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Potential risk factors for vitamin D levels in medium- and long-term use of antiepileptic drugs in childhood

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Abstract

Antiepileptic drugs (AED) have potential side effects through vitamin-D. Prevalence of vitamin D insufficiency and potential risk factors for the longitudinal changes of vitamin D levels compared to its baseline levels under AED treatment were investigated in this study. This retrospective study includes patients whose AED therapy were started in only autumn months, between 2000 and 2014. Detailed assessment of neurologic diagnosis and brain MRI findings, ambulatory status, types and durations of AED treatment, and baseline bone health blood tests (vitamin-D, alkaline phosphatase, calcium, and phosphate levels) were obtained on all patients. Vitamin-D deficiency was defined as 25(OH)D <20 ng/mL, while vitamin-D insufficiency was defined as 25(OH)D between 21 and 29 ng/mL. A total of 172 children (mean age 9.6 ± 4.3 years) were followed up 5.3 years in average (range 1–14.7). The mean baseline 25(OH)D level was decreased from 24.4 ± 11.6 to 19.6 ± 10.7 ng/mL at the last follow up. The mean change in the vitamin-D levels (ΔD-vitamin) was −4.8 ng/mL (p = 0.003). The rate of vitamin-D deficiency was 54% and insufficiency was 25%. Multivariate logistic regression analysis identified only long-term use of AEDs as a risk factor for the longitudinal decrease. Monotherapy with valproic acid (n = 45), carbamazepine (n = 20), levetiracetam (n = 10) and phenobarbital (n = 12) was compared with each other. There was no difference in terms of longitudinal changes in 25(OH)D levels. In the treatment of childhood epilepsy, 25(OH)D levels should be monitored, especially when long-term AED used, in order to prevent D-hypovitaminosis.

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Authors and Affiliations

  1. Division of Pediatric Neurology, Department of Pediatrics, Istanbul Faculty of Medicine, Istanbul University, Millet cd. Fatih, 34093, Istanbul, Turkey

    Edibe Pempegül Yildiz, Gonca Bektas & Nur Aydinli

  2. Division of Pediatric Endocrinology, Department of Pediatrics, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey

    Şükran Poyrazoglu & Aslı Derya Kardelen

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  1. Edibe Pempegül Yildiz
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  2. Şükran Poyrazoglu
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Correspondence to Edibe Pempegül Yildiz.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Informed consent was obtained from all individual participants included in the study.

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Yildiz, E.P., Poyrazoglu, Ş., Bektas, G. et al. Potential risk factors for vitamin D levels in medium- and long-term use of antiepileptic drugs in childhood. Acta Neurol Belg 117, 447–453 (2017). https://doi.org/10.1007/s13760-017-0775-x

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  • DOI: https://doi.org/10.1007/s13760-017-0775-x

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