PMID- 23266348
OWN - NLM
STAT- MEDLINE
DCOM- 20131024
LR  - 20181202
IS  - 1532-2688 (Electronic)
IS  - 1059-1311 (Linking)
VI  - 22
IP  - 2
DP  - 2013 Mar
TI  - Assessment of atherosclerosis risk due to the homocysteine-asymmetric 
      dimethylarginine-nitric oxide cascade in children taking antiepileptic drugs.
PG  - 124-7
LID - S1059-1311(12)00296-8 [pii]
LID - 10.1016/j.seizure.2012.11.007 [doi]
AB  - PURPOSE: The aim of this study was to assess the atherogenicity risk of 
      antiepileptics in children by investigating the cascade, "hyperhomocysteinemia 
      (HHcy)-->asymmetric dimethylarginine (ADMA) increase-->nitric oxide (NO) decrease", 
      which is thought to contribute to the developmental process of atherosclerosis. 
      METHODS: The participants included 53 epilepsy patients who received either 
      valproic acid (VPA, n=26) or oxcarbazepine (OXC, n=27). Twenty-four healthy sex- 
      and age-matched children served as controls. Fasting plasma total homocysteine 
      (tHcy), ADMA and NO levels were measured. RESULTS: The differences in Hcy, ADMA, 
      NO, vitamin B(12) and folate levels between VPA, OXC and control groups were all 
      insignificant (p>0.05 for all). In the patient group (VPA and OXC groups), 22.6% 
      of the children (12/53) had tHcy levels above the normal cutoff (13.1mumol/l) for 
      children and 17% of the children (9/53) had tHcy levels of greater than 15mumol/l 
      which is accepted as the critical value for an increased atherosclerosis risk 
      (p<0.05 for both). The difference in rate of HHcy between VPA and OXC groups was 
      statistically insignificant (p>0.05, for both cut off levels of HHCy). There was 
      a positive correlation of tHcy levels and antiepileptic drug treatment duration 
      in the patient group (r=+0.276, p<0.05). CONCLUSION: HHcy may develop in patients 
      using OXC. Contrary to some previous publications, our data do not suggest that 
      OXC is safer than VPA in terms of HHcy risk. Further prospective, large scale and 
      longer term studies investigating all suggested pathways responsible for 
      development of atherosclerosis due to HHcy should be conducted to define the 
      exact mechanism responsible for AEDs related atherosclerosis.
CI  - Copyright (c) 2012 British Epilepsy Association. Published by Elsevier Ltd. All 
      rights reserved.
FAU - Emeksiz, Hamdi Cihan
AU  - Emeksiz HC
AD  - Department of Pediatrics, Gazi University, TR-06450 Ankara, Turkey. 
      hcemeksiz@gmail.com
FAU - Serdaroglu, Ayse
AU  - Serdaroglu A
FAU - Biberoglu, Gursel
AU  - Biberoglu G
FAU - Gulbahar, Ozlem
AU  - Gulbahar O
FAU - Arhan, Ebru
AU  - Arhan E
FAU - Cansu, Ali
AU  - Cansu A
FAU - Arga, Mustafa
AU  - Arga M
FAU - Hasanoglu, Alev
AU  - Hasanoglu A
LA  - eng
PT  - Journal Article
DEP - 20121221
PL  - England
TA  - Seizure
JT  - Seizure
JID - 9306979
RN  - 0 (Anticonvulsants)
RN  - 0 (Biomarkers)
RN  - 0LVT1QZ0BA (Homocysteine)
RN  - 31C4KY9ESH (Nitric Oxide)
RN  - 33CM23913M (Carbamazepine)
RN  - 614OI1Z5WI (Valproic Acid)
RN  - 63CV1GEK3Y (N,N-dimethylarginine)
RN  - 94ZLA3W45F (Arginine)
RN  - VZI5B1W380 (Oxcarbazepine)
SB  - IM
MH  - Adolescent
MH  - Anticonvulsants/adverse effects/therapeutic use
MH  - Arginine/*analogs & derivatives/blood
MH  - Atherosclerosis/*blood/chemically induced/epidemiology
MH  - Biomarkers/blood
MH  - Carbamazepine/adverse effects/*analogs & derivatives/therapeutic use
MH  - Child
MH  - Epilepsy/blood/drug therapy/epidemiology
MH  - Female
MH  - Homocysteine/*blood
MH  - Humans
MH  - Male
MH  - Nitric Oxide/*blood
MH  - Oxcarbazepine
MH  - Prospective Studies
MH  - Risk Factors
MH  - Valproic Acid/adverse effects/*therapeutic use
EDAT- 2012/12/26 06:00
MHDA- 2013/10/25 06:00
CRDT- 2012/12/26 06:00
PHST- 2012/04/11 00:00 [received]
PHST- 2012/11/19 00:00 [revised]
PHST- 2012/11/20 00:00 [accepted]
PHST- 2012/12/26 06:00 [entrez]
PHST- 2012/12/26 06:00 [pubmed]
PHST- 2013/10/25 06:00 [medline]
AID - S1059-1311(12)00296-8 [pii]
AID - 10.1016/j.seizure.2012.11.007 [doi]
PST - ppublish
SO  - Seizure. 2013 Mar;22(2):124-7. doi: 10.1016/j.seizure.2012.11.007. Epub 2012 Dec 
      21.