Nonalcoholic fatty liver disease in adolescents receiving valproic acid

Objective: The aim of this study was to investigate the association between the metabolic derangements induced by valproic acid (VPA) and ultrasound-diagnosed nonalcoholic fatty liver disease (NAFLD) in adolescents. Methods: Using a cross-sectional design, we evaluated 86 adolescents with epilepsy who had received VPA monotherapy. Subjects for comparison were 67 normal-weight and 43 weight-matched adolescents. Participants underwent hepatic ultrasound, anthropometric evaluations, and biochemical tests. Results: Although the occurrence of ultrasound-diagnosed NAFLD was higher in VPA-treated patients than in normal-weight controls (36.0% vs 7.5%. P < 0.001), it was similar in VPA-treated patients and weight-matched controls (36.0% vs 34.9%, P > 0.05). The identified predictors of NAFLD in VPA-treated patients were abdominal obesity (OR = 3.2, 95% CI = 2.1-6.8), insulin resistance (OR = 2.8, 95% CI = 1.7-5.2), metabolic syndrome (OR = 2.6, 95% CI = 1.4-4.8), and generalized obesity (OR = 1.9,95% CI = 1.2-3.7). Conclusion: Valproic acid monotherapy is associated with NAFLD in a high percentage of adolescents with epilepsy who have typical VPA-related metabolic disturbances. (C) 2010 Elsevier Inc. All rights reserved.