Coppola Giangennaro, Fortunato Delia, Auricchio Gianfranca, Mainolfi Ciro, Operto Francesca Felicia, Signoriello Giuseppe, Pascotto Antonio, Salvatore Marco
Clinic of Child Neuropsychiatry, Second University of Naples, Italy.
Epilepsia. 2009 Sep;50(9):2140-6. doi: 10.1111/j.1528-1167.2009.02082.x. Epub 2009 Apr 19.
The aim of this study was to assess bone mineral density (BMD) in a large population of children, adolescents, and young adults with epilepsy alone or in association with cerebral palsy and/or mental retardation.
Ninety-six patients were enrolled in the study. The group comprised 50 males and 46 females, aged between 3 and 25 years (mean age 11 years). The control group consisted of 63 healthy children and adolescents (23 males, 40 females), aged between 3 and 25 years (mean age 12.1 years). Patients underwent a dual-energy x-ray absorptiometry (DEXA) scan of the lumbar spine (L1-L4) and the z scores were calculated for each patient; the t score was considered for patients 18 years of age or older.
Abnormal BMD was found in 56 patients (58.3%), with values documenting osteopenia in 42 (75%) and osteoporosis in 14 (25%). A significant difference emerged between epileptic patients and the control group in BMD, z score, and body mass index (BMI) (p = <0.001). Lack of autonomous gait, severe mental retardation, long duration of antiepileptic treatment, topiramate adjunctive therapy, and less physical activity significantly correlated with abnormal BMD.
This study detected abnormal BMD in more than half of a large pediatric population with epilepsy with or without cerebral palsy and/or mental retardation. The clinical significance of these findings has yet to be clarified.
本研究旨在评估大量仅患有癫痫或合并脑瘫和/或智力障碍的儿童、青少年及青年成人的骨密度（BMD）。
96名患者纳入本研究。该组包括50名男性和46名女性，年龄在3至25岁之间（平均年龄11岁）。对照组由63名健康儿童和青少年组成（23名男性，40名女性），年龄在3至25岁之间（平均年龄12.1岁）。患者接受腰椎（L1 - L4）双能X线吸收测定法（DEXA）扫描，并为每位患者计算z值；18岁及以上患者考虑t值。
56名患者（58.3%）发现骨密度异常，其中42名（75%）骨量减少，14名（25%）骨质疏松。癫痫患者与对照组在骨密度、z值和体重指数（BMI）方面存在显著差异（p = <0.001）。缺乏自主步态、严重智力障碍、抗癫痫治疗时间长、托吡酯辅助治疗以及体力活动较少与骨密度异常显著相关。
本研究在大量患有或未患有脑瘫和/或智力障碍的癫痫患儿中，超过半数检测到骨密度异常。这些发现的临床意义尚待阐明。
