Vitamin D deficiency in a Portuguese epilepsy cohort: who is at risk and how to treat.

Abstract

The epilepsy-related risk factors for vitamin D deficiency, particularly the use of enzyme-inducing antiepileptic drugs (EIAEDs), and how to treat vitamin D deficiency in patients with epilepsy remain unclear. Our aims were to explore risk factors and the influence of EAIEDs in vitamin D status and to determine the efficacy of a daily dose of oral cholecalciferol (vitamin D3) in epileptic patients with vitamin D deficiency. Clinical data were collected and 25-hydroxyvitamin D (25(OH)D) serum levels were measured. All patients with vitamin D deficiency (25(OH)D ≤20 ng/mL) or insufficiency (25(OH)D from 21-29 ng/mL) were treated with 6,670 IU/day cholecalciferol for eight weeks and 25(OH)D was then remeasured. Descriptive and inferential statistics were employed. A total of 92 patients (44.6% males), with mean age of 41.0±14.8 years, were included. Measurements of 25(OH)D revealed that 79.3% patients had abnormal levels: 56.5% were vitamin D deficient and 22.8% were vitamin D insufficient. The statistically significant risk factors for vitamin D deficiency identified were: number of AEDs, treatment with EIAEDs, low sun exposure, high body mass index (BMI) and a high frequency of epileptic seizures. After treatment, 25(OH)D mean level increased by 98.99% (regardless of EIAED use or being overweight). In our sample, more than half of the adults with epilepsy showed 25(OH)D deficiency. Patients on EIAEDs had lower 25(OH)D levels. A daily dose of 6,670 IU cholecalciferol successfully led to the correction of 25(OH)D levels. A higher dose in obese patients or in patients taking EIAEDs may not be warranted and this should be considered in future guidelines for routine vitamin D deficiency treatment.

• Authors: Inês Antunes Cunha, Ana Mr Saraiva, Pedro Lopes, Joana Jesus-Ribeiro, Cátia Duarte, Fátima Leitão, Francisco Sales, Isabel Santana, Conceição Bento
• Journal: Epileptic disorders : international epilepsy journal with videotape (Epileptic Disord) Vol. 23 Issue 2 Pg. 291-298 (Apr 01 2021) ISSN: 1950-6945 [Electronic] United States
• PMID: 33875410 (Publication Type: Journal Article)

Chemical References

• Vitamins
• Vitamin D
• Cholecalciferol

Topics

• Adult
• Cholecalciferol
• Epilepsy (drug therapy, etiology)
• Female
• Humans
• Male
• Middle Aged
• Portugal
• Vitamin D
• Vitamin D Deficiency (complications, drug therapy, epidemiology)
• Vitamins