We evaluated the serum levels of lipids, lipoproteins, apolipoproteins,
along with a number of minerals and trace elements such as Ca, Mg, Cu
and Zn in a group of children after 6 months of valproic acid
monotherapy. Thirty patients with seizures, mean age, 9.8 +/- 2.6 years
and 79 healthy children (controls), mean age, 10.9 +/- 3.2 years. formed
the two styd groups. The patient group was treated with valproic acid
(27.9 +/- 14.8 mg/kg/24 hr). Patients underwent clinical and laboratory
evaluations including liver function tests. NH3, lipid, mineral and
selected trace element levels before and after six months on valproic
acid treatment, whereas controls only one evaluation. Liver function
data and NH3 levels were found to be elevated in the group of patients.
whereas albumin level was reduced. Triglycerides, total cholesterol,
HDL-C, apolipoprotein (ApoA)-1, Apo B and Ca concentrations were found
relative to control values. LDL-C, VLDL-C, Mg, Cu, Zn, were measured
significantly altered (P < 0.0001) compared to controls. The ratios
ApoA-1/ApoB, HDL-C/ApoA-1, LDL-C/Apo B, which were closely related to
the size of LDL particles, where correlated with Zn/Cu (P < 0.001).
Serum lipid profile, especially LDL size, indirectly evaluated for the
first time and metal levels were found to be significantly changed,
after six months on valproic acid monotherapy, suggesting a possible
risk of developing coronary heart disease. Since valproic acid is a
long-term treatment. it could be recommended that the incorporation of
measurements of lipids, lipoproteins, apolipoproteins and trace elements
in the “follow up” laboratory testing could be a preventive measure