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Bone mineral density loss in ambulatory children with epilepsy in spite of using supplemental vitamin D in Southern Iran: a case–control study

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Abstract

Epilepsy might have adverse effect on bone density due to underlying disease, drugs, vitamin D deficiency, immobilization and malnutrition. We investigated the bone mineral density in ambulatory vitamin-D supplemented children with epilepsy. This case–control study was conducted on 90 epileptic children aged 11.4 ± 3.3 years, and age and gender matched controls in pediatric neurology clinics of Shiraz, in Southern Iran, 2016. Anthropometric measurements, puberty, sun exposure, physical activity and biochemical variables were assessed. Bone mineral density was evaluated by dual-energy X-ray absorptiometry method. Data were analyzed by SPSS.v21. Prevalence of low bone mass in femur was more in patients (27%) than the controls (9%) (P value = 0.002). Age, weight Z score and height Z score were the most significant associated factors on lumbar BMD, BMAD, and femur BMD. Seizure duration and how it responded to anticonvulsants were the most associated factors with both lumbar and femur bone density. Sodium valproate and carbomazepin usage had negative association with lumbar Z score (beta = − 0.216, P = 0.017 and beta = − 0.336, P = 0.027, respectively). We hypothesized that epilepsy per se could affect bone density by an unknown pathophysiology, which was independent from vitamin D deficiency, effects of anticonvulsant and physical activity.

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Abbreviations

AED:

Antiepileptic drugs

BMI:

Body mass index

BMAD:

Bone mineral apparent density

BMD:

Bone mineral density

DXA:

Dual-energy X-ray absorptiometry

25OHD:

25-hydroxy vitamin D

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Acknowledgements

This study was supported by the Shiraz University of Medical Sciences with the Grant number of 95-01-49-13302. The authors wish to thank Mr. H. Argasi at the Research Consultation Center (RCC) of Shiraz University of Medical Sciences for his invaluable assistance in editing this manuscript.

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Authors and Affiliations

  1. Neonatology Research Center, Neuroscience Research Center, Shiraz University of Medical Sciences, Shiraz, Iran

    Soroor Inaloo, Mohammad Paktinat, Pegah Katibeh & Hamid Nemati

  2. Shiraz Endocrinology and Metabolism Research Center, Shiraz University of Medical Sciences, Shiraz, Iran

    Forough Saki, Mohammad Hossein Dabbaghmanesh & Gholam Hossein Ranjbar Omrani

Authors
  1. Soroor Inaloo
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  2. Mohammad Paktinat
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  3. Forough Saki
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  4. Pegah Katibeh
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  5. Hamid Nemati
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  6. Mohammad Hossein Dabbaghmanesh
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  7. Gholam Hossein Ranjbar Omrani
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Contributions

SI: Concept, design, data gathering. MP: Concept, design, data gathering. FS: Concept, design, data gathering, preparing the manuscript and correspondence. PK: design, data gathering of patients. HN: design, data gathering of patients. MHD: data gathering of controls. GHRO: data gathering of controls.

Corresponding author

Correspondence to Forough Saki.

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Conflict of interest

Forough Saki, Soroor Inaloo, MohammadPaktinat, pegah Katibe, Hamid Nemati, Mohammad Hossein Dabbaghmanesh, and Gholamhossein Ranjbar Omrani declare that they have no conflict of interest.

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Inaloo, S., Paktinat, M., Saki, F. et al. Bone mineral density loss in ambulatory children with epilepsy in spite of using supplemental vitamin D in Southern Iran: a case–control study. J Bone Miner Metab 37, 537–544 (2019). https://doi.org/10.1007/s00774-018-0951-y

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  • DOI: https://doi.org/10.1007/s00774-018-0951-y

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