title: Bone mineral metabolism changes in epileptic children receiving valproic acid.
abstract: 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.
authors.affiliation: Department of Pediatrics, Faculty of Medicine, Trakya University, Edirne, Turkey. nacioner@trakya.edu.tr
authors.forename: N
authors.initials: N
authors.lastname: Oner
authors.forename: M
authors.initials: M
authors.lastname: Kaya
authors.forename: S
authors.initials: S
authors.lastname: Karasalihoğlu
authors.forename: H
authors.initials: H
authors.lastname: Karaca
authors.forename: C
authors.initials: C
authors.lastname: Celtik
authors.forename: F
authors.initials: F
authors.lastname: Tütüncüler
mesh_terms: 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*
chemical_list: D000927:Anticonvulsants; D015675:Osteocalcin; D014635:Valproic Acid; D000469:Alkaline Phosphatase; D002118:Calcium