APOB and metabolic syndrome: Valproate or its metabolites may inhibit the glucuronidase enzyme, resulting in reduced triglyceride, LDL, and HDL production.11 Horie and Suga16 also observed that valproate treatment increased hepatic peroxisomal oxidation, reducing LDL-C and apolipoprotein B. Valproate-induced weight gain may result in insulin resistance, resulting in dyslipidemia and hyperinsulinemia.17