HUBUNGAN LAMA TERAPI ASAM VALPROAT TERHADAP KADAR KALSIUM DARAH DAN STATUS GIZI PADA ANAK PENDERITA EPILEPSI = THE RELATIONSHIP BETWEEN DURATION OF VALPROIC ACID THERAPY WITH CALCIUM LEVEL AND NUTRITIONAL STATUS IN CHILDREN WITH EPILEPSY

Background: Valproic acid is one of the most widely used antiepileptic drugs in children; however, long-term therapy is suspected to affect calcium metabolism and nutritional status, including an increased risk of obesity. Objectives: To assess the association between the duration of valproic acid therapy and serum calcium levels, nutritional status, and obesity. Methods: A retrospective cohort study was conducted on 48 children with epilepsy aged 6 months to 18 years who received valproic acid therapy at the Pediatric Neurology Clinic of Dr. Wahidin Sudirohusodo Hospital, Makassar. Subjects were divided into two groups based on treatment duration: ≤6 months (n=24) and >6 months (n=24). The evaluated parameters included serum calcium levels, nutritional status, obesity, and body mass index (BMI). Result: Both groups had similiar baseline characteristics except for treatment duration and nutritional status. The proportion of hypocalcemia was higher in the >6-month group (70.8%) compared with the ≤6-month group (58.3%), although not statistically significant (p=0.365). Mean calcium levels were lower in the >6-month group but not statistically significant (7.3 ± 2.8 vs. 8.0 ± 2.3 mg/dL; p=0.523). Obesity was observed in 20.8% of subjects in the >6-month group and was absent in the ≤6-month group, and statistically significant (p=0.05; OR 2.263; 95% CI 1.617–3.167). Conclusion: Long-term therapy is significantly associated with nutritional status and an increased proportion of obesity. These findings highlight the need for regular monitoring of nutritional parameters and mineral metabolism in children receiving prolonged valproic acid therapy.