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Neurology 2003;60:571-574
© 2003 American Academy of Neurology

Fasting serum insulin and lipid levels in men with epilepsy

V. Pylvänen, MD, M. Knip, MD PhD, A. J. Pakarinen, MD PhD, J. Turkka, MD PhD, M. Kotila, MD PhD, J. Rättyä, MD, V. V. Myllylä, MD PhD and J. I.T. Isojärvi, MD PhD

From the Departments of Neurology (Drs. Pylvänen, Turkka, Rättyä, Myllylä, and Isojärvi) and Clinical Chemistry (Dr. Pakarinen), University of Oulu; and Hospital for Children and Adolescents (Dr. Knip) and Department of Neurology (Dr. Kotila), University of Helsinki, Finland.

Address correspondence and reprint requests to Dr. Virpi Pylvänen, Department of Neurology, P.O. Box 5000, 90014 Oulu, Finland; e-mail: virpi.pylvanen{at}oulu.fi

Background: Previous studies suggest that obese women taking valproate (VPA) for epilepsy are insulin resistant.

Objective: To assess the effects of antiepileptic drugs on serum insulin and lipid levels in men with epilepsy.

Methods: Body mass index (BMI) and fasting serum concentrations of insulin and lipids were measured in 102 men with epilepsy who were treated with VPA, carbamazepine (CBZ), or oxcarbazepine (OXC) monotherapy. Thirty-two healthy men served as control subjects.

Results: Obesity was not more common among VPA-treated men than among other men with epilepsy or the control subjects. However, the obese VPA-treated men had higher serum insulin levels (p < 0.001) than the obese control subjects despite similar BMI. CBZ and OXC did not have any significant effect on any of the measurements. Fasting serum insulin concentrations above the normal range were observed in seven obese VPA-treated patients (35%) but in only one obese control subject (5%). Five obese VPA-treated patients (25%) and one obese control subject (5%) had serum triglyceride levels above the normal range, and a low high-density lipoprotein/total cholesterol ratio was observed in two obese VPA-treated patients (10%).

Conclusions: Obese valproate-treated men have high serum insulin levels, indicating insulin resistance. Moreover, some of the valproate-treated men cluster cardiovascular risk factors such as obesity, hyperinsulinemia, and elevated serum triglyceride concentrations. CBZ and OXC do not seem to have any significant effects on serum insulin or lipid levels in men with epilepsy.






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