Valproate modulates glucose metabolism in patients with epilepsy after first exposure
Valproate modulates glucose metabolism in patients with epilepsy after first exposure
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DOI：
10.1111/epi.13114
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发表时间：
2015-11-01
期刊：
影响因子：
5.6
通讯作者：
Haldre, Sulev
中科院分区：
文献类型：
--
作者：
Rakitin, Aleksei;Koks, Sulev;Haldre, Sulev
据报告，丙戊酸盐（VPA）治疗与体重增加和代谢变化（如高胰岛素血症）相关。高胰岛素血症和其他代谢变化是否是体重增加的后果，还是VPA治疗的直接结果，仍然是一个有争议的问题。本研究的目的是探索首次静脉（IV）给药后直接进行口服葡萄糖耐量试验（OGTT）期间VPA治疗对葡萄糖和胰岛素水平的影响。16例新诊断癫痫的患者（18- 46岁）在VPA治疗开始前以及首次IV VPA给药后立即接受75 g葡萄糖OGTT。我们观察到输注VPA后120分钟OGTT期间的血糖水平显著低于未接受VPA治疗的OGTT期间测量的血糖水平（平均值+/-标准差[SD]分别为4.28 +/-0.94 mmol/l vs. 4.75 +/-1.09 mmol/l，p=0.038）。然而，胰岛素和C肽的血液浓度在两次测量之间没有显著差异。这是首次在新诊断的癫痫患者中显示OGTT期间VPA的潜在急性降糖作用的研究。
Valproate (VPA) treatment has been reported to be associated with weight gain and metabolic changes, such as hyperinsulinemia. The question of whether hyperinsulinemia and other metabolic changes are consequences of increased weight, or are instead direct results of VPA treatment, remains a matter of debate. The aim of the current study was to explore the influence of VPA treatment on glucose and insulin levels during the oral glucose tolerance test (OGTT) directly following the first intravenous (IV) administration. Sixteen patients (18-46years old) with newly diagnosed epilepsy underwent an OGTT with 75g glucose prior to the start of VPA treatment, as well as directly following the first IV VPA administration. We observed that plasma glucose levels during the 120min of OGTT session following infusion of VPA were significantly lower than those measured during OGTT without VPA treatment (mean +/- standard deviation [SD] 4.28 +/- 0.94mmol/l vs. 4.75 +/- 1.09mmol/l respectively, p=0.038). However, blood concentrations of insulin and C-peptide did not differ significantly between the two measurements. This is the first study to show a potential acute glucose-lowering effect of VPA during OGTT in patients with newly diagnosed epilepsy.