Abstract:
OBJECTIVE:To determine whether valproate (VPA) monotherapy influences homocysteine metabolism in patients with epilepsy. DESIGN:Systematic review and meta-analysis. DATA SOURCES:We searched all articles in English through PubMed, Web of Science and EMBASE published up to August 2013 concerning the homocysteine levels in VPA monotherapeutic patients with epilepsy. PARTICIPANTS:VPA-treated patients with epilepsy (n=266) and matched healthy controls (n=489). OUTCOME MEASURES:Heterogeneity between studies was assessed using I(2) statistics. Pooled standardised mean difference (SMD) and 95% CIs were calculated using a random effect model. RESULTS:A total of eight eligible studies were enrolled in our meta-analysis. We compared the plasma levels of homocysteine in VPA-treated patients with epilepsy and healthy controls. There was significant heterogeneity in the estimates according to the I(2) test (I(2)=65.6%, p=0.005). Plasma homocysteine levels in VPA-treated patients with epilepsy were significantly higher than in healthy controls under a random effect model. (SMD, 0.62; 95% CI 0.32 to 0.92). Further subgroup analyses suggested that no significant differences were present when grouped by ethnicity and age, but the risk of heterogeneity in the West Asian group (I(2)=47.4%, p=0.107) was diminished when compared with that of the overall group (I(2)=65.6%, p=0.005). CONCLUSIONS:Our meta-analysis indicates that VPA monotherapy is associated with the increase in plasma homocysteine levels in patients with epilepsy. Whether this association is influenced by ethnicity needs further research.
journal_name
BMJ Openjournal_title
BMJ openauthors
Ni G,Qin J,Fang Z,Chen Y,Chen Z,Zhou J,Zhou Ldoi
10.1136/bmjopen-2014-004936subject
Has Abstractpub_date
2014-07-16 00:00:00pages
e004936issue
7issn
2044-6055pii
bmjopen-2014-004936journal_volume
4pub_type
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