Carnitine Deficiency in Chinese Children with Epilepsy on Valproate Monotherapy.

OBJECTIVE

To explore the incidence and independent risk-factors of secondary carnitine deficiency in Chinese children with epilepsy on valproate monotherapy.

METHODS

The free carnitine and acylcarnitines levels in 299 children with epilepsy on valproate monotherapy between June 2014 and September 2015 were compared with age- and sex-matched 299 healthy controls.

RESULTS

Children with valproate monotherapy had lower free carnitine levels [23.86 (10.60) µmol/L] than the controls [36.37 (9.37) µmol/L] (P<0.01). Most acylcarnitines were significantly lower in children with valproate monotherapy than controls. 63 children (21.1%) with epilepsy had carnitine deficiency; 54 were asymptomatic. Female gender (OR 2.1), high alanine aminotransferase levels (OR 1.0) and long duration of VPA treatment (1-12 mo) (OR 1.9) were independent risk factors for secondary carnitine deficiency induced by VPA.

CONCLUSION

Carnitine deficiency with valproate is more likely in females, those with transaminitis, and those receiving the drug for 1-12 months.