Effects of Folate Supplementation on Carotid Intima‑Media Thickness, Biomarkers of Inflammation, and Oxidative Stress in Carbamazepine‑Treated Epileptic Children

Abstract

Background: This study was conducted to assess the effects of folate supplementation on carotid intima‑media thickness (CIMT), biomarkers of inflammation, and oxidative stress in carbamazepine‑treated epileptic children.

Methods: This randomized, double‑blind, placebo‑controlled
trial was carried out in 54 epileptic children aged 2–12 years old receiving carbamazepine monotherapy. Participants were randomly allocated into two groups to receive either 5 mg folate supplements or placebo (n = 27 in each group) for 12 weeks.

Results: After the 12‑week intervention, compared with the placebo, folate supplementation resulted in a signifcant reduction in plasma homocysteine (Hcy) (changes from baseline - 2.1 ± 2.5 vs. +0.1 ± 0.4 µmol/L, P < 0.001), serum high‑sensitivity C‑reactive protein (hs‑CRP) (changes from baseline - 1.5 ± 3.5 vs. +0.4 ± 1.4 mg/L, P = 0.01), a signifcant increase in plasma nitric oxide (NO) (changes from baseline + 1.9 ± 5.8 vs.
-2.0 ± 6.4 µmol/L, P = 0.02), and total antioxidant capacity (TAC) concentrations (changes from baseline + 88.6 ± 116.0 vs. +1.8 ± 77.4 mmol/L, P = 0.002). We did not observe any signifcant effects in mean levels of left and right CIMT, maximum levels of left and right CIMT, and total glutathione (GSH) and malondialdehyde (MDA) levels following the supplementation of folate compared with the placebo.

Conclusions: Overall, folate supplementation at a dosage of 5 mg/day for
12 weeks among epileptic children receiving carbamazepine had benefcial effects on Hcy, hs‑CRP, NO, and TAC levels, but did not affect CIMT, and GSH and MDA levels.

Keywords: Carotid intima‑media thickness, epilepsy, folate, inflammation, oxidative stress