Text Box: PLASMA HOMOCYSTEINE AND LIPOPROTEIN A LEVELS AS A RISK FACTOR FOR ATHEROSCLEROTIC VASCULAR DISEASE IN EPILEPTIC CHILDREN TAKING ANTICONVULSANT
Tümer L1, Serdaroğlu A2, Hasanoğlu A1, Biberoğlu G1, 
Aksoy E2, Gücüyener K2
Gazi University, Faculty of Medicine, Departments of Pediatric Metabolism1 and Neurology2, Ankara Turkey

Objective: Elavated total homocysteine and lipoprotein a levels are independent risk factors in atherosclerosis. High homocysteine concentrations also increases binding of lipoprotein a to fibrin. Deficiency of vitamin B12 and folat leads to increased concentrations of plasma homocysteine. It was shown that during treatment with antiepileptic drugs deficiency of vitamin B12 and folat could occur. It was also demonstrated that antiepileptic drugs could significantly modify serum lipids and lipoproteins in epileptic patients. The purpose of this study was to assess the effect of anticonvulsant treatment on plasma homocysteine level and lipoprotein a in epileptic children.
Methods: Plasma total homocysteine and lipoprotein a concentrations were measured in 111 epileptic children taking anticonvulsant drugs for longer than 6 months. 46 healthy, sex and age matched children served as controls.
Results: Patients and controls differed significantly in concentrations of homocysteine (p<0.05) and lipoprotein a (p<0.001). The number of patients with homocysteine concentrations of > 9mM was significantly higher in the patient group than control group. 28.8 % of the patient group  had lipoprotein a concentrations above cut-off value (30mg/dl) for the increase risk of early atherosclerosis where as none of the control patients had concentrations above this value.
Conclusions: These data showed that prolonged anticonvulsant treatment may increase plasma homocysteine  and lipoprotein a concentrations and it may be useful measuring their levels routinely for preventing  atherosclerosis in epileptic children taking anticonvusant drugs.



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