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Weight and fat distribution in patients taking valproate: A valproate‐discordant gender‐matched twin and sibling pair study
Author(s) -
Petty Sandra J.,
Kantor Susan,
Lawrence Kate M.,
Berkovic Samuel F.,
Collins Marnie,
Hill Keith D.,
Makovey Joanna,
Sambrook Philip N.,
O'Brien Terence J.,
Wark John D.
Publication year - 2014
Publication title -
epilepsia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.687
H-Index - 191
eISSN - 1528-1167
pISSN - 0013-9580
DOI - 10.1111/epi.12745
Subject(s) - waist , medicine , body mass index , leptin , anthropometry , endocrinology , zygosity , overweight , sibling , twin study , blood pressure , obesity , heritability , psychology , biology , developmental psychology , genetics
Summary Objectives Chronic treatment with valproate (VPA) is commonly associated with weight gain, which potentially has important health implications, in particular increased central fat distribution. We utilized a VPA ‐discordant same‐sex, twin and matched sibling pair study design to primarily examine for differences in fat distribution between patients with epilepsy treated with VPA compared to their matched twin or sibling control. Weight, blood pressure, and leptin levels were assessed. Methods Height, weight, waist and hip measurements, exercise, blood pressure ( BP), and serum leptin levels were measured. Body composition was measured using dual‐energy x‐ray absorptiometry ( DXA ). Abdominal fat was expressed as a percentage of the abdominal region ( AF at%); and of whole body fat ( WBF ); ( AF at% WBF ). Mean within‐pair differences were assessed ( VPA ‐user and nonuser). Restricted maximum likelihood ( REML ) linear mixed model analysis was fitted to examine associations of anthropometrics, zygosity, gender, menopausal status, VPA dose and duration, with weight and AF at%. Results We studied 19 pairs of VPA ‐discordant, gender‐matched (five male, 14 female) twins and siblings. Mean (standard deviation, SD ) duration of therapy for VPA users was 11.0 (7.4) years. There were no statistically significant within‐pair differences in age, height, weight, body mass index ( BMI) , BP , leptin level, WBF , AF at%, or AF at% WBF . For pairs in which VPA ‐user was treated for >11 years there were statistically significant mean within‐pair differences in AF at%, (+7.1%, p = 0.03, n = 10 pairs), mean BP (+11.0 mm Hg, p = 0.006, n = 8 pairs); but not in AF at% WBF . VPA duration was positively associated with weight (estimate +0.98 kg/per year of VPA , p = 0.03); VPA treatment duration and dose were not significantly associated with AF at%. Significance This study demonstrated a relationship between long‐term VPA use and abdominal adiposity ( AF at%), which could have significant health implications. We recommend ongoing monitoring of weight, BMI, and blood pressure for patients taking VPA .