title: Normal vitamin D and low free estradiol levels in women on enzyme-inducing antiepileptic drugs.
abstract: Relationships between reproductive hormone levels, bone turnover marker levels, bone mineral density, and rates of bone loss were evaluated in premenopausal women with epilepsy taking enzyme-inducing antiepileptic drugs (EIAEDs: phenytoin or carbamazepine) or lamotrigine. Calciotropic and reproductive hormone levels, bone turnover marker levels, and bone mineral density were measured at baseline and 1 year. Bone mineral density did not differ between groups. Serum calcium (P<0.001) and estrone (P<0.001) levels were lower in the EIAED group. Sex hormone-binding globulin levels were higher (P<0.001) and percentage free estradiol levels were lower (P<0.001) in the EIAED group. We detected no relationship between bone mineral density change and calciotropic hormone or bone turnover marker levels. Women with higher sex hormone-binding globulin and lower free estradiol levels sustained more bone loss at the total hip (P=0.04 and P=0.02) and a trend toward more bone loss at the lumbar spine (P=0.07 and P=0.08). These findings suggest that lower estrogen levels may contribute to bone loss in premenopausal women with epilepsy.
authors.affiliation: Department of Neurology, Columbia University, New York, NY, USA. ap390@columbia.edu
authors.forename: Alison M
authors.initials: AM
authors.lastname: Pack
authors.forename: Martha J
authors.initials: MJ
authors.lastname: Morrell
authors.forename: Don J
authors.initials: DJ
authors.lastname: McMahon
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Shane
mesh_terms: D000293:Adolescent; D000328:Adult; D000927:Anticonvulsants / Q000494:pharmacology / Q000627:therapeutic use*; D015519:Bone Density / Q000187:drug effects; D002220:Carbamazepine / Q000494:pharmacology / Q000627:therapeutic use*; D004827:Epilepsy / Q000097:blood* / Q000188:drug therapy; D004958:Estradiol / Q000097:blood*; D005260:Female; D006801:Humans; D000077213:Lamotrigine; D010672:Phenytoin / Q000494:pharmacology / Q000627:therapeutic use*; D014227:Triazines / Q000494:pharmacology / Q000627:therapeutic use; D014807:Vitamin D / Q000097:blood*
chemical_list: D000927:Anticonvulsants; D014227:Triazines; D014807:Vitamin D; D002220:Carbamazepine; D004958:Estradiol; D010672:Phenytoin; D000077213:Lamotrigine