title: Greater Calcium Intake is Associated with Better Bone Health Measured by Quantitative Ultrasound of the Phalanges in Pediatric Patients Treated with Anticonvulsant Drugs.
abstract: We aimed to investigate and compare the effects of chronic antiepileptic therapy on bone health in pediatric patients using quantitative ultrasound of the phalanges (QUS) and controlling for potential confounding factors, particularly nutrient intake. The amplitude-dependent speed of sound (Ad-SoS) was measured in 33 epileptic children and 32 healthy children aged 6.5 ± 3.1 and 6.3 ± 1.1 (mean ± SD) years, respectively. There were no significant differences in the demographics such as age, weight and height between epileptic children and the control group children. None of the children in the epileptic or the treatment group were found to have a vitamin D deficiency. There were no significant differences in laboratory tests between groups. Lower QUS figures were found in the epileptic children (p = 0.001). After further adjustment for potential confounders such age, height, weight, calcium intake, vitamin D intake, physical activity and sex, the differences remained significant (p < 0.001). After further classification of the participants based on the tertile of calcium intake, no significant differences were found between patients and healthy controls in the greatest tertile of calcium intake (p = 0.217). We conclude that anticonvulsant therapy using valproate may lead to low bone mass in children and that an adequate intake of calcium might counteract such deleterious effects.
authors.affiliation: Metabolic Bone Disease Research Group, School of Nursing and Occupational Therapy, University of Extremadura, Cáceres 10003, Spain. viventevera@odon.ucm.es.
authors.forename: Vicente
authors.initials: V
authors.lastname: Vera
authors.affiliation: Metabolic Bone Disease Research Group, School of Nursing and Occupational Therapy, University of Extremadura, Cáceres 10003, Spain. jmmorang@unex.es.
authors.forename: Jose M
authors.initials: JM
authors.lastname: Moran
authors.affiliation: Metabolic Bone Disease Research Group, School of Nursing and Occupational Therapy, University of Extremadura, Cáceres 10003, Spain. pbarrosg@yahoo.es.
authors.forename: Patricia
authors.initials: P
authors.lastname: Barros
authors.affiliation: Metabolic Bone Disease Research Group, School of Nursing and Occupational Therapy, University of Extremadura, Cáceres 10003, Spain. luzcanal@unex.es.
authors.forename: Maria L
authors.initials: ML
authors.lastname: Canal-Macias
authors.affiliation: Metabolic Bone Disease Research Group, School of Nursing and Occupational Therapy, University of Extremadura, Cáceres 10003, Spain. rafaelbonmatty@unex.es.
authors.forename: Rafael
authors.initials: R
authors.lastname: Guerrero-Bonmatty
authors.affiliation: Metabolic Bone Disease Research Group, School of Nursing and Occupational Therapy, University of Extremadura, Cáceres 10003, Spain. ccosta@unex.es.
authors.forename: Carmen
authors.initials: C
authors.lastname: Costa-Fernandez
authors.affiliation: Metabolic Bone Disease Research Group, School of Nursing and Occupational Therapy, University of Extremadura, Cáceres 10003, Spain. jmlavado@unex.es.
authors.forename: Jesus M
authors.initials: JM
authors.lastname: Lavado-Garcia
authors.affiliation: Metabolic Bone Disease Research Group, School of Nursing and Occupational Therapy, University of Extremadura, Cáceres 10003, Spain. rroncero@unex.es.
authors.forename: Raul
authors.initials: R
authors.lastname: Roncero-Martin
authors.affiliation: Metabolic Bone Disease Research Group, School of Nursing and Occupational Therapy, University of Extremadura, Cáceres 10003, Spain. jpedrera@unex.es.
authors.forename: Juan D
authors.initials: JD
authors.lastname: Pedrera-Zamorano
mesh_terms: D000927:Anticonvulsants / Q000009:adverse effects*; D015519:Bone Density / Q000187:drug effects*; D002118:Calcium / Q000008:administration & dosage / Q000494:pharmacology*; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D004032:Diet; D005247:Feeding Behavior; D005260:Female; D050278:Finger Phalanges; D006801:Humans; D008297:Male
chemical_list: D000927:Anticonvulsants; D002118:Calcium
keywords: antiepileptic therapy; bone health; children; quantitative ultrasound