A total of 170 patients with epilepsy diagnoses who had taken VPA or CBZ treatment were identified. The final study sample comprised 80 epileptic patients (54 men, 26 women) who met the inclusion criteria and were on the CBZ or VPA for more than 6 months and 45 control subjects. None of the patients showed low serum levels of VPA and CBZ.
3.1. Comparison of demographic, anthropometric and laboratory data
Three studied groups were similar on all variables except for age and HDL level.
Moreover, we found significant difference in HDL level between 3 groups. Patients with CBZ therapy showed a higher HDL level than the others (Table 1).
3.1.1 Comparison between demographic, anthropometric and laboratory data between subjects with MetS and without MetS based on IDF and NCEP criteria
In this study subjects with MetS (by IDF and NCEP criteria) had higher age, weight, waist, FBS, cholesterol, systolic & diastolic pressure, TG, LDL, insulin, BMI and lower HDL compare to without MetS. Moreover, CRP level showed significant elevation in MetS group (by NCEP criteria). We found, approximately 50% of subjects with MetS (by IDF and NCEP criteria) were accompanied by IR (by McAuley). In MetS (by IDF criteria) the frequency of VPA or CBZ use was significantly higher than the control group. (Table 2).
3.2. Significant risk factors for development of MetS based on IDF and NCEP criteria.
In VPA-treated group the risk of MetS (by IDF criteria), significantly increase 19 times more than the control group (OR=19.20 95% CL2.62-140.23, P=0.004) and in CBZ-treated group was 17 percent less than control group (P=0.84) moreover, in epileptic patients for each unit increase in Waist risk of MetS (by IDF definition) significantly increased by 44% (OR=1.44 95% CL1.20-1.73, P<0.001). The results also showed for each unit increase in FBS, TG, and Diastolic pressure, the risk of MetS (by IDF definition) significantly increased by 5%, 2% and 39 % respectively, (OR=1.05 95% CL1.01-1.10, P=0.012, OR=1.02 95% CL1.006-1.03, P=0.006, OR=1.39 95% CL1.13-1.72, P=0.002). In epileptic patients for each unit increase in Waist, FBS, TG, and insulin level the risk of MetS (by NCEP criteria) significantly increased by 24%, 4%, 1% and 22% respectively, (OR=1.24 95% CL1.10-1.39, P<0.001, OR= 1.04 95% CL1.008-1.07, P=0.021, OR=1.011 95% CL 1.001-1.02, P=0.026, OR=1.22 95% CL1.04-1.42, P=0.012). We found significant depression by 8% in risk of MetS based on NCEP criteria for each unit increase in HDL level (OR=0.92 95% CL0.87-0.98, P=0.021) (Table 3).
3.3. Comparison between demographic, anthropometric and laboratory data between subjects with IR and without IR based on HOMA, QUICKI and McAuley criteria
Subjects with IR (by HOMA, QUICKI and McAuley criteria) had higher Waist, FBS, DBP, TG, Insulin, and BMI (P<0.001). Moreover, in this study, people with IR (by QUICKI and McAuley criteria) showed significant elevation in addition to the variables mentioned above such as Weight, Chol, SBP, and LDL level. We found that, in IR (by HOMA and QUICKI criteria). the frequency of VPA or CBZ use was significantly higher than the control group (Table 4).
3.4. Significant risk factors for development of IR based on HOMA, QUICKI, and McAuley criteria
Multiple logistic regression model showed the IR risk (by HOMA criteria) in VPA-treated and CBZ-treated groups significantly increase 15 and 7 times more than the control group, respectively (OR=14.83 95% CL 3.03-72.56, P=0.001. OR=6.81 95% CL=1.53-30.19, P=0.01). In epileptic patients for each unit increase in FBS, TG the risk of IR (by HOMA definition) significantly increased by 27% and 2% (OR=1.27 95% CL 1.14-1.42, P<0.001, OR=1.02 95% CL 1.004-1.03, P=0.014). The results also showed the risk of IR significantly increased by 33% for each unit increase in BMI, (OR=1.33 95% CL 1.03-1.72 P=0.029). In VPA-treated group the IR risk (by QUICKI criteria) significantly increase 9 time and in CBZ-treated group non significantly increased 2.37 time more than the control group (OR=9.13 95% CL 2.55-32.65, P=0.001, OR= 2.37 95% CL 0.63-7.83, P= 0. 2). In our epileptic patients for each unit increase in Systolic pressure, FBS, and TG the risk of IR (by QUICKI definition) significantly increased by 5%, 22%, and 1% (OR=1.05 95% CL1.01-1.10, P=0.017, OR=1.22 95% CL 1.11-1.34, P<0. 001.OR=1.01 95% CL=1.003-1.02 P=0.047). For each unit increase in TG the risk of IR significantly increased by 7% according to the McAuley definition (OR=1.08 95% CL 1.04-1.11, P<0.001) (Table 5).