Abstract | BACKGROUND: OBJECTIVE: To assess the relationship of VPA to bone mass and calcium metabolism in 40 adults with epilepsy on long-term VPA monotherapy, 40 age- and sex-matched epileptic patients taking phenytoin (PHT), and 40 healthy control subjects. Bone mineral density (BMD) of the second metacarpal was determined as T- and Z-scores. RESULTS: BMD reduction from control values was 14% (12% in men, 16% in women) with VPA and 13% (12% in men, 15% in women) with PHT. Among patients on VPA, nine (23%) had T-scores below -2.5 SD, suggesting osteoporosis; 15 (37%) had T-scores between -1 and -2.5 SD, suggesting osteopenia. Serum concentrations of calcium were significantly higher with VPA than in PHT or control groups. Serum concentrations of bone Gla protein (a bone formation marker) and pyridinoline cross-linked carboxy-terminal telopeptide of type I collagen (ICTP; a bone resorption marker) associated with either drug significantly exceeded control values. Z-scores for BMD in the VPA group correlated negatively with calcium and ICTP. High ICTP correlated positively with ionized calcium, implying that increased bone resorption caused the latter. CONCLUSION: Long-term VPA monotherapy can increase bone resorption, leading to decreased BMD.
|
Authors | Y Sato, I Kondo, S Ishida, H Motooka, K Takayama, Y Tomita, H Maeda, K Satoh |
Journal | Neurology
(Neurology)
Vol. 57
Issue 3
Pg. 445-9
(Aug 14 2001)
ISSN: 0028-3878 [Print] United States |
PMID | 11502911
(Publication Type: Journal Article, Retracted Publication)
|
Chemical References |
- Anticonvulsants
- Valproic Acid
|
Topics |
- Adult
- Anticonvulsants
(therapeutic use)
- Bone Density
(drug effects, physiology)
- Bone and Bones
(drug effects, physiopathology)
- Epilepsy
(drug therapy, physiopathology)
- Female
- Humans
- Male
- Middle Aged
- Valproic Acid
(therapeutic use)
|