AMONG CHILDREN FROM 4 YEARS TO 14 YEARS, METABOLIC EFFECTS OF LONG-TERM ANTIEPILEPTIC DRUG THERAPY IN RURAL AREAS OF KUSHINAGAR, UTTAR PRADESH
Main Article Content
Keywords
Antiepileptic drugs, insulin resistance, levetiracetam, non-alcoholic fatty liver disease, oxcarbazepine, sodium valproate
Abstract
Long-term antiepileptic drug (AED) therapy is known to have detrimental metabolic consequences. However, nothing is known about this among Indian youngsters. In comparison to healthy controls, this study aimed to examine the effects of long-term AEDs on children's anthropometry, glycaemic parameters, insulin resistance, lipid profile, and hepatic steatosis. This retrospective analysis was conducted at a district hospital paediatric clinic. Children aged 4 to 14 years with epilepsy who have been on antiepileptic drugs (AEDs) for a minimum of one year were identified. This cohort was separated into monotherapy and polytherapy groups. Age- and gender-matched controls were recruited from healthy youngsters in the neighbourhood. Every case and control had a thorough physical examination and tests, including an abdominal ultrasound and tests for liver transaminases, fasting lipid profiles, fasting insulin, and fasting blood glucose. The study comprised 50 controls and 75 children receiving long-term AED treatment (40 receiving monotherapy and 35 receiving polytherapy). In comparison to controls, children on AED had noticeably greater levels of insulin resistance, fasting blood glucose, and LDL cholesterol. When compared to children on other medications, children on an oxcarbazepine regimen were shown to have a worse metabolic profile. Comparing this group of epileptic children on long-term AED treatment to matched healthy controls revealed a negative metabolic profile. In order to fully define the connection and create effective intervention methods, more extensive community-based research is required. A complete epilepsy care program should include a focus on leading a healthy lifestyle.
References
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16. Cansu A, Serdaroglu A, Cinaz P. Serum insulin, cortisol, leptin, neuropeptide Y, galanin and ghrelin levels in epileptic children receiving oxcarbazepine. Eur J Paediatr Neurol 2011;15:527-31.
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19. Santhosh NS, Sinha S, Satishchandra P. Epilepsy: Indian perspective. Ann Indian Acad Neurol 2014;17:S3-11.
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23. Ranjani H, Mehreen TS, Pradeepa R, Anjana RM, Garg R, Anand K, et al. Epidemiology of childhood overweight & obesity in India: a systematic review. Indian J Med Res 2016;143:160-74
2. Belcastro V, D'Egidio C, Striano P, Verrotti A. Metabolic and endocrine effects of valproic acid chronic treatment. Epilepsy Res 2013;107:1-8.
3. Garoufi A, Vartzelis G, Tsentidis C, Attilakos A, Koemtzidou E, Kossiva L, et al. Weight gain in children on oxcarbazepine monotherapy. Epilepsy Res 2016;122:110-3.
4. Jee Young Kim, HyangWoon Lee. Metabolic and hormonal disturbances in women with epilepsy on antiepileptic drug monotherapy. Epilepsia 2007;48;1366-70.
5. Najafi MR, Bazooyar B, Zare M, Aghaghazvini MR, Ansari B, Rajaei A, et al. The investigation of insulin resistance in two groups of epileptic patients treated with sodium valproate and carbamazepine. Adv Biomed Res 2017;6:25.
6. Yi§ U, Dogan M. Effects of oxcarbazepine treatment on serum lipids and carotid intima media thickness in children. Brain Dev 2012;34:185-8.
7. Isojarvi JI, Pakarinen AJ, Rautio A, Pelkonen O, Myllyla VV. Liver enzyme induction and serum lipid levels after replacement of carbamazepine with oxcarbazepine. Epilepsia 1994;35:1217-20.
8. Pulitano P, Franco V, Mecarelli O, Brienza M, Davassi C, Russo E. Effects of eslicarbazepine acetate on lipid profile and sodium levels in patients with epilepsy. Seizure 2017;53:1-3
9. Katsiki N, Mikhailidis DP, Nair DR. The effects of antiepileptic drugs on vascular risk factors: a narrative review. Seizure 2014;23:677-84.
