Journal of the Korean Pediatric Society 2001;44(7):778-785.
Published online July 15, 2001.
The Changes of Biochemical Bone Markers in Pediatric Epileptic Children Who Received Long-term Antiepileptic Drugs and Usefullness Thereof
Eun Kyung Choi, Kyung Hee Kim, Sun Jun Kim
Department of Pediatrics, Medical School, Chonbuk National University, Chonju, Korea
장기간 항경련제를 투여 받은 간질 환아에서 골대사 표지자의 변화 및 유용성
최은경, 김경희, 김선준
전북대학교 의과대학 소아과학교실
Abstract
Purpose
: Long-term administration of anticonvulsants for pediatric epileptic patients may cause changes of bone metabolism. This study was performed to evaluate the influence of antiepileptics on the bone metabolism and growth in pediatric patients who received antiepileptics. Methods for early detection of adverse bone metabolism were also evaluated.
Methods
: Forty-eight epileptic patients were enrolled in this study. All subjects had taken antiepileptics for at least 6 months. Subjects were grouped according to the antiepileptics : Group I(n= 31) was treated with carbamazepine(CBZ), Group II(n=9) used valproic acids(VPA), Group III(n=8) received multi-drugs including CBZ, VPA. We determined serum osteocalcin and total alkaline phosphatase levels as markers of bone formation, and urinary deoxypyridinoline as marker of bone resorption. Blood and urine samples were collected before the initial medication and follow up at least 6 months later. Serum osteocalcin and urinary deoxypyridinoline were measured by an ELISA method, respectively. Data from subjects were analyzed statistically by SPSS(ver. 10).
Results
: Concentrations of serum osteocalcin and urinary deoxypyridinoline were significantly increased in the carbamazepine treated group. The increment of deoxypyridinoline positively correlated with the duration of treatment, especially in children who received carbamazepine therapy for more than 12 months(P<0.05). The serum concentration of calcium, phosphorus were within normal ranges, but the levels of alkaline phosphatase were significantly increased in all group(P<0.05).
Conclusion
: Our data suggests that serum osteocalcin and alkaline phosphatase, urinary deoxypyridinoline could be useful markers for the early detection of harmful bone metabolism during antiepileptic treatment.
Key Words: Osteocalcin, Deoxypyridinoline, Antiepileptics


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