Study on the Bone Mineral Metabolic Change in Long-term Anticonvulsant-treated Epileptic Outpatients: Measurement by DR-XRA(Quantitative Dual-Energy Radiography; X-Ray Absorptiometry)

Yi, Ho Taek; Chang, Ho Kyun; Lee, Sang Yeon; Jung, In Gwa

Abstract

This study examined, among others, the relationship between the use of anticonvulsant and the bone mineral metabolism(measured via DR-XRA and biochemical study) in 46 adult epileptic outpatients who had been on anticonvulsant for more than one year at Seoul Red Cross Hospital. The study finding wet as follows. 1) There was statistically significant difference between index group(i.e. 46 adult epileptic outpatients) and control group(i.e. 46 healthy adults without previous exposure to anticonvulsant) in terms of bone mineral density. Specifically, the bone mineral density in the epileptic outpatients was significantly lower than that in the healthy adult. Although there was no statistically significant difference between male and female outpatients, their bone mineral density tended to decrease with the increase of age. 2) The bone mineral density in the epileptic outpatients was negatively correlated to both I) the age when the outpatients stared anticonvulsant treatment and ii) the period for which the outpatients were on anticonvulsant 3) Index group was further classified into three subgroup(i.e. low, normal and high subgroup) based on the mean and standard deviation of the bone mineral density in healthy adults control group. 24 outpatients(52.5%) out of 46 fell into low subgroup, of which 10 were male. Overall, there was no statistically significant difference between male and female outpatients in terms of their bone mineral density. 4) Low subgroup's average age(38.6 with SD of 12.5) was significantly higher than those of the other two subgroup. Low subgroup stained anticonvulsant treated when their average age was 24.8(SD 15.0) years, which was higher than those of the other two subgroups. Low subgroup was on anticonvulsant, on average, far 13.3(SD 7.6) years, which was also higher than those of the other two subgroups although there was no significant difference among the subgroups. 5) A series of comparison regarding the possible impact of various types of anticonvulsan(e.g. PHT, CBZ, FB, SV) in terms of i) overall dosage and ii) daily average dosage on bone mineral density showed no significant difference across the three subgroups. 6) There was no significant difference in terms of bone mineral density between the epileptic outpatients on only one type of anticonvulsant and those on two or more types of anticonvulsant. 7) A biochemical study showed that i) each subgroup fell into normal range in terms of blood serum Ca, F, and ALF with no significant difference among the subgroups, and ii) in low subgroup, there were 6 outpatients(25%) with Ca decrease, 2(9.5%) with P decrease, and 5(20.8%) with ALF increase.