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The effect of valproate on bone mineral density in adult epileptic patients.
Pharmacol Res. 2004 Jul; 50(1):93-7.PR

Abstract

The effect of long-term valproate (VPA) treatment on bone mineral density (BMD) in adult epileptic patients is not clearly known, although several studies have been done in children. In adult epileptic patients (n = 50; 24 men, 26 women) treated with VPA, the bone mineral density at lumbar level (L1-L4) and neck, trochanter, and intertrochanter regions of left femur was studied by dual energy X-ray absorptiometry (DXA) at the beginning of the study and after 6 months, with the specific aim to evaluate the effect of long-term valproate monoteraphy on bone mineral density. Routine biochemical parameters were also evaluated. Sixty healthy control subjects were evaluated. Control subjects were similar to patient group with respect to age, race (all White), geographic area, and socioeconomic status. Lumbar and femural BMD values were significantly lower in patient group than control group (0.814 +/- 0.157 g/cm(2) versus 0.894 +/- 0.102 g/cm(2), P = 0.003) and (0.824 +/- 0.144 g/cm(2) versus 0.906 +/- 0.104 g/cm(2), P = 0.001), respectively. Osteopenia were detected in 13 of 60 control subjects (22%) and the others had no osteoporosis. In epileptic group, osteoporosis and osteopenia were detected in 8 subjects (16%), and in 26 subjects (52%), respectively. In epileptic group 16 subjects were normal (32%) at the lumbar regions, and 7 had osteoporosis (14%), 28 had osteopenia (56%), and 15 were normal (30%) at the femoral region. In the second measurements of the patients on valproate treatment, after 6 months, all of the DXA BMD values had worsened compared with the first measurements (P = 0.001 for lumbar BMD values and P = 0.004 for femural BMD values). In the patient group, a significant inverse correlation was observed between duration of valproate therapy and all DXA BMD values in the first and second measurements. Parathyroid hormone, alkaline phosphatase, and phosphor levels of patients were significantly higher than those of control group (52 +/- 11 pg/ml versus 46 +/- 13 pg/ml, P = 0.013), (113 +/- 32 U/l versus 95 +/- 36 U/l, P = 0.006), and (4.50 +/- 0.5 mg/dl versus 4.0 +/- 0.7 mg/dl, P = 0.0001), respectively. However, all of the parameters were within the normal reference ranges. It has been concluded that long-term (more than one year) valproate treatment induces a decrease in bone mineral density in epileptic adults. However, the multivariate analysis did show no association between BMD changes and parathyroid hormone, alkaline phosphatase or phosphorus levels.

Authors+Show Affiliations

Department of Neurology, Turgut Ozal Medical Center, University of Inonu, Malatya, Turkey. aboluk@inonu.edu.trNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Clinical Trial
Journal Article

Language

eng

PubMed ID

15082034

Citation

Boluk, Ayhan, et al. "The Effect of Valproate On Bone Mineral Density in Adult Epileptic Patients." Pharmacological Research, vol. 50, no. 1, 2004, pp. 93-7.
Boluk A, Guzelipek M, Savli H, et al. The effect of valproate on bone mineral density in adult epileptic patients. Pharmacol Res. 2004;50(1):93-7.
Boluk, A., Guzelipek, M., Savli, H., Temel, I., Ozişik, H. I., & Kaygusuz, A. (2004). The effect of valproate on bone mineral density in adult epileptic patients. Pharmacological Research, 50(1), 93-7.
Boluk A, et al. The Effect of Valproate On Bone Mineral Density in Adult Epileptic Patients. Pharmacol Res. 2004;50(1):93-7. PubMed PMID: 15082034.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The effect of valproate on bone mineral density in adult epileptic patients. AU - Boluk,Ayhan, AU - Guzelipek,Mehmet, AU - Savli,Haluk, AU - Temel,Ismail, AU - Ozişik,Handan Işin, AU - Kaygusuz,Akif, PY - 2003/11/17/accepted PY - 2004/4/15/pubmed PY - 2004/12/23/medline PY - 2004/4/15/entrez SP - 93 EP - 7 JF - Pharmacological research JO - Pharmacol Res VL - 50 IS - 1 N2 - The effect of long-term valproate (VPA) treatment on bone mineral density (BMD) in adult epileptic patients is not clearly known, although several studies have been done in children. In adult epileptic patients (n = 50; 24 men, 26 women) treated with VPA, the bone mineral density at lumbar level (L1-L4) and neck, trochanter, and intertrochanter regions of left femur was studied by dual energy X-ray absorptiometry (DXA) at the beginning of the study and after 6 months, with the specific aim to evaluate the effect of long-term valproate monoteraphy on bone mineral density. Routine biochemical parameters were also evaluated. Sixty healthy control subjects were evaluated. Control subjects were similar to patient group with respect to age, race (all White), geographic area, and socioeconomic status. Lumbar and femural BMD values were significantly lower in patient group than control group (0.814 +/- 0.157 g/cm(2) versus 0.894 +/- 0.102 g/cm(2), P = 0.003) and (0.824 +/- 0.144 g/cm(2) versus 0.906 +/- 0.104 g/cm(2), P = 0.001), respectively. Osteopenia were detected in 13 of 60 control subjects (22%) and the others had no osteoporosis. In epileptic group, osteoporosis and osteopenia were detected in 8 subjects (16%), and in 26 subjects (52%), respectively. In epileptic group 16 subjects were normal (32%) at the lumbar regions, and 7 had osteoporosis (14%), 28 had osteopenia (56%), and 15 were normal (30%) at the femoral region. In the second measurements of the patients on valproate treatment, after 6 months, all of the DXA BMD values had worsened compared with the first measurements (P = 0.001 for lumbar BMD values and P = 0.004 for femural BMD values). In the patient group, a significant inverse correlation was observed between duration of valproate therapy and all DXA BMD values in the first and second measurements. Parathyroid hormone, alkaline phosphatase, and phosphor levels of patients were significantly higher than those of control group (52 +/- 11 pg/ml versus 46 +/- 13 pg/ml, P = 0.013), (113 +/- 32 U/l versus 95 +/- 36 U/l, P = 0.006), and (4.50 +/- 0.5 mg/dl versus 4.0 +/- 0.7 mg/dl, P = 0.0001), respectively. However, all of the parameters were within the normal reference ranges. It has been concluded that long-term (more than one year) valproate treatment induces a decrease in bone mineral density in epileptic adults. However, the multivariate analysis did show no association between BMD changes and parathyroid hormone, alkaline phosphatase or phosphorus levels. SN - 1043-6618 UR - https://www.unboundmedicine.com/medline/citation/15082034/The_effect_of_valproate_on_bone_mineral_density_in_adult_epileptic_patients_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1043661803003797 DB - PRIME DP - Unbound Medicine ER -