Study of association between valproic acid levels, biotinidase activity and hair loss in Indian population: A cross-sectional comparative study.

BACKGROUND

Valproic acid (VPA) is the medication prescribed for the treatment of bipolar disorder, epilepsy, and migraine. It is reported that the VPA treatment leads to biotin deficiency due to the low serum biotinidase activity. Alopecia or hair loss is another common side effect of valproate administration.

AIM: The study aims to investigate hair loss complaint in people, who are on Valproate and find the association between valproate levels, serum biotinidase activity and hair loss in persons treated with valproate.

METHODS

This two years cross sectional comparative study involving 150 participants was performed at department of Psychiatry of a tertiary care teaching hospital. The study group had 75 persons taking Valproate compared with 75 persons in the control group. Blood samples were collected for estimation of serum VPA levels and serum biotinidase activity. Quantification of alopecia biomarker Interleukin (IL)-2 was estimated. Data was analyzed by using student T test, Pearson's correlation, and Mann Whitney U test.

RESULTS

The study group comprised of 40 males and 35 females with a mean age of 42.04 (±12.85) years. The control group had 39 males and 36 females with a mean age of 38.38 (±14.42) years. Hair loss was reported in 18 (24%) persons of study cohort compared to 2 (2.66%) among the control group. There was a statistically significant difference between biotinidase levels across the participants with hair loss complaint and those without hair loss complaint. (Mean rank of participants with hair loss complaint = 43.30, mean rank of participants without hair loss complaint = 80.45, U = 656.000, P ≤ 0.001). There was a statistically significant difference between the distribution of IL2 across the study and control groups. (Mean rank of study group = 57.73, mean rank of control group = 83.27, U = 3,395.00, P = 0.025).

CONCLUSION

It can be concluded that there is an association between Valproate levels, biotinidase activity and hair loss.