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Antiepileptic drugs as independent predictors of plasma total homocysteine levels.

Abstract

Low folate levels have consistently been reported in patients with epilepsy on phenytoin (PHT), phenobarbital (PB) and primidone (PRD), while data on valproate (VPA) are conflicting. Furthermore, antiepileptic drugs (AEDs) may be associated with high levels of plasma total homocysteine (p-tHcy). Therefore, we have investigated the levels of p-tHcy, serum folate (S-FA) and erythrocyte folate (E-FA) in patients on PHT, PB and PRD (Group 1, n=21) and VPA (Group 2, n=24). Both groups had their own matched controls. Blood samples were drawn fasting and 6 h post methionine loading (6 h-PML). The Group 1 patients had fasting and 6 h-PML p-tHcy levels significantly higher than their controls (P=0.05 and <0.0001, respectively), and patients without dietary multivitamin supplementation (n=14), had lower fasting S-FA and E-FA levels than their controls (P=0.02 and 0.0003, respectively). The Group 2 patients had fasting and 6 h-PML levels of p-tHcy, S-FA and E-FA not different from their controls. In a multiple stepwise regression model comprising all subjects (n=90), the AEDs of Group 1 and the S-FA levels were independent predictors of p-tHcy levels. Thus, PHT, PB and PRD are associated with high p-tHcy and low folate levels, whereas VPA does not influence S-FA, E-FA and p-tHcy levels in adult patients.

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  • Authors+Show Affiliations

    ,

    Department of Internal Medicine, Rogaland Central Hospital, 4011 Stavanger, Norway. apeland@online.no

    ,

    Source

    Epilepsy research 47:1-2 2001 Nov pg 27-35

    MeSH

    Adult
    Amino Acid Substitution
    Anticonvulsants
    Cholesterol
    Cholesterol, HDL
    Confidence Intervals
    Cysteine
    Epilepsy
    Fasting
    Female
    Folic Acid
    Homocysteine
    Humans
    Hyperhomocysteinemia
    Male
    Middle Aged
    Mutation
    Predictive Value of Tests
    Prevalence
    Statistics, Nonparametric
    Threonine
    Triglycerides
    Vitamin B 12

    Pub Type(s)

    Comparative Study
    Journal Article
    Research Support, Non-U.S. Gov't

    Language

    eng

    PubMed ID

    11673018

    Citation

    Apeland, T, et al. "Antiepileptic Drugs as Independent Predictors of Plasma Total Homocysteine Levels." Epilepsy Research, vol. 47, no. 1-2, 2001, pp. 27-35.
    Apeland T, Mansoor MA, Strandjord RE. Antiepileptic drugs as independent predictors of plasma total homocysteine levels. Epilepsy Res. 2001;47(1-2):27-35.
    Apeland, T., Mansoor, M. A., & Strandjord, R. E. (2001). Antiepileptic drugs as independent predictors of plasma total homocysteine levels. Epilepsy Research, 47(1-2), pp. 27-35.
    Apeland T, Mansoor MA, Strandjord RE. Antiepileptic Drugs as Independent Predictors of Plasma Total Homocysteine Levels. Epilepsy Res. 2001;47(1-2):27-35. PubMed PMID: 11673018.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Antiepileptic drugs as independent predictors of plasma total homocysteine levels. AU - Apeland,T, AU - Mansoor,M A, AU - Strandjord,R E, PY - 2001/10/24/pubmed PY - 2002/2/1/medline PY - 2001/10/24/entrez SP - 27 EP - 35 JF - Epilepsy research JO - Epilepsy Res. VL - 47 IS - 1-2 N2 - Low folate levels have consistently been reported in patients with epilepsy on phenytoin (PHT), phenobarbital (PB) and primidone (PRD), while data on valproate (VPA) are conflicting. Furthermore, antiepileptic drugs (AEDs) may be associated with high levels of plasma total homocysteine (p-tHcy). Therefore, we have investigated the levels of p-tHcy, serum folate (S-FA) and erythrocyte folate (E-FA) in patients on PHT, PB and PRD (Group 1, n=21) and VPA (Group 2, n=24). Both groups had their own matched controls. Blood samples were drawn fasting and 6 h post methionine loading (6 h-PML). The Group 1 patients had fasting and 6 h-PML p-tHcy levels significantly higher than their controls (P=0.05 and <0.0001, respectively), and patients without dietary multivitamin supplementation (n=14), had lower fasting S-FA and E-FA levels than their controls (P=0.02 and 0.0003, respectively). The Group 2 patients had fasting and 6 h-PML levels of p-tHcy, S-FA and E-FA not different from their controls. In a multiple stepwise regression model comprising all subjects (n=90), the AEDs of Group 1 and the S-FA levels were independent predictors of p-tHcy levels. Thus, PHT, PB and PRD are associated with high p-tHcy and low folate levels, whereas VPA does not influence S-FA, E-FA and p-tHcy levels in adult patients. SN - 0920-1211 UR - https://www.unboundmedicine.com/medline/citation/11673018/Antiepileptic_drugs_as_independent_predictors_of_plasma_total_homocysteine_levels_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0920-1211(01)00288-1 DB - PRIME DP - Unbound Medicine ER -