Influence of sodium valproate treatment on body mass and insulin resistance parameters in children with epilepsy

Abstract

Introduction/Objective One of the main side effects in patients undergoing valproic acid treatment is weight gain, which might be the reason for drug discontinuation, especially in adolescent girls, and it also has to be considered before introducing the drug. The main goal of our study is to investigate a possible influence of antiepileptic therapy with sodium valproate on weight and glucose homeostasis in pediatric patients with epilepsy.

Methods The investigation included 49 healthy children with recently diagnosed epilepsy. We measured height, weight, and serum 12-hour overnight fasting glucose and insulin level before initiation and after six- and 12-month valproic acid treatment periods. The body mass index and homeostasis model assessment indexes were calculated for each patient and correlated after the initiation of therapy and after six and 12 months of therapy.

Results We found that children significantly gained weight with statistical significance (p < 0.01) even after six months of therapy with a significant glucose metabolism change and statistical difference in average serum glucose and insulin levels (p < 0.05).

Conclusion Our results show that a 12-month treatment with valproic acid in children with epilepsy has a great impact on weight gain and glucose homeostasis and metabolism. We strongly recommend that all children with recently diagnosed epilepsy at the initiation of valproate therapy should be closely monitored on a six-month basis. Consultations with a nutritionist is advised especially in children with a preexisting body weight problem.

Keywords: valproic acid; child epilepsy; insulin; weight; HOMA