Correlation Analysis Of The Effect Of Sodium Valproate On Bone Metabolism And Bone Density In Epileptic Patients

Purpose: to explore the effect of sodium valproate on bone metabolism and bone mineral density(BMD)in different populations by monitoring bone metabolism and bone mineral density(BMD)in patients with epilepsy,and to explore its possible mechanism.Method: a total of 120 patients with epilepsy were selected from the Department of Neurology and Epilepsy Clinic of the first affiliated Hospital of Xinjiang Medical University from December 2018 to December 2019.The general data and medication of the patients,the blood concentration of valproic acid and the related indexes of serum bone metabolism were recorded,including serum calcium,serum phosphorus,alkaline phosphatase,parathyroid hormone,25-hydroxyvitamin D,serum osteocalcin and the facial bone mineral density of the representative parts of lumbar vertebrae and femoral neck.According to the comparison of serum indexes of bone metabolism,the measured values of bone mineral density of patients of different ages were compared with the reference values of bone mineral density of healthy adults of the corresponding age groups.The correlations between the measured values of bone mineral density and age,sex,BMI,taking time,dosage,serum calcium,phosphorus,alkaline phosphatase,25 hydroxyvitamin D,parathyroid hormone and serum osteocalcin were analyzed.Results: 1 there were significant differences in serum calcium,25 hydroxyvitamin D and parathyroid hormone between the treated group and the non-treated group(P < 0.05).There was no significant difference in serum phosphorus,alkaline phosphatase and serum osteocalcin(P > 0.05),and there was significant difference between lumbar 2-4 vertebra,femoral neck and standardized bone mineral density in different age groups(P< 0.05).3.BMD values of different parts of patients were compared according to the duration of treatment and different doses,there was significant difference between the patients who had been treated for 6 months-2 years and those who had been treated for more than 2 years(P < 0.05).There was no significant difference in bone mineral density among the patients with different dosage(P > 0.05).4.the bone mineral density of lumbar vertebrae and femoral neck was negatively correlated with age and medication time(lumbar vertebrae: r =-0.199,-0.441: r = 0.520,-0.482).There was a positive correlation between bone mineral density of femoral neck and 25 hydroxyvitamin D(r = 0.233).Conclusion: long-term use of sodium valproate in patients with epilepsy may lead to the decrease of serum calcium and25-hydroxyvitamin D and the increase of parathyroid hormone.The bone mineral density of lumbar vertebrae and femoral neck decreased significantly in patients with epilepsy who had been treated for more than 2 years.The bone mineral density of lumbar vertebrae and femoral neck was negatively correlated with age and medication time,and positively correlated with 25 hydroxyvitamin D.