Metabolic and Inflammatory Effects of Antiepileptic Treatment in Children with Epilepsy

Year 2026, Volume: 16 Issue: 1, 172 - 178, 23.01.2026

Şükriye Özde , Sevim Türay

https://doi.org/10.33631/sabd.1830155

Abstract

Aim: The objective of this study was to evaluate the effects of long-term antiepileptic drug (AED) use on metabolic, hematological, endocrine, and inflammatory parameters in children with epilepsy and to compare these markers with healthy controls.
Materials and Methods: This cross-sectional retrospective study included 85 children with idiopathic epilepsy followed at Düzce University Faculty of Medicine who had been receiving AED monotherapy (valproic acid, carbamazepine, or levetiracetam) for at least six months. A control group of 85 healthy children was established using frequency matching for age and sex. Laboratory data, including hemogram parameters, lipid profiles, vitamin B12, folate, vitamin D, TSH, fT4, and CRP levels, were analyzed. Inflammatory indices, such as the neutrophil-to-lymphocyte ratio (NLR), systemic immune-inflammation index (SII), and systemic inflammatory response index (SIRI), were calculated.
Results: Total cholesterol, LDL, HDL, vitamin D, and TSH levels were significantly lower in the epilepsy group compared to the healthy controls (p < 0.05). Conversely, inflammatory markers, including NLR, SII, SIRI, and CRP levels, were significantly higher in children with epilepsy (p < 0.05). No significant differences were observed between the groups regarding other metabolic and hematological parameters.
Conclusion: Long-term AED therapy is associated with significant metabolic, endocrine, and inflammatory alterations. These findings suggest the presence of a mild but persistent inflammatory state in children receiving epilepsy treatment. Routine monitoring of inflammatory markers and vitamin D levels may be clinically vital in the follow-up of pediatric patients. Future prospective studies are needed to confirm these results and assist in individualizing AED selection.

Keywords

Epilepsy , child , adolescent , anticonvulsants , biomarkers , vitamin D

Epilepsili Çocuklarda Antiepileptik Tedavinin Metabolik ve İnflamatuvar Etkileri

Abstract

Amaç: Çocukluk çağı epilepsisinde uzun süreli antiepileptik ilaç (AEİ) kullanımının metabolik, hematolojik, endokrin ve İnflamatuvar parametreler üzerindeki etkilerini değerlendirmek ve sağlıklı kontrol grubuyla karşılaştırmaktır.
Gereç ve Yöntemler: Bu kesitsel retrospektif çalışma, Düzce Üniversitesi Tıp Fakültesi'nde en az altı aydır antiepileptik ilaç(AEİ) monoterapisi (valproik asit veya karbamazepin veya levetirasetam) alan 85 idiyopatik epilepsili çocuk ve yaş-cinsiyet uyumlu 85 sağlıklı çocuk ile yürütülmüştür. Hastaların hemogram, lipid profili, vitamin B12, folat, D vitamini, TSH, serbest tiroksin(fT4) ve CRP düzeyleri incelenmiştir. Ayrıca nötrofil-lenfosit oranı (NLR), sistemik immün-inflamasyon indeksi (SII) ve sistemik İnflamatuvar yanıt indeksi (SIRI) gibi İnflamatuvar belirteçler hesaplanmıştır.
Bulgular: Epilepsi grubunda toplam kolesterol, LDL, HDL, vitamin D ve TSH seviyeleri sağlıklı kontrol grubuna göre anlamlı derecede düşük bulunmuştur (p <0,05). Buna karşın, inflamasyon göstergeleri olan NLR, SII, SIRI ve CRP seviyeleri epilepsili çocuklarda anlamlı derecede yüksek saptanmıştır (p <0,05). Diğer metabolik ve hematolojik parametrelerde gruplar arası anlamlı bir fark gözlenmemiştir.
Sonuç: Uzun süreli AEİ tedavisi; metabolik, endokrin ve İnflamatuvar değişikliklerle ilişkilidir. Bulgular, çocukluk çağı epilepsisinde tedavi sürecinde hafif ancak kalıcı bir İnflamatuvar durumun varlığına işaret etmektedir. AEİ tedavisi alan çocukların takibinde İnflamatuvar belirteçlerin ve vitamin D düzeylerinin rutin kontrolü klinik açıdan büyük önem taşımaktadır. Tedavi seçiminin kişiselleştirilmesi için daha kapsamlı prospektif çalışmalara ihtiyaç duyulmaktadır.

Keywords

Epilepsi , çocuk , ergen , antikonvülzanlar , biyobelirteçler , D vitamini

Ethical Statement

Bu araştırma, Düzce Üniversitesi Tıp Fakültesi Çocuk Sağlığı ve Hastalıkları Anabilim Dalı’nda 2020–2025 yılları arasında yürütülmüş, retrospektif ve kesitsel özellikte bir çalışmadır. Çalışma Helsinki Bildirgesi doğrultusunda planlanmış olup, Düzce Üniversitesi Klinik Araştırmalar Etik Kurulu tarafından onaylanmıştır (Karar No:2025/303). Ayrıca bu çalışma insan veya hayvan katılımcıları içermemektedir. Tüm prosedürler bilimsel ve etik ilkelere uygun olarak yürütülmüştür ve atıfta bulunulan tüm çalışmalar uygun şekilde kaynak gösterilmiştir.

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