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Valproate-associated weight gain and potential predictors in children with epilepsy

Korean Journal of Pediatrics 2007;50(5):484-488.
Published online May 15, 2007.
Valproate-associated weight gain and potential predictors in children with epilepsy
Gook Chan Jang, Eun Young Kim, Young Il Rho, Kyung Rye Moon, Sang Kee Park
Department of Pediatrics, College of Medicine, Chosun University, Gwangju, Korea
Valproate 치료를 받는 간질환아에서 체중증가와 영향을 주는 인자
장국찬, 김은영, 노영일, 문경래, 박상기
조선대학교 의과대학 소아과학교실
Correspondence: 
Sang Kee Park, Email: skpark@mail.chosun.ac.kr
Abstract
Purpose
: The purpose of this study was to determine the incidence and potential predictors of weight gain in older children and teens treated with valproate (VPA) for epilepsy.
Methods
: Sixty-five subjects aged 8 to 17 years of age, who began VPA treatment between January 1, 2001, and December 31, 2004, and who had documented weight and height measurements at medication initiation and at least one follow-up visit were retrospectively identified. Exclusion criteria were follow-up <6 months, discontinuation of VPA within 6 months, and concurrent therapy with medication known to affect weight (such as topiramate, carbamazepin). Body mass index (BMI) was calculated at initiation and either discontinuation of VPA or last follow-up and stratified into four categories: group 1, underweight <5%; group 2, appropriate 5-85%; group 3, potentially overweight 85-95%; group 4, overweight >95%.
Results
: Twenty-eight subjects (77.8%) remained within their same category and eight (22.2%) moved up at least one category. Weight gain (increase in BMI difference) was observed in 72.2% of the 36 subjects treated with VPA. Three factors, neurocognitive status (P=0.017), seizure type (P=0.001) and duration of VPA treatment (P=0.035) were identified to be significant predictors of BMI difference.
Conclusion
: VPA induces weight gain in children and teens with epilepsy. These factors which are normal neurocognitive status, primary generalized type and duration of VPA treatment over the 12 months were predictors for an increase of weight gain. Therefore potential weight gain should be discussed with patients before the initiation of therapy and BMI should be monitored closely.
Key Words: Valproic acid, Weight gain, Body mass index


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