Derangements in bone mineral parameters and bone mineral density in south Indian subjects on antiepileptic medications

作者：Koshy George; Varghese Ron Thomas; Naik Dukhabandhu; Asha Hesargatta Shyamsunder; Thomas Nihal; Seshadri Mandalam Subramaniam; Alexander Mathew; Thomas Maya; Aaron Sanjith; Paul Thomas Vizhalil^*

来源：Annals of Indian Academy of Neurology, 2014, 17(3): 272-276.

DOI：10.4103/0972-2327.138489

• Anticonvulsants
• bone mineral density
• epilepsy
• vitamin D

Background: Although there are reports describing the association of alternations of bone and mineral metabolism in epileptic patients with long-term anticonvulsant therapy, there are only limited Indian studies which have looked at this aspect. Objectives: This study was done to compare the prevalence of changes in bone mineral parameters and bone mineral density (BMD) in ambulant individuals on long-term anticonvulsant therapy with age- and body mass index (BMI)-matched healthy controls. Materials and Methods: There were 55 men (on medications for more than 6 months) and age- and BMI-matched 53 controls. Drug history, dietary calcium intake (DCI), and duration of sunlight exposure were recorded. Bone mineral parameters and BMD were measured. Results: The control group had a significantly higher daily DCI with mean SD of 396 91 mg versus 326 101 mg (P = 0.007) and more sunlight exposure of 234 81 vs 167 69 min (P = 0.05). BMD at the femoral neck was significantly lower in cases (0.783 0.105 g/cm (2) ) when compared to controls (0.819 0.114 g/cm (2) ). Majority of the patients (61%) had low femoral neck BMD (P = 0.04). There was no significant difference in the proportion of subjects with vitamin D deficiency (< 20 ng/mL) between cases (n = 32) and controls (n = 37) (P = 0.234). Conclusions: Vitamin D deficiency was seen in both the groups in equal proportions, highlighting the existence of a high prevalence of this problem in India. Low femoral neck BMD found in cases may stress the need for supplementing calcium and treating vitamin D deficiency in this specific group. However, the benefit of such intervention has to be studied in a larger proportion of epileptic patients.

• 出版日期2014-9