接受卡马西平或丙戊酸钠单药治疗的门诊儿童维生素D缺乏症

Vitamin D Deficiency in Ambulant Children on Carbamazepine or Sodium Valproate Monotherapy.

作者信息

Sreedharan Mini, Devadathan Kalpana, Mohammed Kunju P A, Sasidharan Bindusha, Pillai Jayakumar Parameswaran, Vasumathy Amma Minikumari Amma, Muthubeevi Saboorabeegum

机构信息

Departments of Pediatric Neurology, Government Medical College, Thiruvananthapuram, India.

Departments of Pediatric Neurology, Government Medical College, Thiruvananthapuram, India. Correspondence to: Dr Kalpana Devadathan, Additional Professor, Department of Pediatric Neurology, Government Medical College, Thiruvananthapuram, Kerala, India.

出版信息

Indian Pediatr. 2018 Apr 15;55(4):307-310. Epub 2018 Feb 9.

PMID:29428922

Abstract

OBJECTIVE

To assess the effect of monotherapy with Carbamazepine (CBZ) and Sodium valproate (VPA) on serum 25-OH Vitamin D levels in children with epilepsy compared to controls.

DESIGN

Cross-sectional study.

SETTING

Outpatient department of a tertiary-care Pediatric Neurology centre, and a nearby day-care centre and school.

STUDY PERIOD

June 2012 to May 2013.

PARTICIPANTS

Children with epilepsy aged 2 to 13 years on monotherapy with CBZ (n=28) or VPA (n=28) for at least 6 months; 109 age-matched controls from a nearby day-care centre and school.

RESULTS

The median (IQR) values of 25 (OH) vitamin D was 18.0 ng/mL (13.7-27.3), 21.35 ng/mL (16.4 -25.2) and 30.5 ng/mL (19.1-43.7) in CBZ, VPA and control group, respectively (P= 0.008). 60.7% of patients in CBZ group and 35.7 % in VPA group had low 25 (OH) D levels (%20 ng/mL) compared to 27.8% in controls (P=0.001).The serum alkaline phosphatase level was higher in children on carbamazepine therapy (P=0.001) than controls.

CONCLUSION

This study identifies significant risk of vitamin D deficiency in ambulant children with epilepsy on monotherapy with CBZ or VPA.

摘要

目的

评估与对照组相比，卡马西平（CBZ）和丙戊酸钠（VPA）单药治疗对癫痫患儿血清25-羟基维生素D水平的影响。

设计

横断面研究。

地点

一家三级儿科神经科中心的门诊部以及附近的日托中心和学校。

研究时间

2012年6月至2013年5月。

参与者

年龄在2至13岁、接受CBZ（n = 28）或VPA（n = 28）单药治疗至少6个月的癫痫患儿；来自附近日托中心和学校的109名年龄匹配的对照儿童。

结果

CBZ组、VPA组和对照组中25（OH）维生素D的中位数（四分位间距）值分别为18.0 ng/mL（13.7 - 27.3）、21.35 ng/mL（16.4 - 25.2）和30.5 ng/mL（19.1 - 43.7）（P = 0.008）。与对照组的27.8%相比，CBZ组60.7%的患者和VPA组35.7%的患者25（OH）D水平较低（<20 ng/mL）（P = 0.001）。接受卡马西平治疗的儿童血清碱性磷酸酶水平高于对照组（P = 0.001）。