title: Effects of antiepileptic drugs on bone mineral density and bone metabolism in children: a meta-analysis.
abstract: OBJECTIVE
  The aim of our meta-analysis was to assess the effects of antiepileptic drugs on bone mineral density and bone metabolism in epileptic children.
  
  
  METHODS
  Searches of PubMed and Web of Science were undertaken to identify studies evaluating the association between antiepileptic drugs and bone mineral density and bone metabolism.
  
  
  RESULTS
  A total of 22 studies with 1492 subjects were included in our research. We identified: (1) a reduction in bone mineral density at lumbar spine (standardized mean difference (SMD)=-0.30, 95% confidence interval (CI) [-0.61, -0.05]), trochanter (mean difference (MD)=-0.07, 95% CI [-0.10, -0.05]), femoral neck (MD=-0.05, 95% CI [-0.09, -0.02]), and total body bone mineral density (MD=-0.33, 95% CI [-0.51, -0.15]); (2) a reduction in 25-hydroxyvitamin D (MD=-3.37, 95% CI [-5.94, -0.80]) and an increase in serum alkaline phosphatase (SMD=0.71, 95% CI [0.38, 1.05]); (3) no significant changes in serum parathyroid hormone, calcium, or phosphorus.
  
  
  CONCLUSIONS
  Our meta-analysis suggests that treatment with antiepileptic drugs may be associated with decreased bone mineral density in epileptic children.
authors.affiliation: Neuroscience Care Unit, the Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou 310009, China; Department of Neurosurgery, the Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou 310009, China.
authors.forename: Ying
authors.initials: Y
authors.lastname: Zhang
authors.forename: Yu-xin
authors.initials: YX
authors.lastname: Zheng
authors.forename: Jun-ming
authors.initials: JM
authors.lastname: Zhu
authors.forename: Jian-min
authors.initials: JM
authors.lastname: Zhang
authors.forename: Zhe
authors.initials: Z
authors.lastname: Zheng
mesh_terms: D000293:Adolescent; D000927:Anticonvulsants / Q000008:administration & dosage* / Q000009:adverse effects; D015519:Bone Density / Q000187:drug effects*; D001851:Bone Diseases, Metabolic / Q000139:chemically induced* / Q000453:epidemiology / Q000378:metabolism*; D001842:Bone and Bones / Q000187:drug effects / Q000378:metabolism*; D002648:Child; D002675:Child, Preschool; D004305:Dose-Response Relationship, Drug; D004827:Epilepsy / Q000188:drug therapy / Q000453:epidemiology / Q000503:physiopathology; D005260:Female; D006801:Humans; D008297:Male; D016896:Treatment Outcome
chemical_list: D000927:Anticonvulsants
keywords: Antiepileptic drugs; Bone metabolism; Bone mineral density; Children; Meta-analysis