Gender Differences Of Bone Mineral Density And Relative Factors In Patients With Epilepsy

Objective To evaluate changes of bone mineral density(BMD)and relative biochemical indicators of bone metabolism in patients with epilepsy,to explore potential influencing factors and gender differences of abnormal bone metabolism in patients with epilepsy,to assess characteristics of bone loss in women with epilepsy,cause the attention of clinicians,and in addition to provide reference data for clinical treatment.Methods In this study, patients were long-time follow-ups in nerological epilepsy clinics of tianjin medical university general hospital.110 women with epilepsy were observed,compared to 45 healthy women and 40 healthy men and 96 men with epilepsy as control groups.Relative clinical data of patients and healthy controls were collected,BMD and biochemical indicators were measured in the experimental groups and the control groups respectively.The women epileptic group was compared to the healthy group and men with epilepsy group.Divide epileptic patients into groups by age(10 age year as one group,4 groups in total),cause(≤15years、>15years),time on the therapy(≤10years、>10years),type of drug(hepatic enzyme induce AEDs、nonhepatic enzyme induce AEDs),number of drug intake(monotherapy、polypharmacy),type of seizures(convulsion seizure、nonconvulsion seizure),frequency of seizures(≤10times/year 、 >10times/year) in women and men patients relatively,analyses were conducted among groups, all of the data were analyzed by statistical methods,to explore the above factors effects on BMD.Result Incidence of low BMD and the parathyroid hormone increased in the patients groups compared to the healthy groups,incidence of low BMD in female patients group was higher than male patients group(P<0.05).Analysis of influencing factors,age、time on treatment、number of antiepileptic drugs(AEDs) and type of seizures 、 frequency of seizures 、 course all have adverse impact on BMD(P<0.05).Aging,the time on therapy,number of AEDs and seizures all have negative impacts on bone metabolism.The effect of age on BMD was more visible in female patients group.In women with epilepsy,BMD is lower in group above 40 years old than yonger patients. P<0.001.and in 50-60 age group, incidence of low BMD in female patients is higher when compared to men,P=0.044。Significant effect of course and type of AEDs on BMD was only found in female patients group. BMD of duration of course more than 15 years group is lower than cause of group shorter, P=0.007.Patients on enzyme induce AEDs bear lower BMD than those who use other AEDs,p=0.045。Mutivariate regression analysis showed,age、course、number of AEDs were risk factors to female patients with abnormal bone metabolism,while time on treatment、number of AEDs were risk factors to male patients(P<0.05).Conclusion Epilepsy and AEDs both have negative impact on BMD, may lead to secondary hyperparathyroidism, resulting in bone loss.Aging effects on bone were more obviously in women,monitoring BMD in women above 40 years old is necessary. On the other hand,course,number of AEDs,seizures also have negative impact on BMD.Therefore making reasonable choice of medication for patients to achieve effective control of seizures,to decrease frequency of seizures,avoiding serious seizures,and shortening the course as possible is effective for prevention of bone loss。In addition,patients should avoid accident by seizures,be care of trauma to reduce fracture risk.Incidence of low BMD in female patients group was higher than male patients group,and more influencing factors contribute to abnormal BMD in female patients than male patients.Women with epilepsy was a special group in epileptic patients,and they face many problems such as pregnancy,birth,raise the young problems,in addition women play an important role in family,so more attention should be paid to female patients in clinical treatment.