Effects Of Valproic Acid And Levetiracetam On Bone Metabolism In Preschoolers And School-age Children

Epilepsy is one of the most common neurological disorders,and it is estimated that there are fifty million people with epilepsy.Since the early reports that antiepileptic drugs could release bone metabolic diseases,people pay more and more attention to the effect of antiepileptic drugs on bone metabolism.In China,60%of people with epilepsy originated from childhood,which is the key period for the development of bone.Therefore,exploring the effect of antiepileptic drugs on children bone metabolism is especially important.The common antiepileptic drugs for children is valproate(VPA),carbamazepine(CBZ),and Oxcarbazepine(OXC),levetiracetam(LEV)as newer antiepileptic drugs.Many reports incriminated antiepileptic drugs with enzyme induction activity or their metabolism through hepatic enzyme,as cause of metabolic bone disease due to increasing metabolism of vitamin D.Recently,other studies show that non-enzyme induction antiepileptic drugs can also cause bone metabolic abnormalities,but the mechanism is unclear.Therefore,exploring the effect of non-enzyme induction antiepileptic drugs(VPA,LEV)on children bone metabolism furtherly is necessary.Objective In this study,we will analyze the effect of valproic acid,levetiracetam monotherapy on bone metabolism in preschoolers and school-age children,and try to discover the mechanism of this.Methods Select thirty-nine preschool patients who received monotherapy with antiepileptic drugs,twenty treat with valproic acid,nineteen with levetiracetam;forty school-age patients,twenty-one kids treat with valproic acid,nineteen with levetiracetam as study groups and forty-one healthy children as control groups,twenty-one preschoolers,twenty school-age children..Serum calcium,phosphorus,alkaline phosphate(ALP)and 25-hydroxyvitamin D[25-(OH)D]were measured in healthy controls and in treatment group before,3 and 6 months after antiepileptic drugs treatmentResults There were no significant differences in bone metabolism among preschool and school-age patients who treat with valproic acid or levetiracetam before therapy and noramal groups.Serum calcium,phosphorus,ALP and 25-(OH)D levels showed no marked changes after 3 and 6 months treatment in preschool and school-age patients who treat with levetiracetain.So as preschool patients who treat with valproic acid.But ALP levels were higher than those before treatment in school-age patients who treat with valproic acid after 6 months,however,other serum biochemical parameters showed on significant differences.Conclusion The effect of Levetiracetam monotherapy for serum calcium,phosphorus,alkaline phosphate and 25-hydroxyvitamin D is not obvious in preschool and school-age epileptic patients;valproic acid may influence serum alkaline phosphate of school-age epileptic patients in short time.