Increased high-density lipoprotein cholesterol in patients with epilepsy treated with carbamazepine: A gender-related study

Purpose: Long-term treatment with carbamazepine (CBZ) may alter serum lipop rotein concentrations. Gender-related examinations, however, are rare and i nconsistent in their results. Methods: To examine possible sex differences, serum lipoproteins were analy zed in 127 clinic outpatients (56 women and 71 men) with epilepsies with fo cal or secondarily generalized tonic-clonic seizures (or both) treated with a CBZ monotherapy. Results were compared with a control group of 177 blood donors (67 women an d 110 men) matched for age and weight. Results. Total cholesterol. low-dens ity lipoprotein (LDL) cholesterol and high-density lipoprotein (HDL) choles terol were higher in both male and female patients treated with CBZ compare d with controls. The known sex difference in serum lipoprotein concentratio ns (i.e., higher LDL cholesterol and triglycerides but lower HDL cholestero l in men) was confirmed in controls and patients treated with CBZ, with the exception of LDL cholesterol. The HDL as well as the LDL differences were significantly mon pronounced in women treated with CBZ than in men when com pared with their controls. These results were independent of the dose of CB Z and plasma concentrations. Lathosterol, a cholesterol precursor, and its ratio to cholesterol, an indicator of cholesterol synthesis, were nor diffe rent, when compared between gender and different HDL groups. Conclusions: The observed increase in HDL cholesterol in patients with CBZ, especially in women, might correlate with the previously reported diminish ed rate of death from coronary heart disease in patients with epilepsy as H DL exerts an antiatherogenic effect.