Karbamazepin Kullanan Hastalarda Serum Lipid Düzeylerinin Değerlendirilmesi

Yıl 2023, Cilt: 45 Sayı: 5, 791 - 795, 27.09.2023

Sinem Gürcü , Ali Uncu , Gülgün Uncu

https://doi.org/10.20515/otd.1346515

Öz

Epilepsi, uzun süreli ilaç tedavisi gerektiren nörolojik bir hastalıktır. Karbamazepin (CBZ), kompleks parsiyel nöbetler dahil parsiyel nöbetlerde ve tonik-klonik nöbetlerde etkili olan bir ilaçtır. Bu çalışmada, karbamazepin kullanan hastalarda serum lipid profili üzerine etkisinin değerlendirilmesi amaçlandı. Ocak-Aralık 2021 tarihleri arasındaki tıbbi biyokimya laboratuvar verileri geriye dönük olarak analiz edildi. Çalışmaya monoterapi ve en az 2 yıl CBZ kullanan hastalar (n=59) dahil edildi. 18 yaş altı hastalar dışlandı. Kontrol grubu olarak kan parametreleri normal, farklı nedenlerle polikliniklere başvuran, aynı yaşta, lipid profilini etkileyecek bir hastalığı olmayan 34 sağlıklı kişi seçildi. Hastaların yaş ortalaması 36±8 idi. Karbamazepin ile tedavi edilen hastalarda kontrol grubuna göre LDL-kolesterol düzeyleri daha yüksek bulundu (p<0,05). Hasta ve kontrol grupları arasında trigliserit (TG) ve HDL-kolesterol düzeyleri arasında anlamlı fark yoktu (p>0,05). Karbamazepinin LDL-kolesterol üzerindeki etkisinde cinsiyet farkı yoktu (p>0.05). Yüksek serum LDL-kolesterol seviyeleri kesinlikle ateroskleroz ve koroner arter hastalığına neden olmaktadır. Terapötik düzeyde düzenli olarak kullanılan karbamazepinin lipid profili değişmektedir. Yüksek LDL-kolesterol düzeylerinin ateroskleroz ile ilişkisi nedeniyle, özellikle bu farmakoterapinin uzun süreli kullanımı göz önüne alındığında, CBZ kullanan hastalarda lipid düzeylerinin izlenmesi önemlidir.

Anahtar Kelimeler

Karbamazepin, kolesterol/kan, lipid/kan, LDL-kolesterol, HDL-kolesterol

Evaluation of Serum Lipid Levels in Patients Using Carbamazepine

Öz

Epilepsy is a neurological disease that requires long-term drug therapy. Carbamazepine (CBZ) is a drug that is effective in partial seizures, including complex partial seizures, and tonic-clonic seizures. It was aimed to evaluate the effect on serum lipid profile in patients who used CBZ. Medical biochemistry laboratory data between January and December 2021 were analyzed retrospectively. Patients (n=59) who used monotherapy and at least 2 years of CBZ were included in the study. Patients under 18 years of age were not included. In the control group, 34 healthy people with normal blood parameters, who applied to outpatient clinics for different reasons at the same age, and did not have a disease that would affect the lipid profile, were selected. The mean age of the patients was 36 ±8 years. LDL-cholesterol levels were found to be higher in patients treated with carbamazepine compared to the control group (p<0.05). There was no significant difference in serum triglyceride (TG), and HDL-cholesterol levels in the patient and control groups (p>0.05). There was no gender difference in the effect of carbamazepine on LDL-cholesterol (p>0.05). High serum LDL-cholesterol levels cause atherosclerosis and coronary artery disease. The lipid profile of carbamazepine, which is used regularly at the therapeutic level, changes. Due to the association of high LDL-cholesterol levels with atherosclerosis, it is important to monitor lipid levels in patients using CBZ, especially considering the long duration of use of this pharmacotherapy.

Anahtar Kelimeler

Carbamazepine, cholesterol/blood, lipid/blood, LDL-cholesterol, HDL-cholesterol

Kaynakça

• 1. Karaağaç N, Yeni SN, Şenocak M, et al. Prevalence of epilepsy in Silivri, a rural area of Turkey. Epilepsy. 1999;40:637-642.
• 2. Çelik O, Apaydın Kaya Ç. Epilepsi ve Aile Hekimliği. Jour Turk Fam Phy. 2023; 14 (2): 64-81.
• 3. Methaneethorn J, Manupat L, Nattawut L. A systematic review of population pharmacokinetics of carbamazepine. Sys Rev Pharm. 2020:653-73.
• 4. Yip VLM, Pertinez H, Meng X, et al. Evaluation of clinical and genetic factors in the population pharmacokinetics of carbamazepine. Br J Clin Pharmacol. 2021;87(6):2572-2588.
• 5. Jebari-Benslaiman S, Galicia-García U, Larrea-Sebal A, et al. Pathophysiology of Atherosclerosis. Int J Mol Sci. 2022;23(6):3346.
• 6. Hansson GK. Inflammation, atherosclerosis, and coronary artery disease. N Engl J Med. 2005;21;352(16):1685-95.
• 7. Yanai H, Hiroshi Y. Secondary dyslipidemia: its treatments and association with atherosclerosis. Global health & medicine. 2021:15-23.
• 8. Kullo IJ, Ballantyne CM. Conditional risk factors for atherosclerosis. Mayo Clin Proc. 2005;80(2):219-30.
• 9. Marchio P, Guerra-Ojeda S, Vila JM, et al. Targeting Early Atherosclerosis: A Focus on Oxidative Stress and Inflammation. Oxid Med Cell Longev. 2019;1;2019:8563845.
• 10. Chuang YC, Chuang HY, Lin TK, et al. Effects of long-term antiepileptic drug monotherapy on vascular risk factors and atherosclerosis. Epilepsia. 2012;53(1):120-8.
• 11. Deniz O, Keklikoglu HD, Keskin S, et al. Uzun sureli valproik asit ve karbamazepin tedavisinin vucut kitle indeksi ve serum lipid duzeyi uzerine etkisi. Archives of Neuropsychiatry. 2011;48(2):103-6.
• 12. Tekgul H, Demir N, Gokben S. Serum lipid profile in children receiving antiepileptic drug monotherapy: is it atherogenic? J Pediatr Endocrinol Metab. 2006;19:1151-1155.
• 13. El-Farahaty RM, El-Mitwalli A, Azzam H, et al. Atherosclerotic effects of long-term old and new antiepileptic drugs monotherapy: a cross-sectional comparative study. J Child Neurol. 2015;30:451-457.
• 14. Büyükgöl H, Güneş M. The Effects of Antiepileptic Medications on Lipid Profile, Thyroid Panel, and Vitamin Level. Cureus. 2020;12(10): e11005.
• 15. Isojärvi JIT, Pakarinen AJ, Myllylä VV. Serum Lipid Levels During Carbamazepine Medication: A Prospective Study. Arch Neurol. 1993;50(6):590–593.
• 16. Demircioğlu S, Soylu A, Dirik E. Carbamazepine and valproic acid: effects on the serum lipids and liver functions in children. Pediatr Neurol. 2000;23(2):142-6.
• 17. Mintzer S, Dimova S, Zhang Y, et al. Effects of lacosamide and carbamazepine on lipids in a randomized trial. Epilepsia. 2020;61(12):2696-2704.
• 18. Apak İ, Tamam Y, Çakmak G, et al. Uzun Süreli Karbamazepin Monoterapisinin Epilepsi Hastalarında Serum Lipit Düzeylerine Etkisi. Dicle Tıp Dergisi. 2008;35(2):128-133.