Determinants of low bone mineral density in children with epilepsy
Document Type
Article
Publication Date
1-1-2018
Abstract
Introduction Children with epilepsy on long-term antiepileptic drugs (AEDs) are at risk of low bone mineral density (BMD). The aims of our study were to evaluate the prevalence and determinants of low BMD among Malaysian children with epilepsy. Method Cross-sectional study of ambulant children with epilepsy on long-term AEDs for >1 year seen in a tertiary hospital in Malaysia from 2014 to 2015. Detailed assessment of anthropometric measurements; environmental lifestyle risk factors; serum vitamin D, calcium and parathyroid hormone levels; genotyping of single nucleotide polymorphisms of genes in vitamin D and calcium metabolism; and lumbar spine BMD were obtained. Low BMD was defined as BMD Z-score ≤ −2.0 SD. Results Eighty-seven children with mean age of 11.9 years (56 males) participated in the study. The prevalence of low lumbar BMD was 21.8% (19 patients). Multivariate logistic regression analysis identified polytherapy >2 AEDs (OR: 7.86; 95% CI 1.03–59.96), small frame size with wrist breadth of <15th centile (OR 14.73; 95% CI 2.21–98.40), and body mass index Z-score < −2.0 (OR 8.73, 95% CI 1.17–65.19) as significant risk factors for low BMD. Conclusion One-fifth of Malaysian children with epilepsy on long-term AEDs had low BMD. Targeted BMD should be performed for those who are on >2 AEDs, underweight or with small frame size as they are at higher risk of having low BMD.
Keywords
Epilepsy, Antiepileptic drug, Bone mineral density, Lifestyle, Genetic
Divisions
fac_med,InstituteofBiologicalSciences
Funders
University of Malaya research grant (UMRG 532-13HTM and PG166-2015A)
Publication Title
European Journal of Paediatric Neurology
Volume
22
Issue
1
Publisher
Elsevier