title: The association between BsmI polymorphism and bone mineral density in young patients with epilepsy who are taking phenytoin.
abstract: OBJECTIVE
  This study sought to determine the association between BsmI polymorphism and bone mineral density, 25-hydroxyvitamin D, and parathyroid hormone levels in patients with epilepsy.
  
  
  METHODS
  We recruited ambulatory young adults with epilepsy who were taking phenytoin. Data regarding demographics, basic laboratory studies, history of clinical epilepsy, parathyroid hormone, and vitamin D levels, as well as BsmI polymorphism of the vitamin D receptor (VDR) gene, were obtained. The bone mineral density (BMD) of the lumbar spine and left femur were measured using dual-energy x-ray absorptiometry.
  
  
  RESULTS
  Ninety-four patients were included in the study. BsmI polymorphism had a statistically significant lower T-score of the lumbar spine and left femoral neck than patients with wild-type VDR gene (p < 0.01 and p < 0.01, respectively). In addition, patients with BsmI polymorphism had a statistically significant lower z-score of the lumbar spine and left femoral neck than patients with wild-type VDR gene (p < 0.01 and p < 0.01, respectively). The 25-hydroxyvitamin D level in patients with wild-type genes was higher than in epileptic patients with BsmI polymorphism (p < 0.01 and p < 0.01, respectively). Parathyroid hormone level in patients with wild-type VDR gene or patients having BsmI polymorphism was not correlated with BMD at either site.
  
  
  CONCLUSIONS
  In patients with epilepsy taking phenytoin, having BsmI polymorphism was associated with lower BMD.
authors.affiliation: Neurology Unit, Department of Medicine, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla, Thailand.
authors.forename: Kanitpong
authors.initials: K
authors.lastname: Phabphal
authors.forename: Alan
authors.initials: A
authors.lastname: Geater
authors.forename: Kitti
authors.initials: K
authors.lastname: Limapichart
authors.forename: Pornchai
authors.initials: P
authors.lastname: Sathirapanya
authors.forename: Suwanna
authors.initials: S
authors.lastname: Setthawatcharawanich
authors.forename: Natthawan
authors.initials: N
authors.lastname: Witeerungrot
authors.forename: Natawan
authors.initials: N
authors.lastname: Thammakumpee
authors.forename: Ratana
authors.initials: R
authors.lastname: Leelawattana
mesh_terms: D015652:25-Hydroxyvitamin D 2 / Q000097:blood; D015502:Absorptiometry, Photon; D000293:Adolescent; D000328:Adult; D000927:Anticonvulsants / Q000009:adverse effects* / Q000627:therapeutic use; D015519:Bone Density / Q000187:drug effects* / Q000235:genetics*; D002118:Calcium / Q000097:blood; D003430:Cross-Sectional Studies; D004247:DNA / Q000235:genetics; D003710:Demography; D015252:Deoxyribonucleases, Type II Site-Specific / Q000235:genetics*; D004827:Epilepsy / Q000150:complications* / Q000188:drug therapy / Q000235:genetics*; D005260:Female; D005838:Genotype; D006801:Humans; D008297:Male; D008875:Middle Aged; D010281:Parathyroid Hormone / Q000097:blood; D010672:Phenytoin / Q000009:adverse effects* / Q000627:therapeutic use; D011110:Polymorphism, Genetic / Q000235:genetics*; D060888:Real-Time Polymerase Chain Reaction; D018167:Receptors, Calcitriol / Q000235:genetics; D013056:Spectrophotometry, Ultraviolet; D055815:Young Adult
chemical_list: D000927:Anticonvulsants; D010281:Parathyroid Hormone; D018167:Receptors, Calcitriol; D015652:25-Hydroxyvitamin D 2; D010672:Phenytoin; D004247:DNA; C053864:endodeoxyribonuclease BsmI; D015252:Deoxyribonucleases, Type II Site-Specific; D002118:Calcium