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Both epilepsy and anti‐seizure medications affect bone metabolism in children with self‐limited epilepsy with centrotemporal spikes

骨重建 癫痫 内科学 医学 骨钙素 内分泌学 甲状旁腺激素 维生素D与神经学 奥卡西平 骨矿物 N-末端末端肽 碱性磷酸酶 胃肠病学 骨质疏松症 化学 卡马西平 精神科 生物化学
作者
Xiu‐Yu Shi,Jun Ju,Qian Lu,Lin‐Yan Hu,Yaping Tian,Guang‐Hong Guo,Z. J. Liu,Gefei Wu,Hong‐Min Zhu,Yu‐Qin Zhang,Dong Li,Li Gao,Yang Liu,Chunyu Wang,Jianxiang Liao,Jiwen Wang,Shuizhen Zhou,Hua Wang,Xiaojing Li,Jing‐Yun Gao,Li Zhang,Xiaomei Shu,Dan Li,Yan Li,Chunhong Chen,Xiu‐Ju Zhang,Jianmin Zhong,Qiong‐Xiang Zhai,Yan‐Hong Sun,Xuefeng Lin,Rong‐Na Ren,Fei Yin,Yanhui Chen,Fei‐Yong Jia,Zhixian Yang,Ju‐Li Wang,Zhe‐Zhi Xia,Li‐Wen Wang,Rong Luo,Li‐Ping Zou
出处
期刊:Epilepsia [Wiley]
卷期号:64 (10): 2667-2678 被引量:4
标识
DOI:10.1111/epi.17733
摘要

Bone metabolism can be influenced by a range of factors. We selected children with self-limited epilepsy with centrotemporal spikes (SeLECTS) and lifestyles similar to those of healthy children to control for the confounding factors that may influence bone metabolism. We aimed to identify the specific effects of epilepsy and/or anti-seizure medications (ASMs) on bone metabolism.Patients with SeLECTS were divided into an untreated group and a monotherapy group, and the third group was a healthy control group. We determined the levels of various biochemical markers of bone metabolism, including procollagen type I nitrogenous propeptide (PINP), alkaline phosphatase (ALP), osteocalcin (OC), collagen type I cross-linked C-telopeptide (CTX), calcium, magnesium, phosphorus, parathyroid hormone (PTH), and vitamin D3 (VD3 ).A total of 1487 patients (from 19 centers) were diagnosed with SeLECTS; 1032 were analyzed, including 117 patients who did not receive any ASMs (untreated group), 643 patients who received only one ASM (monotherapy group), and 272 children in the healthy control group. Except for VD3 , other bone metabolism of the three groups were different (p < .001). Bone metabolism was significantly lower in the untreated group than the healthy control group (p < .05). There were significant differences between the monotherapy and healthy control group in the level of many markers. However, when comparing the monotherapy and untreated groups, the results were different; oxcarbazepine, levetiracetam, and topiramate had no significant effect on bone metabolism. Phosphorus and magnesium were significantly lower in the valproic acid group than the untreated group (adjusted p < .05, Cliff's delta .282-.768). CTX was significantly higher in the lamotrigine group than in the untreated group (adjusted p = .012, Cliff's delta = .316).Epilepsy can affect many aspects of bone metabolism. After controlling epilepsy and other confounders that affect bone metabolism, we found that the effects of ASMs on bone metabolism differed. Oxcarbazepine, levetiracetam, and topiramate did not affect bone metabolism, and lamotrigine corrected some of the abnormal markers of bone metabolism in patients with epilepsy.
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