Chaudhuri Jaydip Ray, Mridula Kandadai Rukmini, Rathnakishore Chakrala, Balaraju Banda, Bandaru Vcs Srinivasarao
Department of Neurology, Yashoda hospital, Hyderabad, India.
Department of Neurology, Nizam's Institute of Medical Sciences, Hyderabad, India.
Iran J Child Neurol. 2017 Spring;11(2):48-56.
Epilepsy is a chronic neurological disorder requiring long-term therapy using antiepileptic medications. Reports have incriminated long-term antiepileptic drugs use in deficiency of vitamin D and bone diseases in all age groups. We aimed to investigate the association between serum 25-hydroxyvitamin D levels and pediatric epilepsy in Indian patients.
MATERIALS & METHODS: We prospectively recruited 100 pediatric epilepsy patients, on monotherapy for minimum one-year duration, and 50 age and sex matched controls. This study was carried out at Yashoda Hospital, India from 2011-2014. All cases and controls underwent tests for serum 25-hydroxyvitamin D, alkaline phosphatase, serum calcium and phosphorus levels.
Patients with 25-hydroxyvitamin D deficiency were significantly higher among cases (45%) than controls (24%). Mean alkaline phosphatase was significantly higher in cases and mean serum calcium was significantly lower (8.3±1.5) in cases. Amongst antiepileptic drugs, carbamazepine and sodium valproate were significantly associated with 25-hydroxyvitamin D deficiency. Risk of vitamin D deficiency was highest with sodium valproate usage (odds:4.0;95%CI 1.4-11.6) followed by carbamazepine use (odds: 2.7; 95%CI 1.0-6.8). After adjustment using multiple logistic regression, antiepileptic drugs showed independent association with 25-hydroxyvitamin D deficiency (odds:2.2;95%CI 0.9-4.5).
25-hydroxyvitamin D deficiency was significantly associated with use of carbamazepine and sodium valproate in pediatric epilepsy.
癫痫是一种慢性神经系统疾病，需要使用抗癫痫药物进行长期治疗。有报告指出，长期使用抗癫痫药物会导致各年龄组维生素D缺乏和骨骼疾病。我们旨在研究印度患者血清25-羟基维生素D水平与小儿癫痫之间的关联。
我们前瞻性招募了100例接受单药治疗至少1年的小儿癫痫患者，以及50例年龄和性别匹配的对照。本研究于2011年至2014年在印度亚肖达医院进行。所有病例和对照均接受血清25-羟基维生素D、碱性磷酸酶、血清钙和磷水平检测。
病例组中25-羟基维生素D缺乏患者的比例（45%）显著高于对照组（24%）。病例组的平均碱性磷酸酶显著更高，而病例组的平均血清钙显著更低（8.3±1.5）。在抗癫痫药物中，卡马西平和丙戊酸钠与25-羟基维生素D缺乏显著相关。使用丙戊酸钠时维生素D缺乏的风险最高（比值：4.0；95%置信区间1.4 - 11.6），其次是使用卡马西平（比值：2.7；95%置信区间1.0 - 6.8）。在使用多元逻辑回归进行调整后，抗癫痫药物显示出与25-羟基维生素D缺乏的独立关联（比值：2.2；95%置信区间0.9 - 4.5）。
小儿癫痫中，25-羟基维生素D缺乏与卡马西平和丙戊酸钠的使用显著相关。
