Document Detail


Possible induction of cholinesterase in epileptic patients treated with anticonvulsant drugs: relationship with lipoprotein levels.
MedLine Citation:
PMID:  15317825     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The effect of enzyme-inducing anticonvulsant drugs on the serum concentrations of lipoproteins has been widely studied. However, there is little agreement between the results with regard to the possible development of a lipoprotein profile related to an increased or decreased cardiovascular risk. It has been suggested that cholinesterase (ChE) could be induced by these drugs, something of undeniable interest as ChE appears to have a relation to the metabolism of lipoproteins. The serum activity of ChE was determined in a group of 90 adult epileptic patients (56 male and 34 female) treated with phenobarbital, phenytoin, and carbamazepine. The liver enzyme induction produced by these drugs was then evaluated by determining serum gamma-glutamyltranspherase activity and urinary excretion of D-glucaric acid. A significant increase of serum ChE (p < 0.005) was found in the group of patients compared to a control group (n = 49) with a similar distribution for age and sex. A significant correlation was found for both male and female patients between ChE and concentrations of triglycerides, phospholipids, cholesterol, low-density lipoprotein (LDL) phospholipids, LDL-cholesterol, and apolipoprotein B (p < 0.01). Similarly, in female patients, ChE had a significant correlation with the total cholesterol/high-density lipoprotein (HDL) cholesterol and LDL-cholesterol/HDL-cholesterol ratios (p < 0.01). The ChE/HDL-cholesterol relationship, which has been proposed as a marker for cardiovascular risk, presented significant correlations with the total cholesterol/HDL-cholesterol and LDL-cholesterol/HDL-cholesterol ratios in patients of both sexes (p < 0.001). In the case of epileptic patients treated with enzyme-inducing anticonvulsant drugs, there may be an association between the possible induction of ChE and the metabolism of lipoproteins containing apolipoprotein B.
Authors:
María J Tutor-Crespo; Jesús Hermida; J Carlos Tutor
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Publication Detail:
Type:  Clinical Trial; Journal Article    
Journal Detail:
Title:  Journal of clinical pharmacology     Volume:  44     ISSN:  0091-2700     ISO Abbreviation:  J Clin Pharmacol     Publication Date:  2004 Sep 
Date Detail:
Created Date:  2004-08-19     Completed Date:  2004-12-06     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0366372     Medline TA:  J Clin Pharmacol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  974-80     Citation Subset:  IM    
Affiliation:
Laboratorio Central, Hospital Clínico Universitario, Santiago de Compostela, Spain.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Aged
Anticonvulsants / adverse effects*,  blood,  therapeutic use
Body Weight / physiology
Cholinesterases / biosynthesis*,  blood
Enzyme Induction / drug effects
Epilepsy / drug therapy,  enzymology*
Female
Glucaric Acid / blood,  urine
Humans
Lipoproteins / blood*
Male
Middle Aged
gamma-Glutamyltransferase / blood
Chemical
Reg. No./Substance:
0/Anticonvulsants; 0/Lipoproteins; 25525-21-7/Glucaric Acid; EC 2.3.2.2/gamma-Glutamyltransferase; EC 3.1.1.8/Cholinesterases

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