title: The association between BsmI polymorphism and risk factors for atherosclerosis in patients with epilepsy taking valproate.
abstract: OBJECTIVE
  To evaluate the association between the BsmI polymorphism and vascular risk factors or metabolic syndrome in patients with epilepsy treated with valproate.
  
  
  METHODS
  We performed a cross-sectional study to determine glucose homeostasis, lipid profile, and evidence of metabolic syndrome, as well as the BsmI polymorphism in seizure free adults with epilepsy.
  
  
  RESULTS
  We recruited 75 patients with epilepsy to the current study. The frequency of the BsmI polymorphism was 22.7%. We found that patients with BsmI polymorphism had significantly higher total levels of triglycerides, total cholesterol, HDL-C and LDL-C. There were no differences in terms of fasting blood glucose level and fasting insulin levels between patients with the BsmI polymorphism and those with the wild type vitamin D receptor (VDR) gene. Insulin resistance was identified in 6 of 17 patients with the BsmI polymorphism, and 18 of 58 patients with the wild type VDR gene. We calculated the homeostasis model assessment (HOMA) index and found no difference in HOMA levels between the groups. Systolic blood pressure was higher in patients with the BsmI polymorphism. There was a higher prevalence of metabolic syndrome in patients with the BsmI polymorphism than in patients with the wild type gene. The prevalence of metabolic syndrome in BsmI polymorphism carriers was 64.7% compared with 41.4% in patients with the wild type VDR gene.
  
  
  CONCLUSIONS
  Young patients with epilepsy taking valproate who carry the BsmI polymorphism are at an increased risk of having vascular risk factors.
authors.affiliation: Neurology Unit, Department of Medicine, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla 90110, Thailand. Electronic address: pkanitpo@medicine.psu.ac.th.
authors.forename: Kanitpong
authors.initials: K
authors.lastname: Phabphal
authors.forename: Alan
authors.initials: A
authors.lastname: Geater
mesh_terms: D000328:Adult; D000927:Anticonvulsants / Q000627:therapeutic use*; D050197:Atherosclerosis / Q000209:etiology*; D002784:Cholesterol / Q000378:metabolism; D003430:Cross-Sectional Studies; D004827:Epilepsy / Q000150:complications / Q000188:drug therapy / Q000235:genetics; D005260:Female; D006801:Humans; D008297:Male; D011110:Polymorphism, Genetic / Q000235:genetics*; D018167:Receptors, Calcitriol / Q000235:genetics; D014280:Triglycerides / Q000378:metabolism; D014635:Valproic Acid / Q000627:therapeutic use*
chemical_list: D000927:Anticonvulsants; D018167:Receptors, Calcitriol; D014280:Triglycerides; D014635:Valproic Acid; D002784:Cholesterol
keywords: Atherosclerosis; Epilepsy; Valproate; Vitamin D polymorphism