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

Document Type : Original Article


1 Clinical Neurology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran

2 Clinical Neurology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran & Department of Neurology, Shiraz University of Medical Sciences, Shiraz, Iran

3 Endocrine and Metabolism Research Center, Shiraz University of Medical Sciences, Shiraz, Iran

4 Department of Neurology, Shiraz University of Medical Sciences, Shiraz, Iran & Neuroscience Research Center, Shiraz University of Medical Sciences, Shiraz, Iran


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, 80 epileptic patients were treated with VPA (40 patients) or CBZ (40 patients) monotherapies for more than 6 months, and 45 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 19 times higher than controls (OR= 19.20; 95% CI= 2.62-140.23, P=0. 004) and risk of IR was increased 15 and 9 times more than controls (OR=14.83; 95% CI=3.03-72.56, P=0.001) and (OR=9.13; 95% CI=2.55-32.65, P= 0.001), 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 17% less than controls and the risk of IR increased 7 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.


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