Atherogenic Lipid Profiles and Cardiovascular Risk Indices in Epilepsy: A Retrospective Study

Abstract

Objective: Epilepsy is increasingly recognized as a condition associated with elevated cardiovascular risk, potentially influenced by both the disease itself and long-term antiseizure medication (ASM) use. Atherogenic lipid indices enable a more detailed evaluation of cardiovascular risk that may not be evident through conventional lipid measurements. Methods: In this retrospective analysis, 71 patients with epilepsy and 50 age-and sex-matched healthy individuals were recruited from the Neurology and Cardiology outpatient departments of Siirt Training and Research Hospital between January 1, 2024, and January 1, 2025. According to the criteria established by the International League Against Epilepsy (ILAE), patients were classified into two subgroups: drug-sensitive epilepsy (DSE, n=52) and drug-resistant epilepsy (DRE, n=19). Demographic, clinical, and biochemical data were collected. Atherogenic indices were calculated and compared across groups. The relationships between treatment duration and lipid-based risk indicators were examined using correlation analysis and multivariate linear regression, accounting for potential covariates. Results: Compared with healthy controls, the DRE group exhibited significantly lower high-density lipoprotein cholesterol (HDL-C) levels (p=0.030) and higher Castelli Risk Index II (CRI-II) values (p=0.01). In multivariate regression models, longer epilepsy duration and higher body mass index (BMI) were independently associated with increased CRI-II (p=0.023 and p=0.003, respectively) and Cholesterol Index (CHOLIndex) (p=0.026 and p=0.009, respectively). Conclusions: Epilepsy patients, particularly those with DRE or prolonged treatment duration, demonstrate unfavorable shifts in lipid-based cardiovascular risk markers. © 2026, Sakarya University. All rights reserved.