Metabolic Syndrome in Epileptic Children on Sodium Valproate Therapy- A Cross-Sectional Observational Study

Abstract

Background

Epilepsy is a common neurological disorder affecting children worldwide, with sodium valproate (VPA) being a widely used antiepileptic drug. However, long-term VPA therapy is associated with metabolic complications, including weight gain, dyslipidemia, and increased risk of metabolic syndrome. This study aims to evaluate the impact of VPA on metabolic parameters in pediatric epileptic patients.

Methods

A cross-sectional study was conducted at the Vivekananda Institute of Medical Sciences, Kolkata, involving 50 pediatric epileptic patients on VPA monotherapy for over a year and 50 age- and sex-matched healthy controls. Anthropometric measurements, including BMI and waist circumference, were recorded. Blood samples were analyzed for fasting blood glucose, insulin, total cholesterol, HDL, and triglycerides. Statistical analysis was performed using chi-square tests and t-tests to assess differences between groups.

Results

The study found a significant association between VPA use and increased weight (p=0.0056), waist circumference (p=0.0415), and BMI status (p=0.0502). Cholesterol levels were significantly higher in VPA users, with 8% showing abnormal values (p=0.0144). Triglyceride levels were markedly elevated in the case group compared to controls (p=0.0004), particularly in children aged 5–10 years. However, no significant differences were observed in fasting blood glucose (p=0.7032), insulin levels (p=0.9486), or HDL levels (p=0.7827) between groups.

Conclusion

Pediatric patients on long-term VPA therapy are at a higher risk of developing metabolic syndrome, particularly in the form of obesity and dyslipidemia. Regular metabolic screening and lifestyle interventions are crucial to mitigate these risks. Further studies are needed to establish standardized monitoring guidelines for children undergoing prolonged VPA therapy.