Cross sectional descriptive study to study the prevalence of metabolic syndrome among patients with epilepsy on antiepileptic drugs in a tertiary care centre

Abstract

Epilepsy is the commonest neurological condition affecting people of all ages, race and social class. Patients with epilepsy have two to three times higher risk of mortality compared to general population. The role of epilepsy as a potential risk factor for metabolic syndrome and coronary artery disease is of interest.To study the prevalence of metabolic syndrome among patients with epilepsy.This is a hospital based cross-sectional descriptive study. The subjects were selected from patients attending the epilepsy outpatient clinic of a single tertiary centre (GMCH, Udaipur) during the period of 15 months from January 2021 to March 2022. Fasting blood samples were drawn from them to estimate fasting blood glucose and fasting lipid profile.: Males constituted two thirds of the subjects. Average age was 32.5 years. Mean duration of treatment was 13.6 years (range 3–48 years). 51.9% were on monotherapy. Valproate was used in 33 of the 45 (73.33%) patients. In localization related epilepsy, the commonest drug was carbamazepine used in 57.48%. Eight of the enrolled patients had diabetes mellitus and 35 had impaired fasting glucose. Systemic hypertension was detected in 11.5% patients. No significant association was noted between drug use and cardiovascular risk factors – diabetes mellitus, hypertension or dyslipidemia. Very significant association was noted on lipid profile for carbamzepine, phenytoin and clobazam.Antiepileptic medications, especially valproate and carbamazepine have significant effects on the lipid profile and abdominal obesity in patients on treatment. Metabolic syndrome is more prevalent among adult patients <50 years of age with epilepsy compared to the general population in the same age group. This difference could be related to the effect of the antiepileptic medications, especially valproate. There is a need to monitor patients on antiepileptic medications regularly for development of dyslipidemia and obesity.