Effects Of Sodium Valproate And Topiramate On Weight And Related Metabolism Indexes In Children With Epilepsy

Background: Epilepsy is one of the pediatric nervous system diseases, and the major treatment is the long term application of Anti-Epilepsy Drugs (AEDs). The compliableness of patients is an important factor to determine the curative effect, but the side effects of AEDs may affect the compliableness. sodium valproate and topiramate are the two AEDs which are widely applied nowadays. Some literature reported that Sodium valproate arouses obesity and topiramate arouses emaciation and growth retardation. But the mechanism of the change of BMI is still disputed in or outside the nation, especially in children.Objective: To explore the mechanism of BMI and metabolism changes insodium valproate and topiramate treatment on children with epilepsy by monitoring the metabolism indexes such as BMI, leptin, adiponectin, L/A(leptin/ adiponectin), insulin and HOMA index, et al. The purpose of the study is to improve the timeliness for early detection and treatment on side effects and to improve the compliableness and curative effect. Methods: Children with epilepsy were included in their first visitto the doctor in 2007. According to criterion of ILAE (2001), the objects were divided to sodium valproate group, topiramate group. The related metabolism indexes such as BMI, leptin, adiponectin, L/A (leptin/ adiponectin), lipid, fasting blood glucose, insulin and HOMA index, et al before and after treatment were collected. Data were analyzed and compared by SPSS12.0.Results: There was a significant increase on the index of L/A in sodiumvalproate group after the treatment(t=2.052, p=0.040); but there was no significant difference on leptin although it increased after the treatment (t=0.724,p=0.469); and there was no significant difference on adiponectin although it decreased after the treatment (t=1.610, p=0.107); there was no significant difference on BMI after the treatment(t=0.675, p=0.500). There was a significant decrease on BMI and L/A and an increase on adiponectin in topiramate group(p<0.05). There was no significant difference on leptin in topiramate group(t=0.065, p=0.948). Before and after the treatment, the change value of L/A positively related to change value of leptin, insulin and HOMA index in sodium valproate group(p<0.05), and the change value of L/A negatively related to the change value of adiponectin in topiramate group(p<0.05). There was no relationship between the change value of metabolism indexes and the dosage of sodium valproate or topiramate (p>0.05).Conclusions: Sodium valproate could increase the level of L/A inchildren with epilepsy, but the effect on leptin, adiponectin and BMI was not significant; topiramate could decrease BMI index and L/A while increase the level of adiponectin, but the effect on leptin was not significant. Monitoring the L/A index could improve the timeliness for early detecting the side effect on BMI and metabolism in sodium valproate or topiramate treatment. The dosage of AEDs could not be a sensitive index for monitoring the side effect. There were no difference for the changes of insulin and HOMA index in both sodium valproate and topiramate group.