Limits...
Comparison of the metabolic syndrome risk in valproate-treated patients with epilepsy and the general population in Estonia.

Rakitin A, Eglit T, Kõks S, Lember M, Haldre S - PLoS ONE (2014)

Bottom Line: Data were compared with the results of a population-based study of the prevalence of MS in the same geographic region (N = 493; 213 men, 280 women).In VPA-treated patients, the predictive ability of the HOMA-IR index was significantly lower than that of BMI, with areas under the receiver operating characteristic curves of 0.808 and 0.897 (P = 0.05), respectively.The HOMA-IR index likely has a lower predictive ability for MS in VPA-treated patients compared to its predictive ability in the general population.

View Article: PubMed Central - PubMed

Affiliation: Department of Neurology and Neurosurgery, University of Tartu, Tartu, Estonia; Neurology Clinic, Tartu University Hospital, Tartu, Estonia.

ABSTRACT

Background: No study has explored the risk of metabolic syndrome (MS) in patients with epilepsy treated with valproate (VPA) at the population level. The aim of this study was to compare the risk of MS in VPA-treated patients in Estonia to the risk in the general population.

Methods: This study involved 118 patients with epilepsy (63 men, 55 women) who received VPA monotherapy. MS was diagnosed according to the National Cholesterol Education Program Adult Treatment Panel III criteria. Data were compared with the results of a population-based study of the prevalence of MS in the same geographic region (N = 493; 213 men, 280 women).

Results: In the multiple logistic regression analysis, after adjustment for age and sex, the risk of MS in VPA-treated patients was not increased compared to the control subjects (odds ratio [OR] = 1.00; 95% confidence interval [CI], 0.59-1.68). VPA-treated patients had higher serum insulin concentrations than control subjects, independent of body mass index (BMI). A positive association was found between MS development and BMI (OR = 1.47; 95% CI, 1.25-1.73) in VPA-treated patients, but there were no associations with the VPA dosage or the homeostasis model assessment-estimated insulin resistance (HOMA-IR) index. In control subjects, BMI and HOMA-IR had similar predictive abilities for MS occurrence. In VPA-treated patients, the predictive ability of the HOMA-IR index was significantly lower than that of BMI, with areas under the receiver operating characteristic curves of 0.808 and 0.897 (P = 0.05), respectively.

Conclusions: The risk of MS is not increased among VPA-treated patients with epilepsy in Estonia compared to the general population. The HOMA-IR index likely has a lower predictive ability for MS in VPA-treated patients compared to its predictive ability in the general population.

Show MeSH

Related in: MedlinePlus

Receiver operating characteristic (ROC) curves of the homeostasis model assessment-estimated insulin resistance (HOMA-IR) and body mass index (BMI) values in control subjects.BMI and HOMA-IR curves were obtained by logistic regression to determine the probability of metabolic syndrome (MS) in control subjects. AUC, area under the curve.
© Copyright Policy
Related In: Results  -  Collection

License
getmorefigures.php?uid=PMC4117573&req=5

pone-0103856-g002: Receiver operating characteristic (ROC) curves of the homeostasis model assessment-estimated insulin resistance (HOMA-IR) and body mass index (BMI) values in control subjects.BMI and HOMA-IR curves were obtained by logistic regression to determine the probability of metabolic syndrome (MS) in control subjects. AUC, area under the curve.

Mentions: Logistic regression analysis showed no significant correlation between MS development in VPA-treated patients and any clinical characteristic, including age, sex, VPA dosage, HOMA-IR, epilepsy etiology, seizure occurrence in the last year, and subjectively reported weight gain during VPA treatment. Positive correlations were found between MS development and BMI (OR = 1.47; 95% CI, 1.25–1.73). Longer durations of VPA treatment tended to increase the risk of MS, with borderline statistical significance (OR = 1.01; 95% CI, 1.0–1.02). In overweight VPA-treated patients, the predictors of MS were HOMA-IR (OR = 2.56; 95% CI, 1.40–4.70) and age (OR = 1.07; 95% CI, 1.01–1.13). In control subjects, MS development was correlated positively with HOMA-IR (OR = 2.00; 95% CI, 1.61–2.49), BMI (OR = 1.18; 95% CI, 1.12–1.24), and age (OR = 1.04; 95% CI, 1.02–1.06). ROC analysis showed that BMI and HOMA-IR similarly predicted MS occurrence in control subjects, with areas under the ROC curve (AUCs) of 0.847 and 0.848 (P = 0.97), respectively (Figure 2). The predictive ability of HOMA-IR was lower than that of BMI in VPA-treated patients, with AUCs of 0.808 and 0.897 (P = 0.050), respectively (Figure 3).


