Riancho J A, del Arco C, Arteaga R, Herranz J L, Albajar M, Macias J G
Department of Internal Medicine, Hospital Marques de Valdecilla, School of Medicine, Santander, Spain.
Acta Neurol Scand. 1989 Apr;79(4):296-9. doi: 10.1111/j.1600-0404.1989.tb03788.x.
Previous studies about the serum levels of vitamin D metabolites in epileptic patients have given conflicting results. We have investigated the influence of chronic anti-epileptic treatment on mineral metabolism in 17 ambulatory epileptic children who were studied for 2 seasons with high and low levels of solar radiation, respectively. No differences in serum calcium, phosphate or 1.25-dihydroxyvitamin D were observed between patients and control children. Patients also had normal levels of 25-hydroxyvitamin D [25(OH)D] in summer. However, serum 25(OH)D concentrations were lower in patients than in controls in winter months (12.6 +/- 1.4 versus 19.6 +/- 1.2 ng/ml, P less than 0.001). These findings point out the influence of the intensity of solar irradiation, and subsequently of vitamin D availability, on the effect of anticonvulsant drugs on vitamin D metabolism, and may help to explain the conflicting results of previous reports. Prophylactic vitamin D therapy should be considered when climatic conditions or patients' life styles do not allow an adequate exposure to sunlight.
先前关于癫痫患者血清维生素D代谢产物水平的研究结果相互矛盾。我们调查了17名门诊癫痫儿童长期抗癫痫治疗对矿物质代谢的影响,分别在太阳辐射水平高和低的两个季节对他们进行了研究。患者与对照儿童之间的血清钙、磷或1,25-二羟基维生素D水平未见差异。患者在夏季的25-羟基维生素D[25(OH)D]水平也正常。然而,在冬季,患者的血清25(OH)D浓度低于对照组(12.6±1.4对19.6±1.2 ng/ml,P<0.001)。这些发现指出了太阳照射强度以及随后维生素D可获得性对抗惊厥药物对维生素D代谢影响的作用,并且可能有助于解释先前报告中相互矛盾的结果。当气候条件或患者生活方式不允许充分暴露于阳光下时,应考虑预防性维生素D治疗。