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Assessment of low-density lipoprotein oxidation, paraoxonase activity, and arterial distensibility in epileptic children who were treated with anti-epileptic drugs

Published online by Cambridge University Press:  02 June 2010

Mustafa Yildiz ,
Gonul Simsek ,
Hafize Uzun ,
Serap Uysal ,
Sevim Sahin  and
Huriye Balci
Mustafa Yildiz*
Affiliation:
Department of Physiology, Istanbul University, Istanbul, Turkey Department of Cardiology, Kartal Kosuyolu Yuksek Ihtisas Educational and Research Hospital, Istanbul University, Istanbul, Turkey
Gonul Simsek
Affiliation:
Department of Physiology, Istanbul University, Istanbul, Turkey
Hafize Uzun
Affiliation:
Department of Biochemistry, Istanbul University, Istanbul, Turkey
Serap Uysal
Affiliation:
Department of Pediatric Neurology, Istanbul University Cerrahpaşa Medical Faculty, Istanbul University, Istanbul, Turkey
Sevim Sahin
Affiliation:
Department of Pediatric Neurology, Istanbul University Cerrahpaşa Medical Faculty, Istanbul University, Istanbul, Turkey
Huriye Balci
Affiliation:
Cerrahpaşa Medical Faculty, Fikret Biyal Research Laboratory, Istanbul University, Istanbul, Turkey
*
Correspondence to: M. Yildiz, Associate Professor, MD, PhD, Cardiologist, Internal Medicine Specialist and Physiologist, Department of Cardiology, Kartal Kosuyolu Yuksek Ihtisas Educational and Research Hospital, Istanbul, Turkey. Tel: +90 532 371 17 01; Fax: +90 216 459 63 21; E-mail: [email protected]
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Abstract

Objective

Studies show that anti-epileptic drugs increase oxidative stress. Thus, low-density lipoprotein oxidation increases and atherogenesis is induced. Paraoxonase-associated high-density lipoprotein protects low-density lipoprotein and high-density lipoprotein oxidation. The effects of anti-epileptic drugs on paraoxonase activity has not been investigated yet. The aim of this study is to investigate the effect of anti-epileptic drugs on paraoxonase activity, lipid profiles, folat, vitamin B12, homocysteine, thyroid hormones, apolipoprotein A-1, total anti-oxidant capacity, malondialdehyd, nitric oxide, and oxidised low-density lipoprotein. The association with carotid–femoral pulse wave velocity and current biochemical parameters had been searched for assessing the effects of anti-epileptic drugs on the vascular system.

Patients and methods

We recruited 59 epileptic patients treated with anti-epileptic drugs and 23 controls (group IV) at least 6 months ago. The epileptic group was divided into three groups by receiving anti-epileptic drugs as follows: group I: carbamazepine, group II: valproic acid, and group III: carbamazepine and valproic acid. Arterial distensibility was assessed with the Complior device.

Results

There was no difference between the current biochemical parameters in epileptic children. Serum-free T4 was decreased, when compared with group IV. Thyroid-stimulating hormone was increased in group II, compared with group IV. The carotid–femoral pulse wave velocity was increased in group III, compared with group IV. The carotid–femoral pulse wave velocity was correlated with thyroid-stimulating hormone and valproic acid levels.

Conclusions

Anti-epileptic drugs may induce atherogenesis by affecting the thyroid hormones. According to the current data, the effects of thyroid hormones on vascular system may be independent of other biochemical markers. Epileptic patients using anti-epileptic drugs must be followed closely for arterial stiffness, and also for the development and progression of atherosclerosis.

Keywords

Carbamazepinevalproic acidarterial distensibilityparaoxanaseoxidised low-density lipoprotein
Type
Original Articles
Information
Cardiology in the Young , Volume 20 , Issue 5 , October 2010 , pp. 547 - 554
Copyright
Copyright © Cambridge University Press 2010

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