Correlation between Hyperhomocysteinemia and Common Carotid Artery Intima media Thickness in Carbamazepine treated Epileptic patients using Ultrasonography

Objective: The objective was to assess the role of homocysteine in the development of atherosclerosis in common carotid artery in the carbamazepine treated epileptic patients.

Methods: This study was conducted in the Department of Biochemistry, Basic Medical Sciences Institute (BMSI), Jinnah Postgraduate Medical Center (JPMC), Karachi. Three hundred individuals, aged 34 ± 9.5 years were selected and divided into three groups. Each group comprised of 100 subjects labeled as Group-A (control group had healthy individuals), Group-B (newly diagnosed epileptic patients without antiepileptic therapy), Group-C (epileptic patients on Carbamazepine therapy, which was further subdivided into C-I having epileptic patients on Carbamazepine therapy less than 1 year n=33, C-II had epileptic patients on Carbamazepine therapy 1-2 years n = 33 and C-III comprised of epileptic patients on Carbamazepine therapy more than 2 years n = 34). Blood concentration of homocysteine was measured and ultrasound of Common Carotid Artery for intima-media thickness was performed.

Results: Significantly elevated level of homocysteine was observed in epileptic patients on CBZ therapy. Common Carotid Artery Intima-media thickness (CCA IMT) was observed significantly high throughout group C but it was more profound in Group-C-III. Homocysteine was found positively correlated with right CCA IMT, left CCA IMT and mean CCA IMT.

Conclusion: Hyperhomocysteinemia was linked with increased risk of atherosclerosis in CBZ treated epileptic patients.