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ABSTRACT
Introduction
It is widely accepted that trace elements have been implicated in various metabolic processes. Valproic acid (VPA) is a remarkably safe and effective antiepileptic drug. There is no consensus option regarding the fluctuations in serum zinc (Zn), copper (Cu), and selenium (Se) in epileptic patients treated with VPA. We applied a meta-analysis to systematically assess the effects of VPA on serum ions in these patients.
Areas covered
In this study, we performed a meta-analysis of the changes in serum Zn, Cu, and Se levels in human samples of healthy controls, epileptic patients, and patients treated with VPA. Twenty-two published analyzable studies were selected by searching the databases of PubMed, China National Knowledge Infrastructure (CNKI), Google Scholar, Web of Science, EMBASE, WAN FANG and Vip.
Expert opinion
Serum Se levels in epileptic patients were decreased compared to healthy controls. Serum Zn levels in patients with VPA treatment were significantly lower than those in epileptic patients. The results of this meta-analysis are instructive for the intake of trace elements such as Zn, Cu, and Se in the diet balance of patients with epilepsy treated with VPA. Meanwhile, this study provides a theoretical basis for the combined use of other drugs that affect the intake and absorption of trace elements and VPA.
Article highlights
Epilepsy is one of the most common neurological diseases that affect the quality of life, and VPA as a first-line treatment of epilepsy has a very good therapeutic effect.
In this study, we performed a meta-analysis of the changes in serum Zn, Cu and Se levels in human samples of healthy controls, epileptic patients, and patients treated with VPA.
Serum Se levels were significantly lower in epileptic patients compared to healthy controls (SMD =−0.49; 95% CI [−0.75, −0.23]; p ≤0.001). Additionally, serum Zn levels in epileptic patients with VPA were significantly lower than those before the treatment (SMD = −3.00; 95% CI [−5.08, −0.92]; p = 0.005).
Epileptic patients should pay attention to the intake of trace elements including serum Se in their daily diet. It is essential to monitor serum Se levels in epileptic patients.
VPA can reduce serum Zn levels in epileptic patients. Therefore, it would be appropriate to recommend blood level monitoring of Zn in patients treated with VPA.
5. Expert opinion
Serum Se levels in epileptic patients were decreased compared to healthy controls. Serum Zn levels in patients with VPA treatment were significantly lower than those in epileptic patients. The results of this meta-analysis are instructive for the intake of trace elements such as Zn, Cu, and Se in the diet balance of patients with epilepsy treated with VPA. Meanwhile, this study provides a theoretical basis for the combined use of other drugs that affect the intake and absorption of trace elements and VPA.
Author contributions
F. Guo, W. Jia and Y. Song conceived and designed the study. W. Jia, Jing J. Kong, X. Zhang, D. Shao, H. Tang, Y. Wang, L. Yang and G. Li selected the studies and collected the data. W. Jia and Z. He analyzed data, and all authors interpreted the results. F. Guo, X. Xu, H. Hu, and T. Boczek drafted and revised the manuscript. All authors read and approved the final version of the manuscript.
Declaration of interest
The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.
Reviewer declarations
Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.
Supplementary material
Supplemental data for this article can be accessed here.