title: Bone health and vitamin D status in young epilepsy patients on valproate monotherapy.
abstract: OBJECTIVE
  To evaluate bone health and vitamin D adequacy in a cohort of epilepsy patients on chronic valproate (VPA) monotherapy.
  
  
  METHODS
  Bone mineral density (BMD) using dual X-ray absorptiometry and serum concentrations of 25-hydroxyvitamin D, parathyroid hormone, calcium, phosphorus, and alkaline phosphatase were measured in 50 young adult epilepsy patients on VPA monotherapy and 50 age, sex and socioeconomically matched healthy subjects.
  
  
  RESULTS
  Mean age of epilepsy patients was 26±7.2 (±SD) years, and females constituted 66%. Significantly lower mean lumbar spine and femoral neck BMDs (g/cm(2)) and lower femoral neck Z-score were observed in epilepsy patients in comparison with controls. Prevalence of low BMD (Z-score ≤-2.0) was 26% and 10% at lumbar spine, and 10% and 4% at femoral neck in epileptic and control groups respectively. No correlation was found between duration or dosage of VPA and BMDs. Vitamin D deficiency (≤20ng/ml) was highly prevalent (>90%) in epilepsy patients and controls.
  
  
  CONCLUSIONS
  Chronic VPA therapy is associated with lower BMD measurements in young epilepsy patients. Hypovitaminosis D is highly prevalent in general population.
  
  
  CONCLUSIONS
  Prophylactic and therapeutic strategies against osteoporosis should be implemented in VPA-treated patients. Routine evaluation for bone disease by measuring BMD and supplementation of calcium and vitamin D can allow effective treatment of epilepsy without bone adverse effects.
authors.affiliation: Department of Pharmaceutics and Pharmaceutical Technology, School of Pharmacy, University of Damascus, Damascus, Syria.
authors.forename: Ola
authors.initials: O
authors.lastname: Albaghdadi
authors.affiliation: Department of Internal Medicine, School of Medicine, University of Damascus, Damascus, Syria.
authors.forename: Mohammad Salem
authors.initials: MS
authors.lastname: Alhalabi
authors.affiliation: Department of Internal Medicine, School of Medicine, University of Damascus, Damascus, Syria.
authors.forename: Zaynab
authors.initials: Z
authors.lastname: Alourfi
authors.affiliation: Department of Pharmaceutics and Pharmaceutical Technology, School of Pharmacy, University of Damascus, Damascus, Syria. Electronic address: ylama@hotmail.com.
authors.forename: Lama A
authors.initials: LA
authors.lastname: Youssef
mesh_terms: D000328:Adult; D000927:Anticonvulsants / Q000009:adverse effects*; D015519:Bone Density / Q000187:drug effects*; D015331:Cohort Studies; D004827:Epilepsy / Q000188:drug therapy*; D005260:Female; D006801:Humans; D008297:Male; D014635:Valproic Acid / Q000009:adverse effects*; D014807:Vitamin D / Q000031:analogs & derivatives* / Q000097:blood; D055815:Young Adult
chemical_list: D000927:Anticonvulsants; D014807:Vitamin D; D014635:Valproic Acid; C104450:25-hydroxyvitamin D
keywords: Bone mineral density; Epilepsy; Valproate; Vitamin D