EFFECT OF VALPROATE AND OXCARBAZEPINE THERAPY ON ASYMMETRIC DIMETHYL ARGININE (ADMA) AND HOMOCYSTEINE LEVELS IN NEWLY DIAGNOSED EPILEPTIC CHILDREN

Journal Title: Journal of Advanced Medical and Dental Sciences Research - Year 2017, Vol 5, Issue 7

Abstract

Aim: The aim of our study was to evaluate the effect of valproate and oxcarbazepine therapy in children newly diagnosed with epilepsy. Changes in serum asymmetric dimethyl arginine (ADMA), homocysteine, folate and B12 levels were assessed as possible markers of cardiovascular risk and correlation between homocysteine and ADMA levels was ascertained. Materials and Methods: Drug naïve patients newly diagnosed with epilepsy of age 7-17 years (n= 62), with no known cause of hyperhomocysteinemia, were enrolled for the study. A pre treatment analysis of homocysteine, folate and B12 was done using chemiluminescent competitive immunoassay. Serum ADMA levels were measured by ELISA. Thereafter, treatment of 34 children was started on valproate and 28 were prescribed oxcarbazepine. After six months of continuous treatment, the analysis was repeated. Results: Sixty two newly diagnosed, drug naïve patients of epilepsy were recruited for the study. After initial assessment of biochemical parameters, treatment was initiated. Valproate was started on 34 patients and 28 were given oxcarbazepine. No significant variations were observed in age, gender and seizure type. There was a significant increase in ADMA and Hcy levels in both the groups after six months of therapy (p < 0.05). A decrease in folate levels was registered in both the groups, but the change was significant only in the group on OXC treatment (p = 0.003). A significant increase in B12 concentration was observed in the group on VPA (p = 0.002) and a decrease was registered in children on OXC treatment (p = 0.026). . Differences between the groups were significant in ADMA, Hcy and B12 levels (p = 0.000, 0.000 and 0.003 respectively). 41.1% (14/34) children on valproate therapy and 21.4% (6/28) patients on oxcarbazepine had hyperhomocysteinemia after six months of therapy. No correlation was observed between ADMA and Hcy changes in both the groups. In subjects on valproate, at follow up, ADMA levels exhibited a positive correlation with B12 (r= 0.389; p= 0.023) and Hcy levels correlated negatively with folate (r= -0.444; p= 0.008). In patients on OXC therapy, ADMA correlated negatively with B12 at recruitment(r= -0.503; p= 0.006). After six months of therapy, Hcy and folate levels had a significant negative correlation (r= -0.427; p= 0.024). Conclusion: Anti-epileptic therapy can affect ADMA, Hcy and related vitamins but increase in ADMA may be independent of Hhcy. Further studies are needed to understand the etiology of ADMA increase

Authors and Affiliations

Namrata Khanna, Sajjan Lal Verma, Pradeep K Maurya, Vandana Tiwari, Dinkar Kulshreshtha

Keywords

Related Articles

Retrospective Evaluation of Success of Dental Implants in Medically Compromised Patients

Background: Dental implants are one of the most successful treatment choices for edentulous areas. The surgical and rehabilitation phases of dental implant surgery are greatly affected by the history and clinical examina...

CLINICAL EVALUATION OF PROSTHETIC COMPLICATIONS IN PATIENTS TREATED WITH IMPLANT SUPPORTED OVER-DENTURE

Background: The use of implants to treat edentulous jaws has become a well-established and accepted contemporary clinical method. Interest in the use of implants for fully or partially edentulous patients has increased....

DRUG RESISTANCE PATTERN AMONG PATIENTS WITH TUBERCULOSIS- A CLINICAL STUDY

Background: Tuberculosis (TB) is a contagious disease caused by the bacillus Mycobacterium (M.) tuberculosis and occasionally by Mycobacterium bovis, and Mycobacterium africanum. There are cases of drug-resistant TB thro...

Study of Maternal and Perinatal Outcomes in Multiple Pregnancy

Background: Multiple gestations or multiple pregnancies occur when two or more fetuses are conceived at the same time in the same woman, it can either be a monozygotic or dizygotic pregnancy. Multiple gestations are asso...

Microflora of Endodontic Infection - A Review

The aim of endodontic treatment is to identify and eradicate the etiological factor responsible for infection. Thorough Cleaning of the root canal system by instrumentation, irrigation and removal of endodontic biofilm i...

Download PDF file
  • EP ID EP558334
  • DOI -
  • Views 128
  • Downloads 0

How To Cite

Namrata Khanna, Sajjan Lal Verma, Pradeep K Maurya, Vandana Tiwari, Dinkar Kulshreshtha (2017). EFFECT OF VALPROATE AND OXCARBAZEPINE THERAPY ON ASYMMETRIC DIMETHYL ARGININE (ADMA) AND HOMOCYSTEINE LEVELS IN NEWLY DIAGNOSED EPILEPTIC CHILDREN. Journal of Advanced Medical and Dental Sciences Research, 5(7), 57-63. https://europub.co.uk/articles/-A-558334