The effects of topiramate and valproate therapy on insulin, c-peptide, leptin, neuropeptide Y, adiponectin, visfatin, and resistin levels in children with epilepsy.
OBJECTIVE
Antiepileptic drugs may affect the endocrine system. We investigated the effects of valproic acid and topiramate on the levels of insulin, c-peptide and adipocytokines in pre-pubertal patients with idiopathic partial and generalized epilepsy.


METHODS
Forty-one children with epilepsy were included. The patients were divided into two groups (valproic acid; n = 21, topiramate; n = 20). The weight, height, body mass index and homeostasis model assessment of insulin resistance (HOMA-IR) were recorded and insulin, c-peptide, leptin, neuropeptide Y, adiponectin, visfatin and resistin levels were determined at 0, 6 and 12 months of therapy.


RESULTS
In the valproate group, weight and height increased significantly. Seven of 21 patients were overweight at the end of one year. Leptin was higher in the overweight subgroup. Although insulin and HOMA-IR increased (p < 0.05), none of the patients showed hyperinsulinism or IR. Resistin had decreased at the 6th and 12th months (p < 0.05). In the topiramate group, some statistically nonsignificant changes were demonstrated.


CONCLUSIONS
The mechanisms behind valproate and topiramate-related weight control are still unclear, especially in children. Valproate and topiramate affect the weight, BMI, and insulin, leptin and adipocytokine levels in prepubertal children. We suggest that further studies including more patients with a long follow-up period are necessary to draw a firm conclusion regarding an association between the treatment with these drugs and the levels of leptin, insulin and adipocytokines.
Turgut Ozal University, Faculty of Medicine, Department of Child Neurology, Ankara, Turkey. Electronic address: mjgsonmez@yahoo.com.
Fatma Mujgan
FM
Sonmez
Dilek
D
Zaman
Ayse
A
Aksoy
Orhan
O
Deger
Rezzan
R
Aliyazicioglu
Gülay
G
Karaguzel
Kerim
K
Fazlioglu
D052242:Adiponectin / Q000097:blood; D000927:Anticonvulsants / Q000494:pharmacology / Q000627:therapeutic use*; D015992:Body Mass Index; D001835:Body Weight / Q000187:drug effects; D002096:C-Peptide / Q000097:blood; D002648:Child; D004827:Epilepsy / Q000097:blood / Q000188:drug therapy*; D005260:Female; D005632:Fructose / Q000031:analogs & derivatives* / Q000494:pharmacology / Q000627:therapeutic use; D006801:Humans; D007328:Insulin / Q000097:blood; D020738:Leptin / Q000097:blood; D008297:Male; D009478:Neuropeptide Y / Q000097:blood; D054409:Nicotinamide Phosphoribosyltransferase / Q000097:blood; D052243:Resistin / Q000097:blood; D000077236:Topiramate; D014635:Valproic Acid / Q000494:pharmacology / Q000627:therapeutic use*
D052242:Adiponectin; D000927:Anticonvulsants; D002096:C-Peptide; D007328:Insulin; D020738:Leptin; D009478:Neuropeptide Y; D052243:Resistin; D000077236:Topiramate; D005632:Fructose; D014635:Valproic Acid; D054409:Nicotinamide Phosphoribosyltransferase
Adipocytokines; C-peptide; Insulin; Topiramate; Valproate; Weight