Effect of duration of sodium valproate therapy on bone mineral density and vitamin D levels

Epilepsy Behav. 2024 Apr:153:109733. doi: 10.1016/j.yebeh.2024.109733. Epub 2024 Mar 5.

Abstract

Objective: This study aimed to evaluate the impact of prolonged sodium valproate use on bone mineral density (BMD) and Vitamin D levels in pediatric epilepsy patients.

Methods: In a cross-sectional study conducted at the Epilepsy Clinic of Niloufer Hospital, Hyderabad, India, 50 pediatric patients (aged 4-10 years) were recruited. The cohort comprised 30 epilepsy patients on sodium valproate treatment (cases) and 20 healthy siblings without epilepsy or valproate use (controls). BMD was assessed using dual-energy X-ray absorptiometry to measure height-adjusted total body less head Z-scores (TBLH Z-scores), and serum 25-hydroxyvitamin D levels were measured. Statistical analysis included independent samples t-tests, Mann-Whitney U tests, and Pearson correlation, with a preliminary power analysis ensuring adequate sample size.

Results: Cases exhibited significantly lower BMD TBLH Z-scores (Mean = -1.543) compared to controls (Mean = 0.515, p <.001) and reduced Vitamin D levels (Mean = 9.17 for cases vs. 27.80 for controls, p <.001). A negative correlation was observed between the duration of sodium valproate use and both BMD Z-scores (r = -0.626, p <.001) and Vitamin D levels (r = -0.707, p <.001).

Conclusions: The findings suggest a significant negative impact of prolonged sodium valproate use on both bone density and Vitamin D levels in pediatric patients. These results underscore the importance of monitoring and managing bone health in children receiving long-term sodium valproate therapy.

Keywords: Anti-epileptic; Bone Mineral Density; Epilepsy; Sodium Valproate; Vitamin D.

MeSH terms

  • Absorptiometry, Photon
  • Bone Density*
  • Child
  • Cross-Sectional Studies
  • Epilepsy* / chemically induced
  • Epilepsy* / drug therapy
  • Humans
  • Valproic Acid / adverse effects
  • Vitamin D
  • Vitamins

Substances

  • Valproic Acid
  • Vitamin D
  • Vitamins