Effect of valproic acid treatment on body composition, leptin and soluble leptin receptor in epileptic children

Objective: To determine the influence of Valproic Acid (VPA) treatment on body composition and some adipocytokines in lean and overweight children and adolescents.

Methods: A cross-sectional cohort study was conducted at the Medical University Innsbruck, Austria. Children >6 years old with previously diagnosed epilepsy and antiepileptic drug (AED) therapy since at least six months were eligible. Body composition, glucose homeostasis, leptin concentration, the sOB-R and the FLI were determined.

Results: 87 children and adolescents (mean age 12.3±3.6) were investigated for the VPA group. For the control group, 55 patients (mean age 12.3±3.1) were investigated. VPA-treated children had higher weight Standard Deviation Score (SDS), Body-Mass-Index SDS, body fat, leptin concentrations (each p<0.001), serum insulin concentrations (p=0.014), homeostasis model assessment (HOMA) index (p=0.009), as well as lower FLIs (p<0.001) compared to controls. Lean children (BMI <85th centile) undergoing VPA monotherapy revealed higher leptin concentrations and higher percentages of body fat (each p=0.001) compared to lean controls. Overweight VPA treated children showed higher body fat and leptin concentrations (each p<0.001) as well as lower FLI and sOB-R concentrations (each p<0.001) compared to lean VPA treated children.

Conclusion: VPA monotherapy was associated with higher body weight, body fat and serum leptin concentrations as well as impaired glucose homeostasis. Higher sOB-R levels in lean VPA treated children compared to lean controls could possibly influence weight maintenance. Low sOB-R concentrations and FLI in overweight VPA treated patients might contribute to disturbances in glucose homeostasis and to the development of the metabolic syndrome in these children later in life.