| Objective: To explore the effect of oxcarbazepine and valproic acid on bone metabolism in childhood epilepsy patients and its possible mechanism,so as to provide a basis for clinicians to effectively prevent and treat abnormal bone metabolism and improve patients’ quality of life in childhood epilepsy.Methods: Selected 60 patients who were treated in our hospital from August 2014 to February 2016 and were all treated with antiepileptic drugs.The drugs used included valproic acid and oxcarbazepine,and the antiepileptic drugs were divided into valproic acid group and oxcarbazepine group according to their types.At the same time,24 patients aged 5to 14 years old who did not take medication for epilepsy in our hospital were selected as the control group.For each group of patients,blood phosphorus,serum calcium,bone alkaline phosphatase,serum alkaline phosphatase,parathyroid hormone and other biochemical indicators,and anteroposterior bone density of ward triangle,left femoral neck greater trochanter and lumbar spine 2 ~ 4 vertebral body was measured,and the difference of biochemical parameters,bone mineral density and corresponding T value was compared between patients in the valproic acid group and the control group,similarly compared between the oxcarbazepine group and the control group.Analysis used t-test to analyze the effects of AEDs on bone metabolism in children with epilepsy.Results:(1)Serum calcium(2.31±0.12 mmol/L)was significantly lower in the valproic acid group than in the control group(2.48±0.11 mmol/L).Parathyroid hormone(48.3±10.8pmol/L)was significantly higher in the valproic acid group than in the control group(37.2±11.2pmol/L).Bone alkaline phosphatase(151.5±10.3 U/L)was significantly higher in the valproic acid group than in the control group(123 ± 8.5 U/L).The difference was statistically significant(P<0.05).There was no statistically significant difference between serum phosphorus and alkaline phosphatase levels in the control group(P>0.05).The parathyroid hormone(57.6 ± 10.9 pmol/L)was significantly higher in the oxcarbazepine group than in the control group(37.2±11.2 pmol/L).Bone alkaline phosphatase(80.6±7.6U/L)was significantly lower in the oxcarbazepine group than in the control group(123±8.5U/L),the difference was statistically significant(P<0.01).Howerver,the serum calcium,phosphorus and alkaline phosphatase levels were not statistically different from those in the control group(P>0.05).(2)There were no significant differences in bone mineral density and corresponding T values between valproic acid in the Ward triangle,femoral neck,and greater trochanter and control,oxcarbazepine and control groups(P>0.05).The valproic acid group had a bone mineral density at lumbar 2(0.6104±0.1251),lumbar 3(0.6204±0.1143),lumbar 4(0.6011±0.1103)and lumbar 2-4 vertebrae(0.6103±0.1129)with the control group(lumbar 2,lumbar 3,lumbar4 and lumbar 2-4 vertebrae were 0.6958±0.1756,0.6913±0.1522,0.6827±0.1886,0.6799±0.1333 respectively,and the difference was statistically significant(P<0.05);The bone mineral density values in the valproic acid group corresponded to T values at lumbar 2(-7.7653 ± 2.8576),lumbar 3(-7.1676 ± 3.1531),lumbar 4(-6.6589±4.1334),and lumbar 2-4 vertebrae(-5.7088±1.7665),Compared with the control group(lumbar 2,lumbar 3,lumbar 4,lumbar 2-4 vertebrae were:-5.4325 ±2.5311,-5.5041 ± 2.9021,-4.0277 ± 4.6582,-4.5616 ± 2.0012),the difference was statistically significant(P<0.05),but the difference between oxcarbazepine group and control group was not statistically significant(P> 0.05).Conclusions:(1)Valproic acid could induce the change of indices related to bone metabolism,and reduce bone density of lumbar 2-4 vertebrae,which might affect bone metabolism in childhood epilepsy patients.(2)Oxcarbazepine could induce the change of indices related to bone metabolism,but no decrease in bone density was found. |
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