Carnitine Deficiency in Chinese Children with Epilepsy on Valproate Monotherapy

ABSTRACT

Objective: To explore the incidence and independent risk-factors of secondary carnitinedeficiency in Chinese children with epilepsy on valproate monotherapy. Methods: The freecarnitine and acylcarnitines levels in 299 children with epilepsy on valproate monotherapybetween June 2014 and September 2015 were compared with age- and sex-matched 299healthy controls. Results: Children with valproate monotherapy had lower free carnitinelevels [23.86 (10.60) µmol/L] than the controls [36.37 (9.37) µmol/L] (P<0.01). Mostacylcarnitines were significantly lower in children with valproate monotherapy than controls.63 children (21.1%) with epilepsy had carnitine deficiency; 54 were asymptomatic. Femalegender (OR 2.1), high alanine aminotransferase levels (OR 1.0) and long duration of VPAtreatment (1-12 mo) (OR 1.9) were independent risk factors for secondary carnitinedeficiency induced by VPA. Conclusions: Carnitine deficiency with valproate is more likely infemales, those with transaminitis, and those receiving the drug for 1-12 months