Comparison of the metabolic syndrome risk in valproate-treated patients with epilepsy and the general population in Estonia.

Rakitin A, Eglit T, Kõks S, Lember M, Haldre S - PLoS ONE (2014)

Receiver operating characteristic (ROC) curves of the homeostasis model assessment-estimated insulin resistance (HOMA-IR) and body mass index (BMI) values in control subjects.BMI and HOMA-IR curves were obtained by logistic regression to determine the probability of metabolic syndrome (MS) in control subjects. AUC, area under the curve.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4117573&req=5

pone-0103856-g002: Receiver operating characteristic (ROC) curves of the homeostasis model assessment-estimated insulin resistance (HOMA-IR) and body mass index (BMI) values in control subjects.BMI and HOMA-IR curves were obtained by logistic regression to determine the probability of metabolic syndrome (MS) in control subjects. AUC, area under the curve.
Mentions: Logistic regression analysis showed no significant correlation between MS development in VPA-treated patients and any clinical characteristic, including age, sex, VPA dosage, HOMA-IR, epilepsy etiology, seizure occurrence in the last year, and subjectively reported weight gain during VPA treatment. Positive correlations were found between MS development and BMI (OR = 1.47; 95% CI, 1.25–1.73). Longer durations of VPA treatment tended to increase the risk of MS, with borderline statistical significance (OR = 1.01; 95% CI, 1.0–1.02). In overweight VPA-treated patients, the predictors of MS were HOMA-IR (OR = 2.56; 95% CI, 1.40–4.70) and age (OR = 1.07; 95% CI, 1.01–1.13). In control subjects, MS development was correlated positively with HOMA-IR (OR = 2.00; 95% CI, 1.61–2.49), BMI (OR = 1.18; 95% CI, 1.12–1.24), and age (OR = 1.04; 95% CI, 1.02–1.06). ROC analysis showed that BMI and HOMA-IR similarly predicted MS occurrence in control subjects, with areas under the ROC curve (AUCs) of 0.847 and 0.848 (P = 0.97), respectively (Figure 2). The predictive ability of HOMA-IR was lower than that of BMI in VPA-treated patients, with AUCs of 0.808 and 0.897 (P = 0.050), respectively (Figure 3).

Bottom Line: Data were compared with the results of a population-based study of the prevalence of MS in the same geographic region (N = 493; 213 men, 280 women).In VPA-treated patients, the predictive ability of the HOMA-IR index was significantly lower than that of BMI, with areas under the receiver operating characteristic curves of 0.808 and 0.897 (P = 0.05), respectively.The HOMA-IR index likely has a lower predictive ability for MS in VPA-treated patients compared to its predictive ability in the general population.

View Article: PubMed Central - PubMed

Affiliation: Department of Neurology and Neurosurgery, University of Tartu, Tartu, Estonia; Neurology Clinic, Tartu University Hospital, Tartu, Estonia.

ABSTRACT

Background: No study has explored the risk of metabolic syndrome (MS) in patients with epilepsy treated with valproate (VPA) at the population level. The aim of this study was to compare the risk of MS in VPA-treated patients in Estonia to the risk in the general population.

Methods: This study involved 118 patients with epilepsy (63 men, 55 women) who received VPA monotherapy. MS was diagnosed according to the National Cholesterol Education Program Adult Treatment Panel III criteria. Data were compared with the results of a population-based study of the prevalence of MS in the same geographic region (N = 493; 213 men, 280 women).

Results: In the multiple logistic regression analysis, after adjustment for age and sex, the risk of MS in VPA-treated patients was not increased compared to the control subjects (odds ratio [OR] = 1.00; 95% confidence interval [CI], 0.59-1.68). VPA-treated patients had higher serum insulin concentrations than control subjects, independent of body mass index (BMI). A positive association was found between MS development and BMI (OR = 1.47; 95% CI, 1.25-1.73) in VPA-treated patients, but there were no associations with the VPA dosage or the homeostasis model assessment-estimated insulin resistance (HOMA-IR) index. In control subjects, BMI and HOMA-IR had similar predictive abilities for MS occurrence. In VPA-treated patients, the predictive ability of the HOMA-IR index was significantly lower than that of BMI, with areas under the receiver operating characteristic curves of 0.808 and 0.897 (P = 0.05), respectively.

Conclusions: The risk of MS is not increased among VPA-treated patients with epilepsy in Estonia compared to the general population. The HOMA-IR index likely has a lower predictive ability for MS in VPA-treated patients compared to its predictive ability in the general population.

Show MeSH
Related in: MedlinePlus