Valproat kullanan epileptik çocuklarda serum insülin,leptin, ghrelin, GH, IGF-1 ve IGFBP-3 düzeyleri

Objective: VPA is commonly used in the treatment of epilepsy in bothchildren and adults. Although it is a very effective drug, it has some unwanted sideeffects like weight gaining due to valproate treatment. The pathogenesis ofvalproate-associated weight gain is still controversial. Ghrelin is an importantregulator of food intake and fullness. İt increases carbonhydrate consumption,decreases fat consumption and reduce energy expenditure as a result of inducedfood intake. İt regulates insulin and leptin secretion. İt seems that, ghrelin is relatedto the excessive weight gain and insulin resistance. In this study we investigatedthe role of ghrelin on valproate-associated weight gain in epileptic children. Effectof VPA treatment on growth in epileptic children is also investigated.Matherials and Methods: Children who were diagnosed as idiopathicgeneralize and idiopathic partial epilepsy according to ILAE-1989 classification andwere treated with VPA in our clinic were enrolled. this study. In 35 epilepticchild (17 female, 18male; 20 puberty, 15 prepuberty). The patients aged 3 to 15year (mean 7,85 ± 3,9 year). Serum samples of cases were taken either beforeor at the sixth month of the treatment in morning the starvation. Samples werestored in a deep freeze -70 oC until assayed. Fasting glucose, insulin, c-peptid,leptin, ghrelin, GH, IGF-1, IGFBP-3 levels were measured on these serumsamples. Serum ghrelin, leptin, GH, IGF-1, IGFBP-3 concentrations havemeasured ELISA method. The results obtained before and at sixth month of thetreatment were compared.Results: Body weight, height, BMI, height SDS measurements and serumghrelin levels were found to be increased at the sixth month of VPA treatment. IGF-1,60IGFBP-3 levels were statistically lower than before the treatment levels. Therewere not a statistical difference between the pubertal and prepubertal age groupsin respect of increase of body weight, height, BMI and height SDS.Conclusion: Weight gain in epileptic children using VPA may be related toincreased serum ghrelin level. Increased serum ghrelin level causes increasedappetite, food intake and weight gain at the early stage of VPA treatment. Inaddition increased ghrelin level may have a negative effect on growth as a result ofthe decrease in IGF-1 level. But for being able to explain the mechanism of VPArelated weight gain and the negative effect of VPA on growth, long term researchsare needed.