Brief CommunicationNonalcoholic fatty liver disease in adolescents receiving valproic acid

ObjectiveThe 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.MethodsUsing 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.ResultsAlthough 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).ConclusionValproic acid monotherapy is associated with NAFLD in a high percentage of adolescents with epilepsy who have typical VPA-related metabolic disturbances.