Effects of carbamazepine on vasculer risk factors and atherosclerosis in epileptic children

Objective: It is known that antiepileptic therapy can create side effects in long-term. One of these side effects is atherosclerosis. Research about the effect of carbamazepine therapy in atherosclerosis development is not sufficient and clear. The objective of this study is to evaluate the relation of carbamazepine and atherosclerosis by investigating the effect of carbamazepine on paraoxonase and arylesterase activity (antioxidant capacity), lipid profile, oxidized LDL and carotid artery intima-media thickness (C-IMT). Methods: This research is based on 21 patients between the ages 2-16 who are diagnosed with epilepsy and were given carbamazepine in Gaziantep University Medical Faculty Department of Child Neurology. Triglyceride, total cholesterol, high-density lipoprotein (HDL), low-density lipoprotein (LDL) measured and LOOH (lipid hydroperoxide), paraoxonase (PON1), arylesterase (ARE) levels are checked in all patients in the first, 3 and 6 months. It is measured by Vivid 9 4D device from the posterior wall of 1 cm proximal of C-IMT carotid artery bifurcation in the first, 3 and 6 months of the therapy, from right and left. Results: 13 (61,9%) of the patient group were male, and 8 (38,1%) were female. The month average of the group was 111,48± 44,81. In the patient group, the statistically significance was found between initial cholesterol values and total cholesterol values on 6th month (p= 0,002). In the patient group, the significant difference was found between the value of initially viewed arylesterase and paraoxonase value and values on 6th month (p= 0,001) (p= 0,004). No significant difference was observed between initial right-left view of C-IMT and values viewed on 6th month in the patient group (p= 0,966). Conclusions: As a result, a significant increase is detected in serum cholesterol levels and antioxidant capacity in patients receiving carbamazepine therapy. This situation gives rise to the thought that enough time for the deterioration of the lipid panel and for oxidant capacity to become chronic has not expired. Large-scaled similar researches are needed in terms of the necessity of measuring C-IMT with ultrasonography (USG) periodically in long-term. Keywords: Carbamazepine, Epilepsy, Atherosclerosis, Carotid intima-media thickness