Zhurnal nevrologii i psikhiatrii imeni S.S. Korsakova · 2026
[The impact of antiepileptic therapy on 25(OH)D levels and bone mineral density in epileptic patients].
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Magomedova P M, Zhidkova I A, Biryukova E V, Azhigova A M, Solonsky D S
Аннотация
OBJECTIVE: To investigate the effects of antiepileptic drugs (AEDs) on bone tissue and the laboratory indicators of bone metabolism in patients with epilepsy receiving AEDs for over three years.
MATERIAL AND METHODS: The study included adult patients of reproductive age with various forms of epilepsy (n=91), categorized into two groups based on treatment regimens: monotherapy and polytherapy. The assessment of 25-hydroxyvitamin D (25(OH)D) levels, serum mineral metabolism indicators, and bone mineral density (BMD) was conducted through X-ray absorptiometry (densitometry), specifically targeting the lumbar spine and proximal femur.
RESULTS: The mean 25(OH)D level in the monotherapy group was 27.2 ng/mL versus 22.5 ng/mL in the polytherapy group. A higher prevalence of 25(OH)D deficiency (<20 ng/mL) was observed among patients receiving AED polytherapy (22.2% vs. 11.2% in the monotherapy group). 25(OH)D insufficiency was present at similar rates in both therapy groups, with 16.7% of patients affected in each group. Regression analysis indicated a trend exhibiting a reduction of 7.155 ng/mL in 25(OH)D levels associated with polytherapy. Furthermore, osteopenia or osteoporosis (as indicated by decreased BMD) was identified in 24.6% of the patient cohort; however, no statistically significant correlation was observed between 25(OH)D levels and densitometry findings (p=0.330).
CONCLUSIONS: The findings suggest that AED polytherapy is associated with lower 25(OH)D levels compared with monotherapy, indicating a cumulative effect of combination therapy on bone metabolism.
MATERIAL AND METHODS: The study included adult patients of reproductive age with various forms of epilepsy (n=91), categorized into two groups based on treatment regimens: monotherapy and polytherapy. The assessment of 25-hydroxyvitamin D (25(OH)D) levels, serum mineral metabolism indicators, and bone mineral density (BMD) was conducted through X-ray absorptiometry (densitometry), specifically targeting the lumbar spine and proximal femur.
RESULTS: The mean 25(OH)D level in the monotherapy group was 27.2 ng/mL versus 22.5 ng/mL in the polytherapy group. A higher prevalence of 25(OH)D deficiency (<20 ng/mL) was observed among patients receiving AED polytherapy (22.2% vs. 11.2% in the monotherapy group). 25(OH)D insufficiency was present at similar rates in both therapy groups, with 16.7% of patients affected in each group. Regression analysis indicated a trend exhibiting a reduction of 7.155 ng/mL in 25(OH)D levels associated with polytherapy. Furthermore, osteopenia or osteoporosis (as indicated by decreased BMD) was identified in 24.6% of the patient cohort; however, no statistically significant correlation was observed between 25(OH)D levels and densitometry findings (p=0.330).
CONCLUSIONS: The findings suggest that AED polytherapy is associated with lower 25(OH)D levels compared with monotherapy, indicating a cumulative effect of combination therapy on bone metabolism.