Department of Neurology, The Sixth People's Hospital of Chengdu, No. 16 South Jianshe Road, Chengdu, Sichuan 610051, People's Republic of China.
Sichuan Provincial Center for Mental Health, Sichuan Academy of Medical Sciences & Sichuan Provincial People's Hospital, 32# W. Sec 2, 1st Ring Rd, Chengdu, Sichuan 610072, People's Republic of China.
Epilepsy Behav. 2020 Dec;113:107489. doi: 10.1016/j.yebeh.2020.107489. Epub 2020 Nov 18.
The aim of this study was to evaluate the effects of valproate (VPA), lamotrigine (LTG), and levetiracetam (LEV) on bone turnover and bone mineral density (BMD) in newly diagnosed adult patients with epilepsy.
Eligible adult patients who were newly diagnosed with epilepsy were treated with VPA, LTG, and LEV. The chemical indicators of bone metabolism and BMD were measured before treatment and 2 years after treatment with different antiseizure medication (ASM) monotherapies. Then, the differences in these parameters before and after treatment were analyzed.
One hundred twenty-four patients completed the 2 years follow-up; 43 received monotherapy with VPA, 32 received LTG, and 49 received LEV. Serum parathyroid hormone (PTH), bone alkaline phosphatase (B-ALP), and β-cross-linked C-telopeptide of type I collagen (β-CTX) levels were elevated in adult patients after 2 years of VPA administration; the serum procollagen I intact N-terminal peptide (PINP) level was noticeably higher in patients after LEV treatment than before treatment. Meanwhile, the BMD of the lumbar spine and femoral neck did not change in patients treated with VPA, LTG, and LEV.
Valproate altered bone turnover in adult patients with epilepsy, while LTG and LEV did not exert harmful effects on bone health in adult patients.
本研究旨在评估丙戊酸（VPA）、拉莫三嗪（LTG）和左乙拉西坦（LEV）对新诊断的成年癫痫患者骨转换和骨密度（BMD）的影响。
符合条件的新诊断为癫痫的成年患者接受 VPA、LTG 和 LEV 单药治疗。在开始不同抗癫痫药物（ASM）单药治疗前和 2 年后，测量骨代谢的化学指标和 BMD。然后，分析这些参数在治疗前后的差异。
124 例患者完成了 2 年的随访；43 例接受 VPA 单药治疗，32 例接受 LTG 单药治疗，49 例接受 LEV 单药治疗。VPA 治疗 2 年后，成年患者的血清甲状旁腺激素（PTH）、骨碱性磷酸酶（B-ALP）和 I 型胶原交联 C 端肽（β-CTX）水平升高；LEV 治疗后患者的血清 I 型前胶原完整 N 端肽（PINP）水平明显高于治疗前。同时，VPA、LTG 和 LEV 治疗的患者腰椎和股骨颈的 BMD 没有变化。
丙戊酸改变了成年癫痫患者的骨转换，而 LTG 和 LEV 对成年癫痫患者的骨骼健康没有不良影响。
