Body composition and bioelectrical impedance vector analysis in children on valproate treatment: a pilot study // Composición corporal y análisis vectorial de bioimpedancia en niños en tratamiento con ácido valproico: estudio piloto
Resumen
Abstract
Valproate treatment seems to be associated with significant weight gain and related metabolic disorders; however, body composition assessment among epileptic patients has not been frequently reported. We aimed to evaluate valproic acid-associated changes in body composition in pediatric epileptic patients. Twenty eight epileptic children aged from 3-14 years, receiving valproic acid (VPA) therapy for at least 6 months were included in this pilot cross sectional study. A control group was matched in a 1:1 pattern by age, sex, and body mass index (BMI). Body composition was measured by bioimpedance (BIA). Prediction BIA-equations, Phase Angle (PA) and Bioimpedance Vector Analysis (BIVA) were calculated. We did not find statistically significant differences in body composition determined by BIA equations, PA and BIVA among pediatric epileptic patients treated with VPA and healthy children. Although the results of this study show no statistically significant differences, there was a trend toward higher body fat mass in VPA treated children. Since BIA and BIVA may detect early changes in body compartments, it would be advisable to assess them in pretherapy and monitoring of patients with epilepsy, in order to detect changes before adverse consequences could happen. It would be necessary to increase the sample size in the future.
Resumen. El tratamiento con ácido valproico (VPA) ha sido frecuentemente relacionado con un incremento significativo del peso corporal, así como con diversos trastornos metabólicos; sin embargo, existen pocos estudios publicados de evaluación de composición corporal en pacientes epilépticos. El objetivo del presente estudio fue valorar los cambios en la composición corporal en pacientes pediátricos epilépticos en tratamiento con VPA. Para ello se realizó un estudio observacional, transversal, incluyendo a veintiocho pacientes epilépticos con edades comprendidas entre 3 y 14 años, en tratamiento con VPA durante al menos 6 meses. Como controles sanos fueron incluidos 28 niños, reclutados en un patrón de 1:1 por edad, sexo e índice de masa corporal. El estudio de composición corporal se determinó por bioimpedancia (BIA). Se calcularon las ecuaciones de predicción de BIA, el ángulo de fase (PA) y el análisis vectorial de bioimpedancia (BIVA). No se encontraron diferencias estadísticamente significativas en la composición corporal determinada por las ecuaciones de BIA, PA y BIVA entre los pacientes epilépticos tratados con VPA y los niños sanos. Aunque los resultados de este estudio no muestran diferencias significativas, se observó una tendencia hacia un mayor porcentaje de masa grasa en los niños tratados con VPA. Dado que BIA y BIVA pueden detectar alteraciones precoces en los compartimientos corporales, sería recomendable realizar una evaluación y seguimiento en los pacientes epilépticos en tratamiento con VPA, con el fin de detectar cambios antes de que pudieran aparecer potenciales complicaciones. Sería necesario aumentar el tamaño de la muestra en el futuro.
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