title: [Carnitine deficiency with valproate sodium therapy--the difference by normal diet and enteral nutrition].
abstract: OBJECTIVE
  Valproate sodium (VPA) treatment is known to reduce blood carnitine levels; however, some enteral nutrition formulas contain carnitine. The objective of this study was to verify the hypothesis that blood carnitine levels are lower after VPA treatment in patients on enteral nutrition than in those on normal diet.
  
  
  METHODS
  Forty-five epilepsy patients under medical treatment in our hospital were classified according to their alimentation type into normal diet group (n = 31) and 14 on enteral nutrition group (n = 14). The differences in the blood free carnitine levels between the two groups were evaluated.
  
  
  RESULTS
  Plasma free carnitine levels were below the normal value in 15 of 31 patients on normal diet and 13 of 14 patients on enteral nutrition. There was a significant reduction of the levels of carnitine in the enteral nutrition group (p < 0.001).
  
  
  CONCLUSIONS
  Although normal diet contains sufficient amount of carnitine, most enteral nutrition formulas lack carnitine; and hence, blood carnitine levels in patients on enteral nutrition after VPA treatment is low. It is therefore suggested that carnitine supplemented diet is necessary for patients treated with VPA, especially for those who receive enteral nutrition.
authors.affiliation: Department of Pediatrics, Suzugamine, Hiroshima. misasa_katoua@yahoo.co.jp
authors.forename: Akira
authors.initials: A
authors.lastname: Kato
mesh_terms: D000293:Adolescent; D000328:Adult; D002331:Carnitine / Q000097:blood* / Q000172:deficiency; D002648:Child; D002675:Child, Preschool; D019587:Dietary Supplements; D004750:Enteral Nutrition; D004827:Epilepsy / Q000188:drug therapy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D014635:Valproic Acid / Q000009:adverse effects / Q000627:therapeutic use*; D055815:Young Adult
chemical_list: D014635:Valproic Acid; D002331:Carnitine