title: Derangements in bone mineral parameters and bone mineral density in south Indian subjects on antiepileptic medications.
abstract: BACKGROUND
  Although there are reports describing the association of alternations of bone and mineral metabolism in epileptic patients with long-term anticonvulsant therapy, there are only limited Indian studies which have looked at this aspect.
  
  
  OBJECTIVE
  This study was done to compare the prevalence of changes in bone mineral parameters and bone mineral density (BMD) in ambulant individuals on long-term anticonvulsant therapy with age- and body mass index (BMI)-matched healthy controls.
  
  
  METHODS
  There were 55 men (on medications for more than 6 months) and age- and BMI-matched 53 controls. Drug history, dietary calcium intake (DCI), and duration of sunlight exposure were recorded. Bone mineral parameters and BMD were measured.
  
  
  RESULTS
  The control group had a significantly higher daily DCI with mean ± SD of 396 ± 91 mg versus 326 ± 101 mg (P = 0.007) and more sunlight exposure of 234 ± 81 vs 167 ± 69 min (P = 0.05). BMD at the femoral neck was significantly lower in cases (0.783 ± 0.105 g/cm(2)) when compared to controls (0.819 ± 0.114 g/cm(2)). Majority of the patients (61%) had low femoral neck BMD (P = 0.04). There was no significant difference in the proportion of subjects with vitamin D deficiency (<20 ng/mL) between cases (n = 32) and controls (n = 37) (P = 0.234).
  
  
  CONCLUSIONS
  Vitamin D deficiency was seen in both the groups in equal proportions, highlighting the existence of a high prevalence of this problem in India. Low femoral neck BMD found in cases may stress the need for supplementing calcium and treating vitamin D deficiency in this specific group. However, the benefit of such intervention has to be studied in a larger proportion of epileptic patients.
authors.affiliation: Department of Endocrinology, Diabetes and Metabolism, Unit-III, Christian Medical College, Vellore, Tamil Nadu, India.
authors.forename: George
authors.initials: G
authors.lastname: Koshy
authors.affiliation: Department of Endocrinology, Diabetes and Metabolism, Unit-III, Christian Medical College, Vellore, Tamil Nadu, India.
authors.forename: Ron Thomas
authors.initials: RT
authors.lastname: Varghese
authors.affiliation: Department of Endocrinology, Diabetes and Metabolism, Unit-III, Christian Medical College, Vellore, Tamil Nadu, India.
authors.forename: Dukhabandhu
authors.initials: D
authors.lastname: Naik
authors.affiliation: Department of Endocrinology, Diabetes and Metabolism, Unit-III, Christian Medical College, Vellore, Tamil Nadu, India.
authors.forename: Hesargatta Shyamsunder
authors.initials: HS
authors.lastname: Asha
authors.affiliation: Department of Endocrinology, Diabetes and Metabolism, Unit-III, Christian Medical College, Vellore, Tamil Nadu, India.
authors.forename: Nihal
authors.initials: N
authors.lastname: Thomas
authors.affiliation: Department of Endocrinology, Diabetes and Metabolism, Unit-III, Christian Medical College, Vellore, Tamil Nadu, India.
authors.forename: Mandalam Subramaniam
authors.initials: MS
authors.lastname: Seshadri
authors.affiliation: Department of Neurological Science, Unit-III, Christian Medical College, Vellore, Tamil Nadu, India.
authors.forename: Mathew
authors.initials: M
authors.lastname: Alexander
authors.affiliation: Department of Neurological Science, Unit-III, Christian Medical College, Vellore, Tamil Nadu, India.
authors.forename: Maya
authors.initials: M
authors.lastname: Thomas
authors.affiliation: Department of Neurological Science, Unit-III, Christian Medical College, Vellore, Tamil Nadu, India.
authors.forename: Sanjith
authors.initials: S
authors.lastname: Aaron
authors.affiliation: Department of Endocrinology, Diabetes and Metabolism, Unit-III, Christian Medical College, Vellore, Tamil Nadu, India.
authors.forename: Thomas Vizhalil
authors.initials: TV
authors.lastname: Paul
keywords: Anticonvulsants; bone mineral density; epilepsy; vitamin D