Influence Of Topiramate And Valproate Acid On Insulin And Leptin Levels In Epileptic Patients

Objective: To investigate whether changes of insulin and leptin levels have a role in the weight loss associated with topiramate and the weight gain associated with valproate acid in epileptic patients. Methods: 142 epileptic patients were chosen , 55 cases of them received topiramate monotherapy and 35 cases didn' t ,24 cases received valproate acid monotherapy and 28 cases as their control group.The fasting serum insulin and leptin levels were measured by radioimmunoassay(RIA). The height, weight,waist and hip was measured and recorded using standard techniques simultaneously. Results: (1)Topiramate and control group: The mean fasting serum insulin level of topiramate group was less than control group(t=2.290,p=0.025),especially to female patients (t=2.130, p=0.040); There was no statistical di fferenee between the mean fasting serum leptin level of the two groups (t=0. 810, p=0.42) , but the mean fasting serum leptin level of male patients was less than that of female patients in two groups (control group:t = -3. 569, p=0.001, topiramate group:t=-2.36, p=0.022). (2) Valproate acid and control group:There were no statistical difference between the mean fasting serum insulin level of the two groups (t=-0. 909, p=0. 368) , but in VPA group, the mean fasting serum insulin level of obese patients was heiger than nonobese patients (t=~2.332,p=0.032) ;The mean fasting serum leptin level of valproate acid group was higher than control group, especially to obese patients (t=-2.808,p=0.011 ) .The mean fasting serum leptin level of obese patients was higher than nonobese in valproate acid group(t=-2. 221, p=0. 037) .Conclusion: Topiramate reduced fasting serum insulin level of nonobese epileptic patients significantly, especially to female patients;Sex hormone may be associated with the effect of topiramate on insulin;Theleptin level had a downtrend in topiramate group.Valproate acid had no influence on fasting serum insulin level of epileptic patients,but can increase their fasting serum leptin level, especially obese epileptic patients. Insulin and leptin related to the weight loss associated with topiramate and the weight gain assodiated with valproate acid.