Department of Pediatrics, Korea University Guro Hospital, 148 Gurodong-ro, Guro-gu, Seoul 152-703, Korea.
Yonsei Med J. 2014 Mar;55(2):417-21. doi: 10.3349/ymj.2014.55.2.417.
This study was to evaluate the relationship of 25(OH)D3 levels with anticonvulsant use and other possible factors in epileptic children and adolescents.
We studied 143 patients with epilepsy (90 boys, 53 girls; 11.21±4.49 years), who had been treated with anticonvulsants for more than 1 year. Patients who had taken multiple vitamins before the blood test and those who have the limitation of physical activity (wheelchair-bound) were excluded from the study. We evaluated the difference in vitamin D status according to the type and number of anticonvulsants taken and other factors such as gender, age, intelligence and seizure variables.
For patients with mental retardation or developmental delay, 25(OH)D3 levels were lower than the levels in patients with normal intelligence quotient levels (p=0.03). 25(OH)D3 levels were lower in patients who had taken anticonvulsants for more than 2 years as compared to those who had taken them for less than 2 years (p=0.03). Those taking oxcarbazepine had significantly lower vitamin D levels than patients taking valproic acid (p=0.01). However, no effects of number of anticonvulsants taken were detectable. More than two-thirds of the patients were diagnosed with osteopenia or osteoporosis in patients showing either vitamin D insufficiency or deficiency.
The possibility of vitamin D deficiency can be considered in pediatric patients taking anticonvulsants if they have mental retardation or developmental delay or if they have been taking anticonvulsants for more than 2 years or taking hepatic enzyme inducing drugs.
本研究旨在评估癫痫儿童和青少年体内 25(OH)D3 水平与抗癫痫药物使用及其他可能因素的关系。
我们研究了 143 名癫痫患者(90 名男性,53 名女性;11.21±4.49 岁),这些患者接受抗癫痫药物治疗的时间均超过 1 年。排除了在血液检查前服用多种维生素且活动受限(需使用轮椅)的患者。我们根据所服用抗癫痫药物的类型和数量以及其他因素(如性别、年龄、智力和发作变量)评估了维生素 D 状态的差异。
对于智力障碍或发育迟缓的患者,其 25(OH)D3 水平低于智力正常的患者(p=0.03)。与服用抗癫痫药物少于 2 年的患者相比,服用 2 年以上的患者 25(OH)D3 水平更低(p=0.03)。服用奥卡西平的患者维生素 D 水平明显低于服用丙戊酸的患者(p=0.01)。然而,所服用抗癫痫药物的数量对维生素 D 水平无影响。在显示维生素 D 不足或缺乏的患者中,超过三分之二的患者被诊断为骨质疏松或骨量减少。
如果儿童癫痫患者存在智力障碍或发育迟缓,或服用抗癫痫药物超过 2 年或服用肝酶诱导药物,应考虑维生素 D 缺乏的可能性。