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Vitamin E status in pediatric patients receiving antiepileptic drugs
K Kataoka1, N Kanamori, M Oishi
1Department of Pharmacy, Osaka University Hospital, Japan.
Insights
Children with epilepsy on antiepileptic drugs (AED) show decreased vitamin E (tocopherol) levels, particularly alpha-tocopherol. Supplementation with alpha-tocopherol acetate improved levels and reduced lipid peroxides in pediatric patients.
Area of Science:
- Biochemistry
- Clinical Nutrition
- Pediatric Neurology
Background:
- Antiepileptic drugs (AED) are associated with decreased vitamin E levels in epileptic children.
- Tocopherol (vitamin E) status requires investigation in patients undergoing AED therapy.
Purpose of the Study:
- To determine alpha-, beta-, gamma-, and delta-tocopherol concentrations in epileptic patients receiving AED.
- To investigate the relationship between age and tocopherol levels in pediatric epileptic patients.
- To evaluate the effect of alpha-tocopherol acetate supplementation on tocopherol levels and lipid peroxides.
Main Methods:
- Serum samples from 447 epileptic patients were analyzed for tocopherol concentrations.
- High-performance liquid chromatography (HPLC) was used for tocopherol determination.
- Correlation and comparative analyses were performed on age-related tocopherol levels and supplementation effects.
Main Results:
- A negative correlation was observed between age and alpha-tocopherol levels in pediatric patients (1-16 years).
- Older children (7-16 years) had significantly lower alpha-tocopherol levels than younger children (<7 years).
- Alpha-tocopherol acetate supplementation increased alpha- and total tocopherol levels, while decreasing gamma-tocopherol and lipid peroxides.
Conclusions:
- Epileptic children on AED therapy exhibit altered vitamin E status, with lower alpha-tocopherol levels in older children.
- Alpha-tocopherol supplementation appears beneficial in improving vitamin E status and reducing oxidative stress markers in pediatric epilepsy patients.
Abstract:
Decreased vitamin E levels have been reported in epileptic children receiving antiepileptic drugs (AED). In order to investigate the tocopherol status of patients receiving AED, the alpha-, beta, gamma- and delta-tocopherol concentrations were each determined in 447 patients' serum samples using a high-performance liquid chromatographic method. In pediatric patient samples (n = 244, aged 1-16 years), there was a negative relationship (p less than 0.02; r = -0.153) between age and alpha-tocopherol levels, while there was a positive relationship (p less than 0.05; r = 0.142) between age and gamma-tocopherol levels. The mean (+/- SD) alpha-tocopherol levels (0.73 +/- 0.23 mg/dl) in the older children (n = 166, aged 7-16 years) were significantly lower (p less than 0.05) than the levels (0.83 +/- 0.23 mg/dl) found in the younger children (n = 78, aged under 7 years). Administration of alpha-tocopherol acetate, 3 mg/kg/day to 8 children and 5 mg/kg/day to 4 children, increased alpha- and total tocopherol levels (p less than 0.01 for both), while gamma-tocopherol levels and serum lipid peroxide levels were decreased (p less than 0.01 for both). In 203 epileptic patient samples (over 16 years of age), the mean alpha-tocopherol level (0.92 +/- 0.28 mg/dl) tended to be lower (p less than 0.1) than in 22 healthy adult controls (1.01 +/- 0.26 mg/dl).