Nonalcoholic fatty liver disease in adolescents receiving valproic acid.
OBJECTIVE
The aim of this study was to investigate the association between the metabolic derangements induced by valproic acid (VPA) and ultrasound-diagnosed nonalcoholic fatty liver disease (NAFLD) in adolescents.


METHODS
Using a cross-sectional design, we evaluated 86 adolescents with epilepsy who had received VPA monotherapy. Subjects for comparison were 67 normal-weight and 43 weight-matched adolescents. Participants underwent hepatic ultrasound, anthropometric evaluations, and biochemical tests.


RESULTS
Although the occurrence of ultrasound-diagnosed NAFLD was higher in VPA-treated patients than in normal-weight controls (36.0% vs 7.5%, P<0.001), it was similar in VPA-treated patients and weight-matched controls (36.0% vs 34.9%, P>0.05). The identified predictors of NAFLD in VPA-treated patients were abdominal obesity (OR=3.2, 95% CI=2.1-6.8), insulin resistance (OR=2.8, 95% CI=1.7-5.2), metabolic syndrome (OR=2.6, 95% CI=1.4-4.8), and generalized obesity (OR=1.9, 95% CI=1.2-3.7).


CONCLUSIONS
Valproic acid monotherapy is associated with NAFLD in a high percentage of adolescents with epilepsy who have typical VPA-related metabolic disturbances.
Department of Pediatrics, University of Chieti, Chieti, Italy.
Alberto
A
Verrotti
Sergio
S
Agostinelli
Pasquale
P
Parisi
Francesco
F
Chiarelli
Giangennaro
G
Coppola
D000293:Adolescent; D000410:Alanine Transaminase / Q000378:metabolism; D000927:Anticonvulsants / Q000009:adverse effects*; D001794:Blood Pressure / Q000187:drug effects; D001835:Body Weight / Q000187:drug effects; D056486:Chemical and Drug Induced Liver Injury / Q000209:etiology*; D002648:Child; D002784:Cholesterol / Q000378:metabolism; D018592:Cross-Over Studies; D004827:Epilepsy / Q000188:drug therapy; D005260:Female; D006801:Humans; D008297:Male; D015999:Multivariate Analysis; D012189:Retrospective Studies; D014635:Valproic Acid / Q000009:adverse effects*
D000927:Anticonvulsants; D014635:Valproic Acid; D002784:Cholesterol; D000410:Alanine Transaminase