Fatty liver in adults receiving antiepileptic medications: relationship to the metabolic risks

This study aimed to determine the frequency of fatty liver disease (FLD) induced by antiepileptic drugs (AEDs) and its relationship to the metabolic profile. This study included 130 patients (valproate or VPA = 75; carbamazepine or CBZ = 40; lamotrigine or LTG = 15). Liver ultrasonography (US) was done. Serum lipids, uric acid, free fatty acids (FFAs), glucose, insulin and leptin were measured. Compared to controls and patients on CBZ or LTG, higher BMI; TC, TG, LDL-c, uric acid, FFAs, glucose, insulin and leptin concentrations and enlarged liver lobes volume and span and insulin resistance (45%) were reported with VPA. With FLD, significant correlations were reported between BMI with leptin (r = 0.390;p < 0.01), insulin (r = 0.655;p < 0.001) and FFAs (r = 0.570;p < 0.001) and insulin with leptin (r = 0.355;p < 0.01). In multivariate analysis, with FLD, liver span was correlated with BMI (OR:4.50;95%CI:1.54-13.3,p = 0.01) and leptin concentrations (OR:2.55;95%CI:1.04-6.27,p = 0.045). We conclude that VPA therapy is a risk for FLD and is correlated with the associated adverse metabolic profile.