소아 간질 환자에서 Valproic Acid 복용이 Serum Cholesterol에 미치는 영향
The Effect of Valproic Acid on Serum Total Cholesterol Level in Children with Epilepsy
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목 적 : 체중 증가는 valproic acid(VPA)의 잘 알려진 부작용이며, 이는 혈청 total cholesterol(TC)의 증가가 관련이 있다는 것은 잘 알려져 있다. 그러나 VPA와 혈청 TC의 연관성에 대해선 아직 논란의 여지가 있다. 저자들은 소아 간질 환자에서 장기간 VPA로 치료한 뒤 혈청 TC치의 변화 및 이에 관련된 인자를 알아보고자 본 연구를 시행하였다. 방 법 : 부산대학교병원 소아과에서 간질로 진단받고 최소 1년 이상 VPA를 단독으로 복용한 환자를 대상으로 하였다. VPA 투여 전과 투여 후의 BMI와 혈청 TC를 측정하였다. VPA의 투여량, 혈중 약물농도, 성별, 치료 시작 연령, 경련 형태, 경련의 원인, 복용 기간, BMI에 따른 혈청 TC의 변화를 비교분석 하였다. 결 과 : 본 연구는 82명을 대상으로 하였고 남자 49명, 여자 33명 이었다. 치료 전 평균 TC는 153.5±31.0 mg/dL, 치료 후 평균 TC는 158.1±30.2 mg/dL로 TC의 수치에 유의한 변화는 보이지 않았다(P>0.05). VPA의 투여량, 혈중 약물농도, 성별, 치료 시작 연령, 경련 형태, 경련의 원인, 복용 기간, BMI에 따른 혈청 TC의 의미 있는 변화는 없었다(P> 0.05). 결 론 : VPA는 장기적인 투여에 의해서도 혈청 TC에 영향을 미치지 않으며, 치료 전 과체중도 특별한 위험 인자가 되지 않는다.
Abstract
Purpose : Weight gain is a known side effect of valproic acid(VPA), which is associated with change of serum total cholesterol(TC) level. However, there are controversies on the correlation between VPA and serum TC. This investigation was undertaken to evaluate the change of TC level in children with epilepsy on long-term VPA monotherapy and the related factors. Methods : Epileptic patients on VPA monotherapy for more than one year were recruited at the Department of Pediatrics, Pusan National University Hospital. The body mass index (BMI) and TC before and after VPA treatment were obtained from all patients. We analyzed the change of serum TC according to dosage of VPA, serum drug level and other clinical data such as gender, age at start of treatment, type of seizure, etiology of seizure, duration of VPA medication and BMI. which could affect the serum TC. Results : 82 children(49 male and 33 female) were included in this study. Mean serum TC of pre- and post-VPA medication was 153.5±31.0 mg/dL and 158.1±30.2 mg/dL(P>0.05), respectively. There were no clinically significant changes of serum TC level according to dosage of VPA, serum drug level and other clinical data such as gender, age at start of treatment, seizure type, etiology of seizure, duration of VPA medication and BMI(P>0.05). Conclusion : Our results suggest that long-term VPA medication does not affect serum TC, and overweight at pre-VPA medication is not a risk factor.
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