Metabolic syndrome and its associated factors among epileptic patients at Dessie Comprehensive Specialized Hospital, Northeast Ethiopia; a hospital-based comparative cross-sectional study

Abstract

Introduction Metabolic syndrome is a group of metabolic risk factors which are associated with an increased risk of cardiovascular disease and type2 diabetes. Nowadays, several studies have shown that the burden of metabolic syndrome is increasing among epileptic patients, and leads to MS-associated complications, including cardiovascular disease. However, getting published documents has been limited in Ethiopia and the study area. Therefore, we aimed to analyze the magnitude and associated factors of metabolic syndrome among epileptic patients in Dessie Comprehensive Specialized Hospital in compression with respective controls. Methods Hospital-based comparative cross-sectional study design was implemented from June 25 to August 20, 2021. A total of 204 participants with an equal number of cases and controls (n = 102 each) were included. The data was collected through face-to-face interviews and biochemical analyses such as fasting blood glucose and lipid profiles were done through the enzymatic technique. The magnitude of metabolic syndrome was determined using both National Cholesterol Education Program Adult Treatment Panel III and International Diabetes Federation definition criteria. The STATA version 14 was used for statistical data analysis, and a comparison of categorical and continuous variables was done with χ2 and an independent t-test, respectively. The multivariable binary logistic regression analysis was used to identify factors associated with metabolic syndrome, and variables having a P-value of <0.05 were considered statistically significant. Result The prevalence of metabolic syndrome among the epileptic group was (25.5% in National Cholesterol Education Program Adult Treatment Panel III and 23.5% in International Diabetes Federation criteria), whereas it was 13.7% in National Cholesterol Education Program Adult Treatment Panel III and 14.7% in International Diabetes Federation criteria among control groups. According to the International Diabetes Federation criteria, low physical activity (adjusted odds ratio = 4.73, 95% CI: 1.08–20.68), taking multiple antiepileptic drugs (adjusted odds ratio = 8.08, 95% CI: 1.52–42.74), having a total cholesterol level of ≥ 200 mg/dl (adjusted odds ratio = 5.81, 95%: 1.32–41.13) and body mass index (adjusted odds ratio = 1.57, 95% CI = 1.16–2.11) were significantly associated with metabolic syndrome among epileptic participants. Applying National Cholesterol Education Program Adult Treatment Panel III criteria, taking multiple antiepileptic drugs (adjusted odds ratio = 6.81, 95% CI: 1.29–35.92), having a total cholesterol level > 200 mg/dl (adjusted odds ratio = 7.37, 95% CI: 1.32–41.13) and body mass index (adjusted odds ratio = 1.53, 96% CI: 1.16–2.01) were also significantly associated. Conclusion The prevalence of metabolic syndrome among epileptic patients was higher than that of control groups and reaches statistically significant by National Cholesterol Education Program Adult Treatment Panel III. Being on multiple antiepileptic drugs, body mass index, having low physical activity and raised total cholesterol were significantly associated with metabolic syndrome among the epileptic group. Therefore, it is better to focus on controlling weight, having sufficient physical exercise, and regular monitoring of total cholesterol levels in epileptic patients.

Metabolic Syndrome in Patients With Epilepsy

“…VPA suppresses the gene expression of adiponectin in mature adipocytes, leading to hypoadiponectinemia, which is strongly linked to weight gain and insulin resistance [8,9,10]. The literature also mentions involvement of the hypothalamus, whether through damage to the nuclei themselves by epileptic seizures and the resulting imbalance between energy intake and consumption, or excessive activation of the hypothalamus-pituitary-adrenal axis [4].…”

“…In a study conducted by Nair et al, nearly one-third of adults under 50 years old with epilepsy who were undergoing antiepileptic therapy had MetS [3]. Beyene-Kassaw and colleagues conducted a cross-sectional study and found that the prevalence of MetS, based on the NCEP ATP III definition, was 25.5% in adult PWE, compared to 13.7% in the control group [4]. Ndayambaje and colleagues studied 1,076 adult epilepsy patients using AEDs and found a prevalence rate of 30.6%, with the highest rate observed in the 46-60 age group [5].…”

The association between dietary intake of flavonoids and its subclasses and the risk of metabolic syndrome

“…Subjects with MetS mainly present with abdominal obesity, hyperglycemia, hypertension, and dyslipidemia ( 2 ). It was also closely associated with a higher cardiovascular disease (CVD) risk, type 2 diabetes (T2D) risk, and overall mortality ( 3 , 4 ). MetS results from complicated risk factors interaction among genetic, metabolic, diet, lifestyle, and environmental factors ( 5 ).…”