Serum Insulin and Leptin Levels in Children with Epilepsy on Valproate-associated Obesity

BACKGROUND: Weight gain is a common adverse effect of sodium valproic acid (VPA) in children with epilepsy. Several mechanisms of VPA-induced obesity have been suggested such as increased appetite, facultative thermogenesis, and elevated insulin and leptin levels. In this study, we aimed to investigate the role of Insulin and Leptin in the pathogenesis of weight gain caused by VPA. MATERIALS AND METHODS: Body mass index (BMI) was calculated, and serum insulin and leptin levels were measured in 45 consecutive patients and 45 controls. RESULTS: The mean BMI of the cases and control group was 22.97 kg/m(2) and 19.4 kg/m(2), respectively, and it was significantly higher in cases (P < 0.001). Fasting serum insulin levels were higher in VPA group (26.3 μU/ml) than in controls (15.83 μU/ml), which was statistically significant (P < 0.001). Serum leptin levels were also found to be elevated significantly in VPA group (7.9 ng/ml) than in controls (1.6 ng/ml). CONCLUSION: Sodium VPA is associated with significant rise of BMI, hyperinsulinemia, raised insulin resistance, and increased leptin levels in children with epilepsy.