| Objective: To investigate the effect of AEDs monotherapy on some bone metabolism indexes in children with epilepsy,to explore its mechanism,and to further discuss whether whether it is necessary to regularly monitor bone metabolism or take preventive measures to reduce the risk of bone disease in children with epilepsy.Methods: Children with epilepsy attending the epilepsy specialist outpatient clinic of the paediatric first Department of Handan centre hospital between March 2019 and June 2020 were selected for the study.The case group was divided into oxcarbazepine(OXC)group(32 patients),levetiracetam(LEV)group(39 patients),valproate(VPA)group(47 patients),and the control group was children with epilepsy who were observed clinically during the same period(43 patients).Serum levels of calcium(Ca),phosphorus(P),25 hydroxyvitamin D(25-OH-VD),parathyroid hormone(PTH),alkaline phosphatase(ALP),osteocalcin(OC)were analyzed in children with epilepsy before medication,after 3 months and 6 months of medication to explore the effect and mechanism of AEDs monotherapy on some bone metabolic indexes in children with epilepsy.The differences in serum levels of calcium(CA),phosphorus(P),25 hydroxyvitamin D(25-OH-VD),parathyroid hormone(PTH),alkaline phosphatase(ALP),osteocalcin(OC)among children with epilepsy before medication,after 3months and 6 months of medication were analyzed to explore the effects and mechanisms of AEDs monotherapy on some bone metabolic indexes of children with epilepsy.Results: After strict screening,161 children with epilepsy were enrolled in this study.At the end of 3 months after receiving OXC,VPA and LEV single drug treatment,none of the bone metabolic indexes in each group significantly different from those before treatment(P > 0.05).The level of 25-OH-VD(23.94±4.28ng/ml)at the end of 6months after receiving OXC monotherapy was lower than that before treatment(28.31±4.99ng/ml),and the level of Ca(2.31±0.08mmol/L)at the end of 6 months was lower than that before treatment(2.39±0.08mmol/L),all were statistically significant(P< 0.05).No significant changes were observed in the levels of bone metabolic markers at the end of 6 months after receiving LEV monotherapy(P > 0.05).The level of Ca(2.32±0.10mmol/L)was lower than that before treatment(2.36±0.07mmol/L),the level of 25-OH-VD(21.28±4.52ng/ml)was lower than that before treatment(29.13±4.25ng/ml),and the level of PTH(53.34±10.28pg/ml)was higher than that before treatment(40.94±14.54pg/ml),all of which were statistically significant(P <0.05).Conclusions: In OXC group,Ca and 25-OH-VD decreased at the end of 6 months.LEV monotherapy had no significant adverse effect on serum markers of bone metabolism in children with epilepsy.In VPA group,serum Ca and 25-OH-VD were decreased and PTH was increased at the end of 6 months.Clinicians should conduct regular monitoring of relevant bone metabolism indicators in children on long-term oral AEDs and add vitamin D combination therapy appropriately according to the bone metabolism level. |
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