儿童癫痫患者低骨密度的决定因素。

Determinants of low bone mineral density in children with epilepsy.

机构信息

Division of Paediatric Neurology, Department of Paediatrics, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.

出版信息

Eur J Paediatr Neurol. 2018 Jan;22(1):155-163. doi: 10.1016/j.ejpn.2017.10.007. Epub 2017 Oct 24.

DOI:10.1016/j.ejpn.2017.10.007

PMID:29122496

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.

摘要

介绍

长期服用抗癫痫药物 (AEDs) 的癫痫儿童存在骨密度降低的风险。本研究旨在评估马来西亚癫痫儿童长期服用 AEDs 后低骨密度的发生率及其影响因素。

方法

本研究为 2014 年至 2015 年在马来西亚一家三级医院接受长期 AEDs 治疗>1 年的门诊癫痫患儿进行的横断面研究。详细评估了人体测量学测量值、环境生活方式危险因素、血清维生素 D、钙和甲状旁腺激素水平、维生素 D 和钙代谢基因单核苷酸多态性的基因分型以及腰椎骨密度。低骨密度定义为骨密度 Z 评分≤-2.0 SD。

结果

87 名平均年龄为 11.9 岁（56 名男性）的患儿参与了本研究。低腰椎骨密度的患病率为 21.8%（19 例）。多变量逻辑回归分析发现，服用>2 种 AEDs 的药物疗法（OR：7.86；95%CI 1.03-59.96）、手腕宽度<第 15 百分位数的小体型（OR 14.73；95%CI 2.21-98.40）和体质指数 Z 评分<-2.0（OR 8.73，95%CI 1.17-65.19）是低骨密度的显著危险因素。