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논문KCI 등재

항경련제에 의한 골밀도 감소와 골대사 변화의 기전

Mechanisms of Decreased Bone Mineral Density and Altered Bone Metabolism Induced by Antiepileptic Drugs

이향운|이진화|김용재|최경규|강은숙|정혜원|김숙희
대한신경과학회 (Korean Neurological Association)|2005.12|대한신경과학회지 (Journal of the Korean Neurological Association)|제23권 제6호|pp. 758-764

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참고문헌

주제분류신경과학

초록

Abstract

Background: The adverse effects of antiepileptic drugs (AEDs) on bone metabolism have been reported in epilepsy patients, however the underlying mechanisms have yet to be completely understood. The purpose of this study was to determine whether or not there is an abnormality in bone mineral density (BMD) in epilepsy patients with long-term AED treatment, and also to investigate the underlying mechanisms related to those abnormalities. Methods: BMD was measured by densitometer using dual-energy X-ray absorptionmetry (Lunar PIXI) at the right calcaneus in both patients who had already taken AEDs longer than 6 months, and in patients with newly diagnosed epilepsy. A total of 80 patients (45 women and 35 men) were recruited for the former group, and 29 (11 women and 18 men) for the latter group. In the latter group, BMD and markers for bone metabolism were measured before and after 6 months of AED treatment including serum parathyroid hormone (PTH), total and ionized calcium, osteocalcin, 25-(OH) vitamin D, and urine pyrilinks. Results: BMD decreased in epileptic women compared to the control group (p=0.021). Decreased BMD was most prominent in patients with phenytoin or phenobarbital. Osteocalcin and PTH levels increased after 6 months of AED therapy (p=0.002 and p<0.0001, respectively). Conclusions: BMD decreased in patients with epilepsy, especially in women even in premenopausal age, in those who are taking phenytoin or phenobarbital. AEDs increase bone turnover, which may relate to these alterations in bone mass and bone metabolism.

참고문헌 (34)

  1. "Menopause and bone density issues for women with epilepsy", 61 suppl 2, pp.16~22 (2003)
  2. "Increased bone turnover in epileptic patients treated with carbamazepine", 47, pp.385~388 (2000)
  3. "Bone mineral density measured by dual-energy X-ray absorptiometry and novel markers of bone formation and resorption in patients in antiepileptic drugs", 9, pp.631~637 (1994)
  4. "Bone density and antiepileptic drugs:a case-controlled study", 8, pp.339~342 (1999)
  5. "Decreased bone mass and increased bone turnover with valproate therapy in adults with epilepsy", 57, pp.445~449 (2001)
  6. "Effect of antiepileptic drugs on bone mineral density and bone metabolism in epileptic patients", 22, pp.310~314 (2004)
  7. "Effect of chronic anticonvulsant therapy on serum 25-hydroxycalciferol levels in adults", 287, pp.900~904 (1972)
  8. "Plasma levels and therapeutic effect of 25-hydroxycholecalciferol in epileptic patients taking anticonvulsant drugs", 4, pp.9~12 (1972)
  9. "The effect of anticonvulsant therapy on serum levels of 25-hydroxy- vitamin D,calcium,and parathyroid hormone", 41, pp.1130~1135 (1975)
  10. "Long-term anticonvulsant therapy leads to low bone mineral density-evidence for direct effects of phenytoin and carbamazepine on human osteoblast-like cells", 108, pp.37~43 (2000)
  11. "The clinical relevance of calcaneus bone mineral measurements:a review", 5, pp.35~58 (1988)
  12. "KSO pilot course for osteoporosis expert", pp.33~48
  13. "Hyperparathyroid and hypoparathyroid disorders", 343, pp.1863~1875 (2000)
  14. "Androgens and bone metabolism", 72, pp.202~206 (2005)
  15. "Sex differences in age-related changes in vertebral body size,density and biochemical competence in normal indivisuals", 11, pp.67~73 (1990)
  16. "Periosteal bone formation - a negected determinant of bone strength", 349, pp.320~323 (2003)
  17. "Secondary forms of osteoporosis Disorders of bone and mineral metabolism", pp.889~904 (1992), Raven Press
  18. "A comparative study of the relative influence of different anticonvulsant drugs,UV exposure and diet on vitamin D and calcium metabolism in out-patients with epilepsy", 59, pp.569~577 (1986)
  19. "Biochemical evidence for osteomalacia with carbamazepine therapy", 62, pp.282~286 (1980)
  20. "Anticonvulsant drugs and bone metabolism", 74, pp.284~288 (1986)
  21. "Osteomalacia in institutionalized epileptic patients on long-term anticonvulsant therapy", 64, pp.122~131 (1981)
  22. "Decreased serum ionized calcium and normal vitamin D metabolite levels with anticonvulsant drug treatment", 58, pp.1003~1009 (1984)
  23. "Antiepileptic drug induced bone loss in young male patients who have seizures", 59, pp.781~786 (2002)
  24. "Bone mass and turnover in women with epilepsy on antiepileptic drug monotherapy", 57, pp.252~257 (2005)
  25. "Adverse effects of antiepileptic drug on bone structure", pp.633~642
  26. "Effects of anti-epileptic drug therapy on bone mineral density in ambulatory epileptic children", 16, pp.382~385 (1994)
  27. "Serum gamma glutamyl transferase and alkaline phosphatase activities in epileptics receiving anticonvulsant therapy", 72, pp.245~251 (1976), Clin Chim Acta
  28. "Isoenzymes of alkaline phosphatase in epileptic patients receiving carbamazepine monotherapy", 44, pp.480~482 (1991)
  29. "Pathophysiology behind anticonvulsant osteomalacia", 94, pp.21~28 (1983)
  30. "Low plasma 25-hydroxyvitamin D and serum calcium in institutionalized epileptic subjects consequences and response to treatment with vitamin D", pp.79~91
  31. "Effect of chronic anticonvulsant therapy on serum 25-hydroxycalciferol levels in adults", 287, pp.900~904 (1972)
  32. "Diphenylhydantoin inhibition of calcitonin secretion in the pig", 92, pp.330~333 (1973)
  33. "Phenytoin affects osteoblastic secretion from osteoblastic rat osteosarcoma 17", 2.8 cells in culture, 1990, pp.11, 309~312
  34. "Monomeric serum calcitonin and bone turnover during anticonvulsant treatment and in congenital hypothroidism", 111, pp.57~63 (1987)

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