Topiramate On Bone Metabolism In Patients With Epilepsy Impact

Epilepsy is common neurological disease of the central nervous system is one of neurons simultaneously abnormal discharge results, with a recurrent and repeatable, short-term, such as stereotypes of the characteristics of central nervous system dysfunction syndrome. And with each attack brain tissue are in a serious state of hypoxia-ischemia, patients with brain damage larger. And a serious impact on patients with the normal work and life. Most of the patients require long-term or even lifelong taking anti-epileptic drugs, about 80% of patients with epilepsy drug treatment system can be completely controlled attack. And long-term side effects of taking anti-epileptic drugs is seriously harming the health of the population, the 21st century with new antiepileptic drugs after extensive clinical application of the quality of life for people and the increasing demand for osteoporosis in patients with epilepsy incidence and impact factors has become increasingly popular. Especially after taking a long-term effect on bone metabolism in patients with increased risk of spontaneous fracture, early detection of adverse reactions, have focused on prevention and treatment, rational drug use to enhance the quality of life of these patients appears to be particularly important.Bone rely mainly on the reduction of bone mineral density testing equipment. We explore the use of dual-energy x-absorption spectrometry (dual energy x-ray absorptiometry, DEXA) to measure liver enzymes induced by taking 41 cases of patients taking topiramate in 22 cases, and comparative analysis studies to understand the new antiepileptic drug topiramate Ester on whether it will affect bone density. At the same time, some biochemical indicators of further explore the possible mechanism.This study selected in December 2005 a December 2007 Sino-Japanese Friendship Jilin University hospital inpatient and outpatient neurology of people with epilepsy, the First Hospital of Jilin University in patients with epilepsy, as well as out-patient medical follow-up of healthy adults.All cases of drug use by the group clinical manifestations, diagnosis EEG clear. And no serious liver and kidney disease, without diabetes, heart and lung function was normal, with the exception of epilepsy, no other endocrine system diseases, in addition to other patients with a single AEDs, without taking other effects of endocrine drugs. Medication epilepsy patients for a total of 63 cases, 31 cases male, female 32 cases, of which taken alone antiepileptic drug topiramate 22 were taken alone induction of liver enzymes (carbamazepine, phenobarbital, and other anti-epileptic drugs) 41 and 15 compared to the control group, the bone mineral density were measured values and the associated biochemical markers, the results of statistical processing software on the new antiepileptic drug topiramate on bone metabolism and the possible mechanism. The results of this study show that the induction of liver enzymes in 41 cases of patients and 29 normal, 12 were reduced bone mass. Topiramate group of 22 patients with normal 20. 2 bone loss. In the three groups were not found in patients with osteoporosis. We will induction of liver enzymes in the group with topiramate group with the same drug treatment extracted with topiramate group chi-square test, the results showed that there were significant differences (P <0.05). They were compared with control group, there were significant differences (P <0.05). The results suggest a long-term antiepileptic drug can be taken to reduce bone mineral density. Taking anti-epileptic drugs and dosage forms and medication regimens may influence bone metabolism risk factors. The treated group were not found in patients with osteoporosis, consider the results of this treatment is still taking medications due to short. To further explore topiramate cause a reduction in bone mass detection mechanism we associated with bone metabolism of certain biochemical markers. The results showed that: long-term use of liver enzyme induction agent and long-term use of non-induction of liver enzymes that topiramate group of patients with epilepsy have the bone ALP concentration increased, and significantly higher than the normal control group, and urinary DPD level with the control group Compared basically the same, the impact of the anti-epileptic drugs are bone formation mechanism. And no significant impact on bone resorption. In addition topiramate group of patients with 24-hour urinary calcium excretion of phosphorus increased significantly, but no significant blood calcium concentration changes. Liver enzymes induced by long-term use of the patients taking topiramate in patients and normal parathyroid hormone in the blood increased. This is the induction of liver enzymes in the body through metabolism in the liver caused by the process of secondary parathyroid hormone increase, it induced P450 enzyme function of liver cells increased, resulting in the catabolism of vitamin D acceleration; inhibited vitamin D hydroxylation , in 1,25 - (0 H) 2 D3 levels decline. And the activity of liver enzymes induced by the AEDS induced hepatic P450 oxidase reduce parathyroid hormone metabolism, thereby increasing secondary cause of parathyroid hormone, increased osteolytic effect, I have suggested that the use of such drugs in patients with there is still a bone in the destruction mechanism, which is different from previous studies and a new conclusion. And topiramate is not because of liver metabolism, bone mass caused by the comprehensive analysis of the mechanisms to reduce the impact of the formation of bone, and the promotion of the body's daily calcium loss.Long-term use of antiepileptic drug topiramate can lead to abnormal bone metabolism, bone density caused lower. The possible mechanism is topiramate, mainly through increased urinary calcium excretion of phosphorus, and promote the loss of body calcium, and also by reducing bone formation, the combined effects of bone metabolism, leading to bone loss, osteoporosis and even the occurrence of a tendency to fracture. This suggested that the liver enzymes induced by the use of patients merely supplementary calcium, the effect is not significant, but the use of non-induction of liver enzymes such as patients taking topiramate in patients with early enhance calcium intake, calcium excretion can be reduced Early in the prevention of osteoporosis is an effective measure. Clinical medication for patients with epilepsy, guiding treatment, and ultimately improve the quality of life of patients with epilepsy have greater clinical significance. patients with epilepsy have greater clinical significance.