Non-HDL Cholesterol, Obesity, and Metabolic Syndrome in Epileptic Patients

To compare cardiovascular risk factors in patients with epilepsy with those of non-epileptic neurologic patients to determine their association with antiepileptic drug therapy.

This observational study with a cross-sectional design was performed in a tertiary care hospital in the Eastern Province of Saudi Arabia from January to December 2018. A total of 110 patients with epilepsy were included in the study, along with 46 age- and sex-matched non-epileptic controls (approximate ratio of 2:1). Blood pressure reading (BP), anthropometric measurements, fasting blood sugar levels, and fasting lipid profiles were performed for all subjects.

Raised non-high-density lipid cholesterol (nHDLC) was the most common cardiovascular risk in epileptic patients, with a frequency of 51% compared to 30.4% in controls (P = .019). Epileptic patients who were male (58.3%, 28/48, P = .012) and those aged < 35 years (47.3%, 26/55, P = .036) were more likely to have high nHDLC. Obesity was also common in epileptic patients with frequency of 49.1% (n = 54) versus 30.4% (n = 14) in controls (P = .032). Metabolic syndrome was present in 26.3% of epileptic patients versus 23.9% of controls (P = .749). Among the epileptic patients, of those with high nHDLC, 85.7% had satisfactory seizure control (P = .019).

Raised nHDLC and obesity but not metabolic syndrome appear to be highly prevalent in epileptic patients compared to those without epilepsy. Antiepileptic drugs alone may not play a role in developing high lipid levels. More studies are needed to determine the causes of higher risk factor profile in epileptic patients and their relationship with seizure control.