Serum thyroid hormone balance and lipid profile in patients with epilepsy

Hamed, Sherifa A.; Hamed, Enas A.; Kandil, Mahmoud R.; El-Shereef, Hala K.; Abdellah, Moustafa M.; Omar, Hanan

doi:10.1016/j.eplepsyres.2005.08.004

Cited by 53 publications

(40 citation statements)

References 47 publications

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“…Glutathione peroxidase in our patients was significantly higher than those in the control group. This is in agreement with several studies [11,35,36,37] . We suggest that GPX upregulation, in patients with epilepsy receiving AEDS, might be a consequence of induced GPX synthesis in the liver as a compensatory mechanism for decreased glutathione levels in the same group of patients.…”

Section: ]supporting

confidence: 82%

“…our study revealed alteration of various vascular risk factors including lipid profile, CRP, GPX and uric acid in young adult patients with epilepsy on traditional AEDs and their contribution to increased CA-IMT, a strong potential marker of early or subclinical atherosclerosis. Dyslipidemia has long been known to be an important risk factor for atherosclerosis [9] .We demonstrated that alteration of lipid profile is common among patients with epilepsy in agreement with others [10,11,12] . The increased levels of TC, LDL-c and TG were significantly higher in our patients than control group.…”

Section: Discussionsupporting

confidence: 70%

“…This finding is in parallelism with Menon et al [11] however our results were in disagreement with Krause et al [33] who revealed significantly lower serum concentrations of uric acid in epileptic patients compared to a group of normal controls. Uric acid was significantly higher in patients with VPA monotherapy than both the CBZ group and polytherapy group.…”

Section: Discussioncontrasting

confidence: 56%

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The Predictors of Early Atherosclerosis in Young Adult Epileptic Patients

Soliman

Yousef

Fattah

et al. 2016

Zagazig University Medical Journal

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Background: Patients with epilepsy develope a wide range of medical and neurologic disorders, compared with the general population. The association between epilepsy and atherosclerosis is not clearly defined. Several studies claims that epileptic patients may have the risk to develop atherosclerosis. Methods: This study included 40 adult epileptic and 40 control subjects. For all, Common carotid artery intima media thickness (CA-IMT), fasting lipid profile, serum uric acid (SUA), C -reactive protein (CRP) and glutathione peroxidase (GPX), were assessed. Results: Total cholesterol (TC) ,low density lipoproteins (LDL), Total Triglycerides (TG) ,CRP, GPX were significantly higher in patients compared to control. CA-IMT was significantly higher in epileptic patients treated with antiepileptic drugs (AEDS) compared to control group. The longer the duration of AEDs the thicker was the CA-IMT. Conclusions: Our results heightened atherosclerotic risk in patients with epilepsy on AEDS.

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Section: ]supporting

confidence: 82%

Section: Discussionsupporting

confidence: 70%

Section: Discussioncontrasting

confidence: 56%

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The Predictors of Early Atherosclerosis in Young Adult Epileptic Patients

Soliman

Yousef

Fattah

et al. 2016

Zagazig University Medical Journal

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“…Overexpression of P-gp in liver may also be induced by serum components, the expression of which might have changed epileptic rats (Tang et al, 2001). Moreover, changes in hormonal regulation associated with epilepsy (Hamed et al, 2005;Morris and Vanderkolk, 2005) might also induce P-gp in liver as has been shown in a hyperthyroid rat model (Nishio et al, 2005).…”

Section: Discussionmentioning

confidence: 99%

Region-Specific Overexpression of P-glycoprotein at the Blood-Brain Barrier Affects Brain Uptake of Phenytoin in Epileptic Rats

