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首页> 外文期刊>Acta neurologica Scandinavica. >Insulin resistance in patients on valproic acid: relation to adiponectin
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Insulin resistance in patients on valproic acid: relation to adiponectin

机译：丙戊酸患者的胰岛素抵抗：与脂联素的关系

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摘要

Objectives - To investigate the presence of insulin resistance in obese children with idiopathic epilepsy on valproic acid (VPA) monotherapy in comparison to obese otherwise healthy subjects. Secondary outcome was to explore the relation between adiponectin and insulin resistance among those patients. Materials and Methods - Fifty obese children with generalized idiopathic epilepsy on VPA monotherapy and a control group of 49 obese clinically healthy age and sex-matched children with simple obesity were recruited in the study. Anthropometric assessment, fasting plasma insulin (FI), fasting glucose (FG) and fasting adiponectin levels were measured. Fasting glucose insulin ratio (FGIR) and homoeostasis model assessment for insulin resistance (HOMA-IR) were calculated for both patients and control subjects. Measurement of serum VPA trough level was also performed in patients. Results - Patients had significantly higher fasting blood glucose, fasting insulin, lower FGIR and higher HOMA-IR values, compared to controls. Mean adiponectin level was significantly lower in patients compared to controls. The duration of treatment with valproic acid negatively correlated with adiponectin (r = -0.285, P = 0.045), but did not correlate with fasting glucose, insulin, FGIR or HOMA-IR. Total daily VPA dose significantly correlated with fasting insulin (r = 0.495, P < 0.001), FGIR (r = -0.525, P < 0.001) and HOMA-IR (r = 0.404, P = 0.004). Conclusion - This study ascertains the relationship between dose and duration of VPA therapy, insulin resistance and the adipocytokine axis. We are reporting the novel proposal that obese VPA-treated children are more insulin resistant and have lower adiponectin levels than obese and otherwise healthy children.
机译：目的-与肥胖或其他健康受试者相比，研究丙戊酸（VPA）单药治疗的特发性癫痫肥胖儿童的胰岛素抵抗情况。次要结果是探讨这些患者中脂联素与胰岛素抵抗之间的关系。材料与方法-研究招募了50名接受VPA单药治疗的全身性特发性癫痫的肥胖儿童和49名肥胖的临床健康年龄和性别匹配的单纯性肥胖儿童作为对照组。进行人体测量评估，空腹血浆胰岛素（FI），空腹血糖（FG）和空腹脂联素水平。计算患者和对照受试者的空腹葡萄糖胰岛素比（FGIR）和胰岛素抵抗同稳态模型评估（HOMA-IR）。还对患者进行了血清VPA谷值的测量。结果-与对照组相比，患者的空腹血糖，空腹胰岛素，FGIR降低和HOMA-IR值明显升高。与对照组相比，患者的平均脂联素水平显着降低。丙戊酸的治疗时间与脂联素呈负相关（r = -0.285，P = 0.045），但与空腹血糖，胰岛素，FGIR或HOMA-IR不相关。每日总VPA剂量与空腹胰岛素（r = 0.495，P <0.001），FGIR（r = -0.525，P <0.001）和HOMA-IR（r = 0.404，P = 0.004）显着相关。结论-该研究确定了VPA治疗的剂量和持续时间，胰岛素抵抗和脂肪细胞因子轴之间的关系。我们正在报告一项新颖的建议，即肥胖VPA治疗的儿童比肥胖和其他健康的儿童对胰岛素的抵抗力更高，脂联素水平更低。

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