托吡酯
拉莫三嗪
内分泌学
内科学
骨矿物
骨重建
苯妥英钠
医学
骨吸收
骨钙素
化学
骨质疏松症
癫痫
碱性磷酸酶
生物化学
酶
精神科
作者
Junkichi Kanda,Nobuo Izumo,Yoshiko Kobayashi,Kenji Onodera,Taketoshi Shimakura,Noriaki Yamamoto,Hideaki Takahashi,Hiroyuki Wakabayashi
出处
期刊:Biomedical research
[Biomedical Research Press]
日期:2017-01-01
卷期号:38 (5): 297-305
被引量:12
标识
DOI:10.2220/biomedres.38.297
摘要
Long-term treatment with antiepileptic drugs (AED) is associated with an elevated risk of bone fracture due to decreased bone mineral density (BMD). Phenytoin has been shown to affect bone metabolism adversely, whereas newly developed AEDs have not been studied. This study evaluated the effects of topiramate and lamotrigine on bone metabolism in rats. Five-week-old male Sprague-Dawley rats were treated orally with phenytoin (20 mg/kg), topiramate (5 or 20 mg/kg), or lamotrigine (2 or 10 mg/kg) daily for 12 weeks. Phenytoin reduced bone strength, measured by maximum load to failure of the femoral mid-diaphysis, along with reduced femur total BMD. Serum tartrate-resistant acid phosphatase-5b levels significantly increased after phenytoin treatment, while serum osteocalcin levels decreased after topiramate 20 mg/kg treatment. Furthermore, osteoblast surface and bone mineralizing surface were significantly lowered by topiramate. Lamotrigine treatment did not affect bone strength, BMD, or bone turnover. We demonstrated that phenytoin treatment significantly increased bone resorption and lowered BMD and bone strength. Since lamotrigine did not affect bone metabolism, it can be concluded that lamotrigine is safety medicine for bone health. Topiramate was associated with decreased bone formation, which may affect bone strength and BMD with chronic use. Thus, patients taking topiramate should be monitored for changes in BMD to avoid risk of fracture.
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