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Valproate Linked To Hyperinsulinemia And Dyslipidemia In Obese Men

Use of valproate is associated with elevated insulin and serum lipid levels in obese men with epilepsy. The same was not seen for obese men taking carbamazepine or oxcarbazepine.

V. Pylvanen and colleagues from the departments of neurology and clinical chemistry, University of Oulu, Finland, assessed the effects of the three anti-epileptic drugs on serum insulin and lipid levels in 102 epileptic men. The researchers measured body mass index (BMI) as well as fasting serum lipid and insulin levels in 102 men being treated with valproate, carbamazepine or oxcarbazepine as well as 32 healthy controls.

Obesity levels were not more common among patients taking valproate than among those taking other anti-epileptics or control subjects. However, obese men who were taking valproate had higher serum insulin levels than obese control subjects, even though they had similar BMIs (P<0.001). Specifically, seven obese men being treated with valproate (35%) had fasting serum insulin concentrations above the normal range, compared with only one obese man in the control group (5%) Also, five obese men being treated with valproate (25%) had elevated triglycerides, compared with only one obese control subject (5%). Finally, two obese valproate-treated patients (10%) had a low high-density lipoprotein/total cholesterol (HDL/TC) ratio.

Based on these findings, the authors concluded that obese men taking valproate are more likely to have high serum insulin levels, which is a sign of insulin resistance. Also, some of these men have a cluster of cardiovascular risk factors, including obesity, hyperinsulinemia and elevated serum lipids.
Neurology 2003 Feb 25;60:4:571-4. "Fasting serum insulin and lipid levels in men with epilepsy."

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