Abstract
Endocrine disorders are common in adults with epilepsy on
antiepileptic drugs (AEDs). This study aimed to evaluate endocrine
function, lipid metabolism and growth in patients with childhood- or
adolescence-onset epilepsy.
Altogether 148 patients with epilepsy on carbamazepine (CBZ),
oxcarbazepine (OXC), valproate (VPA) or lamotrigine monotherapy during
pubertal maturation and 124 healthy controls participated in this
population-based cohort study. Boys and young men (n = 140)
underwent cross-sectional evaluation once, and girls and young women
(n = 132) twice at an approximate interval of 6 years.
Gonadal structure and serum reproductive and thyroid hormone and lipid
concentrations were evaluated and growth data were gathered.
Elevated serum testosterone and androstenedione levels and
polycystic ovary syndrome (PCOS) were common in female subjects whose
medication, especially VPA, continued into young adulthood. Serum
reproductive hormone concentrations and ovarian structure were similar
in patients off medication and controls in young adulthood. CBZ was
associated with elevated serum sex hormone binding globulin and
decreased dehydroepiandrosterone sulfate levels and VPA with elevated
serum androstenedione concentrations in male patients. Testicular
structure was similar in patients and controls. CBZ, OXC and VPA were
associated with changes in serum thyroid hormone, thyrotropin and lipid
levels during pubertal maturation in female patients, but these levels
returned to normal after withdrawal of medication. Linear growth and
final height were normal in female patients, but overweight was common
if they had been obese and on VPA medication during pubertal maturation.
Elevated serum androgen levels, PCOS and overweight are common if
epilepsy and AED use, especially VPA, continue into young adulthood.
These untoward changes or alterations in serum thyroid hormone or lipid
concentrations are not present in young women with medication withdrawn.
CBZ and VPA are associated with changes in serum sex hormone levels in
boys and young men with epilepsy. Epilepsy and AED use during pubertal
maturation does not seem to affect growth.
| Identifer | oai:union.ndltd.org:oulo.fi/oai:oulu.fi:isbn951-42-7422-9 |
| Date | 03 September 2004 |
| Creators | Mikkonen, K. (Kirsi) |
| Publisher | University of Oulu |
| Source Sets | University of Oulu |
| Language | English |
| Detected Language | English |
| Type | info:eu-repo/semantics/doctoralThesis, info:eu-repo/semantics/publishedVersion |
| Format | application/pdf |
| Rights | info:eu-repo/semantics/openAccess, © University of Oulu, 2004 |
| Relation | info:eu-repo/semantics/altIdentifier/pissn/0355-3221, info:eu-repo/semantics/altIdentifier/eissn/1796-2234 |
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