ABSTRACT
BACKGROUND: Previous studies suggest that obese women taking valproate (VPA) for epilepsy are insulin resistant. OBJECTIVE: To assess the effects of antiepileptic drugs on serum insulin and lipid levels in men with epilepsy. METHODS: Body mass index (BMI) and fasting serum concentrations of insulin and lipids were measured in 102 men with epilepsy who were treated with VPA, carbamazepine (CBZ), or oxcarbazepine (OXC) monotherapy. Thirty-two healthy men served as control subjects. RESULTS: Obesity was not more common among VPA-treated men than among other men with epilepsy or the control subjects. However, the obese VPA-treated men had higher serum insulin levels (p < 0.001) than the obese control subjects despite similar BMI. CBZ and OXC did not have any significant effect on any of the measurements. Fasting serum insulin concentrations above the normal range were observed in seven obese VPA-treated patients (35%) but in only one obese control subject (5%). Five obese VPA-treated patients (25%) and one obese control subject (5%) had serum triglyceride levels above the normal range, and a low high-density lipoprotein/total cholesterol ratio was observed in two obese VPA-treated patients (10%). CONCLUSIONS: Obese valproate-treated men have high serum insulin levels, indicating insulin resistance. Moreover, some of the valproate-treated men cluster cardiovascular risk factors such as obesity, hyperinsulinemia, and elevated serum triglyceride concentrations. CBZ and OXC do not seem to have any significant effects on serum insulin or lipid levels in men with epilepsy.
Subject(s)
Carbamazepine/analogs & derivatives , Epilepsy/blood , Fasting/blood , Insulin/blood , Lipids/blood , Adolescent , Adult , Anticonvulsants/adverse effects , Anticonvulsants/therapeutic use , Body Mass Index , Carbamazepine/therapeutic use , Epilepsy/complications , Epilepsy/drug therapy , Humans , Hyperinsulinism/blood , Hyperinsulinism/complications , Insulin Resistance , Male , Middle Aged , Obesity/blood , Obesity/complications , Oxcarbazepine , Reference Values , Risk Factors , Triglycerides/blood , Valproic Acid/adverse effects , Valproic Acid/therapeutic useSubject(s)
Coma/etiology , Coma/pathology , Hyperemesis Gravidarum/complications , Hyperemesis Gravidarum/diagnosis , Vomiting/complications , Adult , Coma/drug therapy , Diagnosis, Differential , Female , Humans , Hyperemesis Gravidarum/drug therapy , Pregnancy , Vomiting/drug therapy , Wernicke Encephalopathy/complications , Wernicke Encephalopathy/diagnosisABSTRACT
Factors affecting immediate irritant skin reactions are poorly understood. Our purpose was to study the effect of washing on reactions to benzoic acid, a well-known immediate-type irritant. 12 test subjects washed their left upper arms with a diluted dishwashing liquid 2X daily for 6 days. Benzoic acid in a dilution series was tested on both upper arms on days 0, 3 and 6. The reactions were graded visually, and the blood flow, skin color, transepidermal water loss and electrical capacitance of the test sites were measured. On days 3 and 6, the benzoic acid reactions were stronger on the washed arm than on the control arm. This was clinically visible and was associated with changes in blood flow and skin color measurements. Washing itself did not usually cause visible erythema, but transepidermal water loss increased and electrical capacitance decreased. Low concentrations of irritant substances, such as benzoic acid, may cause clinically relevant reactions in repeatedly washed skin. This should be taken into consideration in assessing product safety in the cosmetic, medical and household chemical industries, and when tests for chemical skin irritancy are designed and the results of such tests interpreted.
