Bone metabolism in healthy ambulatory control premenopausal women and in epileptics on anti-convulsant drugs.

Citation:
Kwasa JK, Amayo A NPMKTO. "Bone metabolism in healthy ambulatory control premenopausal women and in epileptics on anti-convulsant drugs." East Afr Med Journal. 2010;87(4):151-155.

Abstract:

Abstract
BACKGROUND:
Long term anti-epileptic drug use causes multiple abnormalities in calcium and bone metabolism that have been documented in both institutionalised and ambulatory patients.
OBJECTIVE:
To assess bone metabolism in ambulatory females of reproductive age, on antiepileptic drugs.
DESIGN:
Cross sectional comparative study.
SUBJECTS:
Ambulatory females in reproductive age group with epilepsy and on regular follow up were compared to healthy females of similar ages not on any treatment.
RESULTS:
The mean duration of treatment for epilepsy was eight years (+/- 6.3). Majority of the patients were on enzyme inducing drugs like phenobarbital, phenytoin, carbamazepine and valproate, either alone or in combination with non-enzyme inducers like lamotrigine (98.2%). There was a significantly lower mean serum calcium and a higher alkaline phosphatase level among the patients (P = 0.002 and 0.0001 respectively) than among the comparators. The urinary marker of bone loss (mean urine calcium excretion) was also significantly raised among the patients (P=0.003). The mean lumbar BMDT-score results were not significantly different in the two groups.
CONCLUSIONS:
Long-term anti-epileptic drug use significantly affects biochemical parameters of bone metabolism. These effects on bone biochemistry markers were not reflected in lumbar spine BMD in this study.

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