10. Svalheim S, Luef G, Rauchenzauner M, Morkrid L, Gjerstad L, Tauboll E. Cardiovascular risk factors in epilepsy patients taking levetiracetam, carbamazepine or lamotrigine. Acta Neurol Scand 2010;190:30-3.
11. Lopinto-Khoury C, Mintzer S. Antiepileptic drugs and markers of vascular risk. Curr Treat Options Neurol 2010;12:300-8.
12. Kim DW, Lee SY, Shon YM, Kim JH. Effects of new antiepileptic drugs on circulatory markers for vascular risk in patients with newly diagnosed epilepsy. Epilepsia 2013;54:e146-9.
13. Luef GJ, Waldmann M, Sturm W, Naser A, Trinka I, Unterberger I, et al. Valproate therapy and non-alcoholic fatty liver disease. Ann Neurol 2004;55:729-32.
14. Luef G, Rauchenzauner M, Waldmann M, Sturm W, Sandhofer A, Seppi K, et al. Non-alcoholic fatty liver disease (NAFLD), insulin resistance and lipid profile in antiepileptic drug treatment. Epilepsy Res 2009;86:42-7.
15. Verrotti, Agostinelli S, Parisi P, Chiarelli F, Coppola G. Nonalcoholic fatty liver disease in adolescents receiving valproic acid. Epilepsy Behav 2011;20:382-5.
16. Cansu A, Serdaroglu A, Cinaz P. Serum insulin, cortisol, leptin, neuropeptide Y, galanin and ghrelin levels in epileptic children receiving oxcarbazepine. Eur J Paediatr Neurol 2011;15:527-31.
17. Ladino LD, Tellez-Zenteno JF. Epilepsy and obesity: a complex interaction. In Mula M, editor. The comorbidities of epilepsy. London: Elsevier Inc, Academic Press; 2019. pp. 131-58.
18. Neligan A, Bell GS, Johnson AL, Goodridge DM, Shorvon SD, Sander JW. The long-term risk of premature mortality in people with epilepsy. Brain 2011;134:388-95.
19. Santhosh NS, Sinha S, Satishchandra P. Epilepsy: Indian perspective. Ann Indian Acad Neurol 2014;17:S3-11.
20. Saadeh S, Younossi ZM, Remer EM, Gramlich T, Ong JP, Hurley M, et al. The utility of radiological imaging in nonalcoholic fatty liver disease. Gastroenterology 2002;123:745-50.
21. Dhir A, Sharma S, Jain P, Bhakhri BK, Aneja S. Parameters of metabolic syndrome in Indian children with epilepsy on valproate or phenytoin monotherapy. J Pediatr Neurosci 2015;10:222-6.
22. Sarangi SC, Tripathi M, Kakkar AK, Gupta YK. Comparison of body composition in persons with epilepsy on conventional & new antiepileptic drugs. Indian J Med Res 2016;143:323-30.
23. Ranjani H, Mehreen TS, Pradeepa R, Anjana RM, Garg R, Anand K, et al. Epidemiology of childhood overweight & obesity in India: a systematic review. Indian J Med Res 2016;143:160-74
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Nov 4, 2024
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Rai Pranav Prakash. (2024). AMONG CHILDREN FROM 4 YEARS TO 14 YEARS, METABOLIC EFFECTS OF LONG-TERM ANTIEPILEPTIC DRUG THERAPY IN RURAL AREAS OF KUSHINAGAR, UTTAR PRADESH. Journal of Population Therapeutics and Clinical Pharmacology, 31(11), 721-726. https://doi.org/10.53555/j40nkd10
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Author Biography
Rai Pranav Prakash
Assistant Professor Department of Paediatrics, Autonomous State Medical College Kushinagar, Uttar Pradesh Pin code 274304
How to Cite
Rai Pranav Prakash. (2024). AMONG CHILDREN FROM 4 YEARS TO 14 YEARS, METABOLIC EFFECTS OF LONG-TERM ANTIEPILEPTIC DRUG THERAPY IN RURAL AREAS OF KUSHINAGAR, UTTAR PRADESH. Journal of Population Therapeutics and Clinical Pharmacology, 31(11), 721-726. https://doi.org/10.53555/j40nkd10