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Bone Mineral Density and Bone Markers in the Children with Epilepsy Taking on Chronic Anticonvulsants

Korean Journal of Pediatrics 2005;48(5):527-533.
Published online May 15, 2005.
Bone Mineral Density and Bone Markers in the Children with Epilepsy Taking on Chronic Anticonvulsants
Soon Bum Lee, So Young Kang, Jeesuk Yu
Department of Pediatrics, College of Medicine, Dankook University, Cheonan, Korea
장기간 항경련제를 복용하고 있는 소아 간질 환아들의 골밀도 및 골대사 지표들
이순범, 강소연, 유지숙
단국대학교 의과대학 소아과학교실
Correspondence: 
Jeesuk Yu, Email: dryujs@dankook.ac.kr
Abstract
Purpose
: Long-term administration of anticonvulsants in children with epilepsy may cause short stature, hypocalcemia and low bone mineral density. This study was performed for the early detection of abnormal bone metabolism in children with epilepsy on taking anticonvulsants.
Methods
: Thirty children aged 5 to 16 years who were diagnosed with epilepsy were enrolled in this study. All had taken anticonvulsants for more than one year. Bone mineral density of lumbar vertebra was measured by dual-energy X-ray absorptiometry. Serum calcium, phosphorous, alkaline phosphatase, 25-hydroxycholecalciferol[25(OH)D3], parathyroid hormone, and urine deoxypyridinoline were measured as biochemical bone markers. Bone age and body mass index were also calculated.
Results
: Bone minreal density, body mass index, bone age, and height were significantly decreased in two female patients who had taken two antiepileptic drugs for more than four years and they also had chronic diseases such as cerebral palsy with microcephaly, encephalomalacia, and microcephaly with atrial septal defect. Bone mineral density had significant positive correlations with body mass index(P<0.01) and bone age(P<0.01).
Conclusion
: This study showed chronic medication of anticonvulsants in children may cause low bone mineral density and short stature. Bone age and body mass index could be the important surrogate markers to find the population at risk. More studies, including a large study population and long term cohort study, will be required.
Key Words: Bone mineral density , Bone markers , Child , Epilepsy , Anticonvulsants


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