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Insulin Resistance in children on Sodium Valproate - A hospital based cross-sectional study in Indian children

Lydia James George1,2, Preeti Singh3, Satinder Aneja4

  • 1MD, Senior Resident, Department of Pediatrics, LHMC, New Delhi, India.

Tropical Doctor
|November 2, 2022
PubMed

Insights

Children on sodium valproate (VPA) therapy show higher insulin resistance (IR) and fatty liver disease prevalence than those on phenytoin sodium (PS) or controls. VPA treatment increases susceptibility to metabolic complications in pediatric patients.

Area of Science:

  • Pediatric Endocrinology
  • Clinical Pharmacology
  • Metabolic Disorders

Background:

  • Insulin resistance (IR) is a growing concern in pediatric populations.
  • Antiepileptic drugs (AEDs) can have various metabolic side effects.
  • Long-term effects of specific AEDs like sodium valproate (VPA) and phenytoin sodium (PS) on pediatric metabolic health require further investigation.

Purpose of the Study:

  • To compare the point prevalence of insulin resistance (IR) and non-alcoholic fatty liver disease (NAFLD) in children on VPA monotherapy versus PS monotherapy.
  • To assess associated metabolic risk factors in these pediatric groups.

Main Methods:

  • A comparative study involving 150 children (aged 6-18 years).
  • Participants were divided into three groups: 50 on VPA, 50 on PS, and 50 healthy controls.
  • Assessment of metabolic complications and risk factors, including IR and NAFLD prevalence.

Main Results:

  • Significantly higher point prevalence of IR (12%) and NAFLD (34%) was observed in children receiving VPA compared to PS and healthy controls.
  • These differences persisted regardless of age, sex, pubertal, or nutritional status.
  • Central obesity, acanthosis, hypertension, and dyslipidemia were associated with IR, but not independently on multivariate analysis.

Conclusions:

  • Sodium valproate (VPA) monotherapy in children is associated with an increased susceptibility to metabolic complications, including IR and NAFLD.
  • Close monitoring of pediatric patients on VPA is crucial for early detection and timely intervention of metabolic disturbances.

Keywords:
AsiaEndocrineGeneral HealthLocationPhysiology

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