Folate and Plasma Homocysteine in Patients on Long Term Antiepileptic Drug (AED) Therapy
Abstract number :
2.118
Submission category :
Year :
2000
Submission ID :
521
Source :
www.aesnet.org
Presentation date :
12/2/2000 12:00:00 AM
Published date :
Dec 1, 2000, 06:00 AM
Authors :
Imran I Ali, Sadik Khuder, Noor Pirzada, Andrea Korsnack, Bradley V Vaughn, Nancy Futrell, MEDICAL Coll OF OHIO, Toledo, OH; Univ OF NORTH CAROLINA, Chapel Hill, NC; STROKE Ctr, Salt Lake City, UT.
RATIONALE: Folate deficiency is associated with elevated plasma homocysteine levels and increased risk of adverse vascular events. Homocysteine may also be epileptogenic. Due to the importance of these associations we undertook a study of folate and homocysteine levels in patients on long term antiepileptic therapy. METHODS: Thirty eight patients evaluated in the Medical College of Ohio Comprehensive Epilepsy Clinic on one or more AED for greater than 6 months were randomly selected. Patients with medical conditions or medications other than AEDs that may affect folate and homocysteine levels were excluded. Twenty healthy controls were used for comparison. Two patients and one control subject were excluded due to insufficient data. Student t-test and Pearson correlation were performed. RESULTS: Six patients with epilepsy were on monotherapy, 21 on two AEDs and 9 on three AEDs. Mean homocysteine levels in the patients were 10.76 ?mol/L (Sd 5.73) and 9.15 (Sd 2.51)in the controls(p <0.3). The mean folate level was lower in the patients (10.15 ng/ml-Sd 0.62) than in controls (12.83- SD 4.31, P<0.02). Homocysteine levels in patients 41 years or younger (18 patients) were 9.09 (SD-1.7) while in those older (18 patients) were 12.43 (Sd 7.5- p<0.08). Homocysteine levels correlated with age (r -0.30, p<0.07) but not with gender or duration of therapy. Folate levels were lower in men (mean 10.44, SD 3.35) compared to women (15.3, SD 5.30, P<0.02). Folate levels also inversely correlated with duration of therapy (r -0.38,p < 0.02). CONCLUSIONS: 1-Mean folate levels were significantly lower in the patients with epilepsy compared to controls. 2-A strong inverse correlation was noted between folate and homocysteine levels (r-.46, p<0.005) 3-Folate levels were lower in men and correlated inversely with duration of AED therapy. 4-Folate supplementation should be considered in all patients on AED therapy regardless of gender. 5-Larger studies are needed to further study the role of multiple AEDs and duration of therapy on folate and homocysteine levels.