Metabolic Syndrome and Insulin Resistance in Sodium Valproate or Carbamazepine Monotherapy: A Case-control Study

Background: Medications can increase the incidence rate of metabolic syndrome (MetS) and insulin resistance (IR). This study aimed to evaluate the effects of Carbamazepine (CBZ) or Valproate (VPA) as monotherapy on the development of MetS and IR in adult Iranian epileptic patients.Methods: In this observational analytic case-control study, ۸۰ epileptic patients were treated with VPA (۴۰ patients) or CBZ (۴۰ patients) monotherapies for more than ۶ months, and ۴۵ age- and sex-matched controls were included.Results: Subjects with MetS or with IR had higher age, weight, waist, FBS, cholesterol, systolic and diastolic pressure, TG, LDL, insulin, BMI, and lower HDL. In MetS and IR, the frequency of VPA or CBZ use was significantly higher than the control group. The multiple regression analysis showed that in VPA-treated epileptic patients, the risk of MetS was increased ۱۹ times higher than controls (OR= ۱۹.۲۰; ۹۵% CI= ۲.۶۲-۱۴۰.۲۳, P=۰. ۰۰۴) and risk of IR was increased ۱۵ and ۹ times more than controls (OR=۱۴.۸۳; ۹۵% CI=۳.۰۳-۷۲.۵۶, P=۰.۰۰۱) and (OR=۹.۱۳; ۹۵% CI=۲.۵۵-۳۲.۶۵, P= ۰.۰۰۱), respectively. An increase in the waist, DBP, and insulin level were also shown as important factors in the risk of MetS. In patients under CBZ therapy, the risk of MetS reduced by ۱۷% less than controls and the risk of IR increased ۷ times more than controls.Conclusion: Treatment with VPA may increase the likelihood of developing MetS and IR more than the CBZ therapy in epileptic patients in Iran.

Keywords:

Cholesterol , CBZ therapy , VPA-treated patients