Bone mineral metabolism changes in epileptic children receiving valproic acid.
OBJECTIVE
The aim of this study was to evaluate bone mineral density (BMD) in epileptic children receiving valproic acid (VPA) and to determine differences between osteopenic and non-osteopenic children.


METHODS
Thirty-three epileptic children, receiving VPA for at least 6 months, were compared with 33 healthy children for BMD. BMD was measured by dual-energy X-ray absorptiometry at lumbar vertebrae, femoral neck and greater trochanter. Serum calcium, phosphorus, alkaline phosphates, osteocalcin and VPA levels were also determined.


RESULTS
Patient's osteocalcin levels were significantly higher (P = 0.02) and femur and trochanter BMD values were significantly lower (P = 0.04 and P = 0.03, respectively). Duration of VPA therapy was significantly longer and doses of VPA were significantly higher in seven osteopenic patients compared with 26 non-osteopenic patients. Osteopenic patients (4.6 +/- 2.4 years) were younger than non-osteopenic patients (7.8 +/- 3.2 years) (P = 0.01).


CONCLUSIONS
Long-term and high dose VPA therapy may cause osteopenia, primarily in younger epileptic children. These patients should be followed closely by BMD measurements.
Oner
N
N
Department of Pediatrics, Faculty of Medicine, Trakya University, Edirne, Turkey. nacioner@trakya.edu.tr
Kaya
M
M
Karasalihoğlu
S
S
Karaca
H
H
Celtik
C
C
Tütüncüler
F
F
D015502:Absorptiometry, Photon; D000293:Adolescent; D000469:Alkaline Phosphatase / Q000097:blood; D000927:Anticonvulsants / Q000009:adverse effects / Q000627:therapeutic use*; D015519:Bone Density / Q000187:drug effects*; D001851:Bone Diseases, Metabolic / Q000139:chemically induced; D002118:Calcium / Q000097:blood / Q000378:metabolism; D002648:Child; D002675:Child, Preschool; D004032:Diet; D004827:Epilepsy / Q000188:drug therapy*; D005269:Femur / Q000000981:diagnostic imaging / Q000503:physiopathology; D006801:Humans; D008159:Lumbar Vertebrae / Q000000981:diagnostic imaging / Q000503:physiopathology; D015675:Osteocalcin / Q000097:blood / Q000187:drug effects / Q000378:metabolism; D014635:Valproic Acid / Q000009:adverse effects / Q000627:therapeutic use*
D000927:Anticonvulsants; D015675:Osteocalcin; D014635:Valproic Acid; D000469:Alkaline Phosphatase; D002118:Calcium