Bone metabolism in healthy ambulatory control premenopausal women and in epileptics on anti-convulsant drugs.
BACKGROUND
Long term anti-epileptic drug use causes multiple abnormalities in calcium and bone metabolism that have been documented in both institutionalised and ambulatory patients.


OBJECTIVE
To assess bone metabolism in ambulatory females of reproductive age, on antiepileptic drugs.


METHODS
Cross sectional comparative study.


METHODS
Ambulatory females in reproductive age group with epilepsy and on regular follow up were compared to healthy females of similar ages not on any treatment.


RESULTS
The mean duration of treatment for epilepsy was eight years (+/- 6.3). Majority of the patients were on enzyme inducing drugs like phenobarbital, phenytoin, carbamazepine and valproate, either alone or in combination with non-enzyme inducers like lamotrigine (98.2%). There was a significantly lower mean serum calcium and a higher alkaline phosphatase level among the patients (P = 0.002 and 0.0001 respectively) than among the comparators. The urinary marker of bone loss (mean urine calcium excretion) was also significantly raised among the patients (P=0.003). The mean lumbar BMDT-score results were not significantly different in the two groups.


CONCLUSIONS
Long-term anti-epileptic drug use significantly affects biochemical parameters of bone metabolism. These effects on bone biochemistry markers were not reflected in lumbar spine BMD in this study.
Kenya Medical Research Institute, P.O. Box 52535-00200, Nairobi, Kenya.
J K
JK
Kwasa
A
A
Amayo
P M
PM
Ndavi
T O O
TO
Kwasa
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000927:Anticonvulsants / Q000627:therapeutic use*; D015519:Bone Density; D016723:Bone Remodeling / Q000502:physiology*; D016022:Case-Control Studies; D003430:Cross-Sectional Studies; D004827:Epilepsy / Q000188:drug therapy* / Q000378:metabolism*; D005260:Female; D006801:Humans; D008875:Middle Aged; D017697:Premenopause / Q000378:metabolism*; D012737:Sex Factors; D055815:Young Adult
D000927:Anticonvulsants