Relationship Between Valproic Acid, Hepatosteatosis and Serum Betatrophin Levels

OBJECTIVE: In our study, it will be investigated whether nonalcoholic fatty liver disease develops due to valproic acid/sodium valproate use in children with epilepsy using shearwave elastography and the relationship between obesity, insulin resistance and serum betatrophin levels. METHODS: Thirty-six patients with a diagnosis of epilepsy who were diagnosed with valproic acid/sodium valproate monotherapy for at least 6 months, and 40 patients with overweight/obesity who did not use antiepileptic drugs were included in the study. Demographic characteristics, pubertal stage and body mass index (BMI) were recorded. Liver parenchymal echogenicity was classified into four groups by using ultrasonography, then tissue stiffness was measured by shear wave elastography (SWE). Serum betatrophin, glucose, HOMO-IR, ALT, AST, lipids and valproic acid levels were studied by ELISA method. RESULTS: BMI was found to be significantly lower in the VPA group compared to the overweight/obese group (p<.001). The degree of hepatosteatosis and elasticity were not different between the two groups. According to SWE, liver elasticity was not different between the groups (p .197). No difference was found in serum betatrophin values in both groups. The increase in insulin, HOMA-IR, LDL-C and TG in the obese group was statistically significant compared to the VPA group. CONCLUSION: No relationship could be established between the use of VPA and hepatocetatosis and serum betatrophin. BMI was found to be normal in VPA users and it was observed that insulin resistance did not develop. This finding may indicate that VPA causes weight gain by its effect on the hypothalamic center.