This is an early access version
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Neurology Department, Faculty of Medicine, Sriwijaya University , Palembang , Indonesia
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Biomedicine Division, Faculty of Medicine, Sriwijaya University , Palembang , Indonesia
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Neurology Department, Faculty of Medicine, University of Indonesia , Depok , Indonesia
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Division of Nephrology and Hypertension, Department of Internal Medicine, Faculty of Medicine, Sriwijaya University , Palembang , Indonesia
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Department of Pharmacology, Faculty of Medicine, Sriwijaya University , Palembang , Indonesia
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Neurology Department, Faculty of Medicine, University of Indonesia , Depok , Indonesia
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Faculty of Medicine, Sriwijaya University , Palembang , Indonesia
Division of Rheumatology, Department of Internal Medicine, Faculty of Medicine, Sriwijaya University , Palembang , Indonesia
Aim To analyze the effect of vitamin D administration on serum 25(OH)D levels and biomarkers of metabolic syndrome and atherosclerosis (homeostatic model assessment of insulin resistance [HOMA-IR], adiponectin, homocysteine, and high sensitivity C-reactive protein [hs-CRP]) in epilepsy patients receiving enzymatic antiseizure medications (ASMs).
Methods This double-blind, randomized, placebo-controlled trial randomized 40 adult epilepsy patients treated with enzymatic ASMs to receive vitamin D3 (2,000 IU/day) or placebo for 12 weeks. The primary outcome was the change in serum 25-hydroxyvitamin D (25[OH]D) levels. Secondary outcomes included changes in HOMA-IR, adiponectin, homocysteine, and hs-CRP. Data were analyzed using a per-protocol approach.
Results Thirty-four patients completed the study. Vitamin D supplementation yielded a significantly greater increase in serum 25(OH)D (10.67 ± 8.16 vs. –1.29 ± 3.96 ng/mL; p < 0.001) and adiponectin (1.38 ± 3.05 vs. 0.34 ± 1.89 µg/mL; p = 0.045), as well as a significantly greater reduction in hs-CRP (–6.74 ± 14.65 vs. 1.81 ± 7.75 mg/L; p = 0.041) compared with placebo. Conversely, no significant differences were observed between groups regarding the changes in HOMA-IR (–0.24 ± 3.71 vs. –0.14 ± 3.38; p = 0.940) or homocysteine (7.90 ± 1.79 vs. 8.15 ± 2.70 µmol/L; p = 0.290).
Conclusion Vitamin D supplementation (2,000 IU/day) effectively restores 25(OH)D levels and improves adiponectin and hs-CRP in epilepsy patients on enzymatic ASMs, suggesting a potential benefit for cardiovascular risk reduction. However, vitamin D alone did not prevent the rise in homocysteine, likely due to the concurrent cessation of B-vitamin supplementation.
Conceptualization, S.H., Z.H., F.O. and R.U.P.; Data curation, S.H., Z.H., F.O. and R.U.P.; Formal Analysis, S.H. and D.A.; Investigation, S.H.; Resources, S.H.; Visualization, S.H. and D.A.; Writing – original draft, S.H. and D.A.; Writing – review & editing, S.H., Z.H., F.O., Z.A., N.P., A.B., D.A. and R.U.P.; Methodology, Z.H., F.O. and R.U.P.; Supervision, Z.H., F.O., Z.A., N.P., A.B. and R.U.P.; Validation, Z.H., F.O., Z.A., N.P., A.B. and R.U.P.; Project administration, R.U.P. All authors have read and agreed to the published version of the manuscript.
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