Vliet¹,

Schaik²,

Edelbroek³

et al. 2007

J Pharmacol Exp Ther

105

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Recent studies have suggested that overexpression of the multidrug transporter P-glycoprotein (P-gp) in the hippocampal region leads to decreased levels of antiepileptic drugs and contributes to pharmacoresistance that occurs in a subset of epileptic patients. Whether P-gp expression and function is affected in other brain regions and in organs that are involved in drug metabolism is less studied. Therefore, we investigated P-gp expression in different brain regions and liver of chronic epileptic rats, several months after electrically induced status epilepticus (SE), using Western blot analysis. P-gp function was determined by measuring phenytoin (PHT) levels in these brain regions using high-performance liquid chromatography, in the absence and presence of a P-gp-specific inhibitor, tariquidar (TQD). In addition, the pharmacokinetic profile of PHT was determined. PHT concentration was reduced by 20 to 30% in brain regions that had P-gp overexpression (temporal hippocampus and parahippocampal cortex) and not in brain regions in which P-gp expression was not changed after SE. Inhibition of P-gp by TQD significantly increased the PHT concentration, specifically in regions that showed P-gp overexpression. Despite increased P-gp expression in the liver of epileptic rats, pharmacokinetic analysis showed no significant change of PHT clearance in control versus epileptic rats. These findings show that overexpression of P-gp at the blood-brain barrier of specific limbic brain regions causes a decrease of local PHT levels in the rat brain.

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“…Hamed et al (128) in a very recent study analyzed thyroid hormones, lipid profile, and GGT in a group of 88 patients with epilepsy to determine whether thyroid dysfunction encountered in patients with epilepsy would also be associated with abnormal lipid profile. The authors concluded that a) altered lipid metabolism might be associated but not solely influenced by thyroid hormones, b) enzyme induction is not the main or only reason for altered thyroid function or HDL-c among patients with epilepsy.…”

Section: The Possible Relationship Among Thyroid Hormones Balance Andmentioning

confidence: 99%

The High Atherosclerotic Risk Among Epileptics: the Atheroprotective Role of Multivitamins

Hamed

Nabeshima

2005

J Pharmacol Sci

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Abstract. Neurologists have little concern about the high atherosclerotic risk among epileptics. Recent evidences mount that chronic epilepsy and prolonged use of antiepileptic drugs (AEDs) are associated with multiple risk factors that are critically implicated in pathobiology and dysfunction of the vessel wall through complex molecular mechanisms that promote atherogenesis. This review is concerned with three metabolic alterations, which are attributed as major risk factors for atherosclerosis among epileptics: altered metabolism of a) homocysteine (Hcy), b) lipids and lipoproteins, and c) uric acid. Most conventional AEDs reduce folic acid levels, thereby raising Hcy levels. Hyperhomosysteinemia is recently believed to induce endothelial dysfunction and promote atherosclerosis through complex oxidative and excitatory neurotoxic molecular mechanisms. However, Hcy itself is a convulsing substance with increased seizure recurrence and intractability to antiepileptic medications. AEDs can disturb lipid metabolism with resultant hypercholestrolemia and dyslipidemia, common recognized risks for atherosclerosis. Altered uric acid metabolism is common among epileptics. Uric acid has been implicated in endothelial cell damage and decreased endothelial nitric oxide bioavailability. In the presence of atherosclerotic milieu, uric acid interacts with other substrate toxicities and increased reactive oxygen species, accelerating atherosclerosis. The above information forms the rationale for future routine screening and correction of such metabolic alterations in epileptics. A convincing argument now develops that routine polyvitamin supplementation (folic acid, vitamin B12, vitamin B6, vitamin C, vitamin E, and β-carotene) becomes increasingly important for women and men receiving AEDs at all ages. The atheroprotective effect of multivitamins is through their antioxidant and anti-inflammatory effects together with their lipid and Hcy lowering effects.

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Serum thyroid hormone balance and lipid profile in patients with epilepsy

Cited by 53 publications

References 47 publications

The Predictors of Early Atherosclerosis in Young Adult Epileptic Patients

The Predictors of Early Atherosclerosis in Young Adult Epileptic Patients

Region-Specific Overexpression of P-glycoprotein at the Blood-Brain Barrier Affects Brain Uptake of Phenytoin in Epileptic Rats

The High Atherosclerotic Risk Among Epileptics: the Atheroprotective Role of Multivitamins

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