Faculty of Health Science and Technology, Aalborg University, Fredrik Bajers Vej 7D, 9220 Aalborg, Denmark.
Department of Neurology, Rigshospitalet Glostrup, Valdemar Hansens vej 1-23, 2600 Glostrup, Denmark.
Seizure. 2021 Mar;86:29-34. doi: 10.1016/j.seizure.2021.01.008. Epub 2021 Jan 23.
Osteoporosis is a bone disorder defined by a decrease in bone mineral density (BMD) which can lead to an increased risk of fractures. Patients with epilepsy are more prone to having fractures. When accounting for seizure-related fractures, the epilepsy patient population still suffers from an increased risk of fractures. This can be attributed to adverse effects of antiepileptic drugs (AEDs).
The aim of this study was to investigate the association between the use of AEDs and decreased BMD in a large unselected population of Danish patients with epilepsy.
The study was a cross-sectional study based on data retrieved from 835 patients visiting an outpatient Epilepsy Clinic in Glostrup, Denmark, from January 1st 2006 - January 31st 2018. The data included results from DXA-scans and demographic information. Logistic regression models and other statistical analyses were performed.
The results showed that the odds for having osteoporosis when taking EIAEDs were 2.2 (95 % CI: 1.2-3.8, P = 0.007) times higher than those taking NEIAEDs. Furthermore, the odds for having osteoporosis increased with duration of epilepsy (OR = 1.0, 95 % CI: 1.0 - 1.0, P = 0.001) and when the patients consume two AEDs compared to one AED (OR = 2.3, 95 % CI: 1.3-4.1, P < 0.001). Additionally, consuming three AEDs compared to one lead to a 2.3 times higher risk of having osteoporosis (95 % CI: 1.2-4.4, P = 0.01).
When accounted for many riskfactors, EIAEDs, polytherapy with AEDs and duration of epilepsy are correlated with osteoporosis. There is a need for using these known riskfactors as guidelines in indentifying patients at increased risk of developing osteoporosis.
骨质疏松症是一种以骨密度（BMD）降低为特征的骨骼疾病，这会增加骨折的风险。癫痫患者更容易发生骨折。当考虑到与癫痫相关的骨折时，癫痫患者人群仍然存在骨折风险增加的情况。这可能归因于抗癫痫药物（AEDs）的不良反应。
本研究旨在调查在丹麦一个未选择的大型癫痫患者人群中，AED 的使用与 BMD 降低之间的关联。
该研究是一项基于 2006 年 1 月 1 日至 2018 年 1 月 31 日期间在丹麦 Glostrup 一家癫痫门诊就诊的 835 名患者的数据的横断面研究。该数据包括 DXA 扫描结果和人口统计学信息。进行了逻辑回归模型和其他统计分析。
结果表明，服用 EIAED 的患者发生骨质疏松症的几率比服用 NEIAED 的患者高 2.2 倍（95 % CI：1.2-3.8，P=0.007）。此外，随着癫痫的持续时间（OR=1.0，95 % CI：1.0-1.0，P=0.001）和患者服用两种 AED 与一种 AED 相比（OR=2.3，95 % CI：1.3-4.1，P<0.001），骨质疏松症的几率也会增加。此外，与服用一种 AED 相比，服用三种 AED 会使发生骨质疏松症的风险增加 2.3 倍（95 % CI：1.2-4.4，P=0.01）。
在考虑了许多危险因素后，EIAED、AED 联合治疗和癫痫持续时间与骨质疏松症相关。需要将这些已知的危险因素作为识别有发生骨质疏松症风险的患者的指南。
