Epileptic Patients Under Valproic Acid Assessment of Insulin Resistance and Cerebral Hemodynamics | ||
| International Journal of Medical Arts | ||
| Articles in Press, Accepted Manuscript, Available Online from 01 October 2025 PDF (1.81 M) | ||
| Document Type: Original Article | ||
| DOI: 10.21608/ijma.2025.384308.2184 | ||
| Authors | ||
| Reham Hamada Mohammed Mohammed* 1; Laila Elmously Naguib Talaat1; Alshaymaa Mohammed Mahmoud Alhabibi2; Seham Elsaid Abdelsadek Abdelmohsen1 | ||
| 1Department of Neurology, Faculty of Medicine for Girls, Al-Azhar University, Cairo, Egypt. | ||
| 2Department of Clinical Pathology, Faculty of Medicine for Girls, Al-Azhar University, Cairo, Egypt. | ||
| Abstract | ||
| Background: The impact of valproic acid [VPA] on insulin resistance [IR] and cerebral hemodynamics in epileptic patients is not clarified. Research continues to explore these potential effects. The aim of the work: This study aimed to assess IR in epileptic patients treated with VPA by measuring serum HOMA-IR and asprosin levels and evaluate the impact of IR on extracerebral and intracerebral blood vessels for early detection and appropriate management of potential complications. Patients and Methods: This was a case-control study carried out on 90 participants aged 18-45 years [47 males, 43 females] between January 2023 and April 2024. Demographic, clinical, and anthropometric data were collected from all participants. IR was assessed using the Homeostasis Model Assessment [HOMA-IR] and asprosin, while cerebral hemodynamics were evaluated through Transcranial Color-Coded Duplex [TCCD] and Carotid Intima-Media Thickness [CIMT] measurements. Results: The analysis revealed increase in Body Mass Index [BMI] and weight in VPA groups, were significantly higher in comparison to both the levetiracetam and control groups [p ≤ 0.001]. The VPA group exhibited significantly higher fasting insulin levels [p ≤ 0.001], HOMA-IR values and asprosin compared to both the levetiracetam and control groups, indicating increased IR. TCCD selected parameters showed no significant differences among the groups. However, CIMT measurements were significantly increased in the VPA group [0.8 ± 0.2 mm] compared to the levetiracetam [0.5 ± 0.1 mm] and control groups [0.5 ± 0.1 mm] [p ≤ 0.001]. Conclusion: The findings suggest that VPA may contribute to increased IR, an atherogenic lipid profile characterized by elevated triglycerides and reduced HDL-cholesterol and abnormal CIMT supporting the need for careful monitoring of metabolic parameters and vascular ultrasound in this population. | ||
| Keywords | ||
| Valproic Acid; Epilepsy; Insulin Resistance; Cerebral Hemodynamics; Asprosin | ||
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