Prevalence and risk factors of low bone mineral density and 25-hydroxyvitamin D status in young healthy epileptic adult patients in a tropical Asian country taking antiepileptic drug.
OBJECTIVE
Antiepileptic drugs have been reported to reduce bone mineral density (BMD) in several countries with varying prevalence but in studies with small sample size and inadequate assessment of confounders, and rarely including young adults. We sought to determine the prevalence, vitamin D status and risk factors for low BMD in young adult epileptic patients in a tropical setting.


METHODS
We prospectively examined left femoral neck and spine with dual-energy X-ray absorption. Demographic data, basic laboratory studies, history of clinical epilepsy, parathyroid hormone and vitamin D level were obtained.


RESULTS
One hundred and twenty three patients were included. The mean (+/-SD) T-score was -0.31+/-1.24 at the spine and -0.19+/-1.11 at the left femoral neck. 36% had osteopenia and 4.1% had osteoporosis at either site. Four patients had vitamin D deficiency. Vitamin D levels were not correlated with BMD. Twenty-five patients had vitamin D insufficiency. Multivariate logistic regression analysis identified low body mass index (BMI) and male sex as risk factors for low BMD at the spine and low BMI and duration of treatment as risk factors for low BMD at the left femoral neck.


CONCLUSIONS
Chronic use of antiepileptic drug (AED) in young adult patients is associated with low BMD.
Phabphal
Kanitpong
K
Division of Neurology, Department of Internal medicine, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla, Thailand. pkanitpo@medicine.psu.ac.th
Geater
Alan
A
Leelawattana
Rattana
R
Sathirapunya
Ponchi
P
Sattawatcharawanich
Suwanna
S
Limapichat
Kitti
K
D000328:Adult; D000927:Anticonvulsants / Q000627:therapeutic use*; D015992:Body Mass Index; D015519:Bone Density / Q000187:drug effects; D003710:Demography; D004827:Epilepsy / Q000097:blood* / Q000188:drug therapy*; D005260:Female; D006262:Health; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D010281:Parathyroid Hormone / Q000097:blood; D015995:Prevalence; D012307:Risk Factors; D013785:Thailand / Q000453:epidemiology; D013997:Time Factors; D014329:Tropical Climate; D014807:Vitamin D / Q000031:analogs & derivatives* / Q000097:blood
D000927:Anticonvulsants; D010281:Parathyroid Hormone; D014807:Vitamin D; C104450:25-hydroxyvitamin D