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October2012 Vol.49 Issue:        4        Table of Contents
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Insulin Sensitivity in Valproate Treated Epileptics

Asmaa M. Ebraheim1, Nevin M.Shalaby1, Gihan M. Ramzy1,

Noha T. Abd-El-Rahim2, Mohammed Taha3

Departments of  Neurology1, Internal Medicine2, Faculty of  Medicine;

Biochemistry3, Faculty of Pharmacy3; Cairo University; Egypt


Background: Obesity and insulin resistance are common side effects of valproic acid (VPA) treatment. However, the exact pathogenesis is still not fully clarified. Objective: To study insulin sensitivity in euglycemic valproate-treated epileptic patients. Methods: Two groups were studied: Thirty seven epileptics on VPA mono therapy, and 26 control subjects, age and sex matched. McAuley’s index (a fasting insulin-triglyceride-based method) was used to assess insulin sensitivity. For all subjects, body mass index (BMI), serum triglycerides and fasting insulin levels were evaluated. Results: About 70% of VPA treated epileptic patients had a McAuley’s index of ≤ 5.8 indicating insulin resistance (IR), however, the mean McAuley’s index did not statistically differ between valproate-treated epileptic patients and non-epileptic subjects.  The daily dose of VPA, but not the duration of therapy, correlated positively with BMI and negatively with McAuley’s index. Fasting insulin was significantly lower in VPA treated epileptic patients than in control subjects, but still, it correlated negatively with McAuley’s index. Conclusion: The presence of lower fasting insulin levels in VPA treated patients, raises inquiries about the exact role played by VPA in modulating insulin secretion, and emphasizes that this area warrants further research; however valproate-treated epileptic patients should be evaluated for insulin resistance with the possibility of developing impaired insulin sensitivity specially with higher doses of treatment. [Egypt J Neurol Psychiat Neurosurg.  2012; 49(4): 317-321]


Key Words: Epilepsy, valproate, insulin resistance.

Correspondence to Gihan M. Ramzy, Department of Neurology, Cairo University, Egypt.

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