luisi
authors.forename: Rosa
authors.initials: R
authors.lastname: Mostardini
authors.forename: Mariarosaria
authors.initials: M
authors.lastname: Matera
authors.forename: Enzo Gabriele
authors.initials: EG
authors.lastname: Barlocco
authors.forename: Elena
authors.initials: E
authors.lastname: Casarosa
authors.forename: Paolo
authors.initials: P
authors.lastname: Balestri
authors.forename: Felice
authors.initials: F
authors.lastname: Petraglia
mesh_terms: D000927:Anticonvulsants / Q000009:adverse effects*; D002648:Child; D004827:Epilepsy / Q000097:blood* / Q000188:drug therapy*; D005260:Female; D006801:Humans; D007118:Immunoassay; D020738:Leptin / Q000097:blood*; D008297:Male; D009765:Obesity / Q000139:chemically induced; D011280:Pregnanolone / Q000097:blood*; D014635:Valproic Acid / Q000009:adverse effects*; D015430:Weight Gain / Q000502:physiology
chemical_list: D000927:Anticonvulsants; D020738:Leptin; D014635:Valproic Acid; D011280:Pregnanolone