Lipids, Lipoproteins, Apolipoproteins, Selected Trace Elements and Minerals in the Serum of Children on Valproic Acid Monotherapy

We evaluated the serum levels of lipids, lipoproteins, apolipoproteins, along with a number of minerals and trace elements such as Ca, Mg, Cu and Zn in a group of children after 6 months of valproic acid monotherapy. Thirty patients with seizures, mean age, 9.8±2.6 years and 79 healthy children (controls), mean age, 10.9±3.2 years, formed the two styd groups. The patient group was treated with valproic acid (27.9±14.8 mg/kg/24 hr). Patients underwent clinical and laboratory evaluations including liver function tests, NH 3 , lipid, mineral and selected trace element levels before and after six months on valproic acid treatment, whereas controls only one evaluation. Liver function data and NH 3 levels were found to be elevated in the group of patients, whereas albumin level was reduced. Triglycerides, total cholesterol, HDL‐C, apolipoprotein (ApoA)‐1, Apo B and Ca concentrations were found relative to control values, LDL‐C, VLDL‐C, Mg, Cu, Zn, were measured significantly altered (P<0.0001) compared to controls. The ratios ApoA‐1/ApoB, HDL‐C/ApoA‐1, LDL‐C/Apo B, which were closely related to the size of LDL particles, where correlated with Zn/Cu (P<0.001). Serum lipid profile, especially LDL size, indirectly evaluated for the first time and metal levels were found to be significantly changed, after six months on valproic acid monotherapy, suggesting a possible risk of developing coronary heart disease. Since valproic acid is a long‐term treatment, it could be recommended that the incorporation of measurements of lipids, lipoproteins, apolipoproteins and trace elements in the “follow up” laboratory testing could be a preventive measure.