Seizure: European Journal of Epilepsy
Volume 19, Issue 3 , Pages 153-158 , April 2010

The effect of anti epileptic drug therapy on serum 25-hydroxyvitamin D and parameters of calcium and bone metabolism—A longitudinal study

  • Bindu Menon

      Affiliations

    • Department of Neurology, Sri Venkateswara Institute of Medical Sciences, Tirupati 517507, Andhra Pradesh, India
    • ,
  • C.V. Harinarayan

      Affiliations

    • Department of Endocrinology and Metabolism, Sri Venkateswara Institute of Medical Sciences, Tirupati 517507, Andhra Pradesh, India
    • Corresponding Author InformationCorresponding author. Tel.: +91 09731561819.

Received 27 June 2009 ,Revised 18 October 2009 ,Accepted 15 January 2010.

References 

  1. Scott RA, Lhatoo SD, Sander JWA. The treatment of epilepsy in developing countries: where do we go from here?. Bull World Health Organ. 2001;79(4):344–351
  2. Shorvon SD, Farmer PJ. Epilepsy in developing countries: a review of epidemiological, sociocultural, and treatment aspects. Epilepsia. 1988;29(Suppl. 1):S36–S54
  3. Sridharan R, Murthy BN. Prevalence and pattern of epilepsy in India. Epilepsia. 1999;40(5):631–636
  4. Hahn TJ, Hendin BA, Scharp CR. Effect of chronic anticonvulsant therapy on serum 25-hydroxycalciferol levels in adults. N Engl J Med. 1972;287:900–904
  5. Richens A, Rowe DFJ. Disturbance of calcium metabolism by anticonvulsant drugs. Br Med J. 1970;4:73–76
  6. Bouillon R, Reynaert J, Claes JH, Lissens W, De Moor P. The effect of anticonvulsant therapy on serum levels of 25-hydroxyvitamin D, calcium, and parathyroid hormone. J Clin Endocrinol Metab. 1975;41:1130
  7. Ganapathy GR, Rao GVGK, Gourie Devi M. Bone changes after long term anticonvulsant therapy. Neurol India. 1973;21:159–164
  8. Pack AM, Morrell MJ, Randall A, McMahon DJ, Shane E. Bone health in young women with epilepsy after one year of antiepileptic drug monotherapy. Neurology. 2008;70(18):1586–1593
  9. Farhat G, Yamout B, Mikati MA, Demirjian S, Sawaya R, El-Hajj Fuleihan G. Effect of antiepileptic drugs on bone density in ambulatory patients. Neurology. 2002;58(9):1348–1353
  10. Sheth RD, Binkley N, Hermann BP. Progressive bone deficit in epilepsy. Neurology. 2008;70(3):170–176
  11. Harinarayan CV, Ramalakshmi T, Prasad UV, Sudhakar D, Srinivasarao PVLN, Sarma KVS, et al. High prevalence of low dietary calcium, high phytate consumption, and vitamin D deficiency in healthy south Indians. Am J Clin Nutr. 2007;85:1062–1067
  12. Food composition table. In:  Gopalan C,  Sastri BVR,  Balasubramanyam SC editor. Nutritive value of Indian foods. Hyderabad, India: National Institute of Nutrition ICMR; 1996;[Appendix 1:92-4]
  13. Heaney RP, Dowell MS, Hale CA, Bendich A. Calcium absorption varies within the reference range for serum 25-hydroxyvitamin D. J Am Coll Nutr. 2003;22:142–146
  14. Lips P. Relative value of 25(OH)D and 1,25(OH)2D measurements. J Bone Miner Res. 2007;22:1668–1671
  15. Heaney RP. Vitamin D depletion and effective calcium absorption. A letter to the editor. J Bone Miner Res. 2003;18:1342
  16. Lips P. Vitamin D deficiency and secondary hyperparathyroidism in the elderly: consequences for bone loss and fractures and therapeutic implications. Endocr Rev. 2003;22:477–501
  17. Harinarayan CV, Ramalakshmi T, Venkataprasad UV. High prevalence of low dietary calcium and low vitamin D status in healthy south Indians. Asia Pac J Clin Nutr. 2004;13:359–365
  18. Shatrugna V, Kulkarni B, Kumar PA, Rani KU, Balakrishna N. Bone status of Indian women from low income group and its relationship to the nutritional status. Osteoporos Int. 2005;16:1827–1835
  19. Jonnalagadda SS, Diwan S. Nutrient intake of first generation Gujarati Asian Indian immigrants in the U.S.. J Am Coll Nutr. 2002;21:372–380
  20. Sallamander Concepts. RDA – Recommended Dietary Allowance of nutritional elements. Internet: http://www.anyvitamins.com/rda.htm [last accessed on 24th Dec 2008].
  21. Swaminathan M. Recommended dietary intake of nutrients. New Delhi, India: Indian Council of Medical Research; 1981;
  22. Recommended Dietary Allowances. In: Essentials of food and nutrition: fundamental aspects, vol. 1. Bangalore, India: Bappco Pub; 1997. p. 508–21.
  23. Institute of Medicine, Standing Committee on Scientific Evaluation of Dietary Reference Intakes-Calcium. In: Dietary Reference Intakes for calcium, phosphorus, magnesium, vitamin D, and fluoride. Washington, DC: National Academy Press; 1997. p. 71–145.
  24. Altay EE, Serdaroğlu A, Tümer L, Gücüyener K, Hasanoğlu A. Evaluation of bone mineral metabolism in children receiving carbamazepine and valproic acid. J Pediatr Endocrinol Metab. 2000;13(7):933–939
  25. Välimäki MJ, Tiihonen M, Laitinen K, Tähtelä R, Kärkkäinen M, Lamberg-Allardt C, et al. Bone mineral density measured by dual-energy x-ray absorptiometry and novel markers of bone formation and resorption in patients on antiepileptic drugs. J Bone Miner Res. 1994;9(5):631–637
  26. Zhou C, Assem M, Tay JC, Watkins PB, Blumberg B, Schuetz EG, et al. Steroid and xenobiotic receptor and vitamin D receptor crosstalk mediates CYP24 expression and drug-induced osteomalacia. J Clin Invest. 2006;116(6):1703–1712[Epub 2006 May 11]
  27. Valsamis HA, Arora SK, Labban B, McFarlane SI. Antiepileptic drugs and bone metabolism. http://www.nutritionandmetabolism.com/content/3/1/36 [last accessed on 24th Dec 2008].
  28. Tomita S, Ohnishi JI, Nakano M, Ichikawa Y. The effect of anticonvulsant drugs on vitamin D3-activating cytochrome P-450-linked monooxygenase system. J Steroid Biochem Mol Biol. 1991;39:479–485
  29. Cinti DL, Golub EE, Bronner F. 25-Hydroxycholecalciferol: high affinity substrate for hepatic cytochrome P-450. Biochhem Biophys Res Commun. 1976;72:546–553
  30. Theodoropoulos C, Demers C, Mirshahi A, Gascon-Barre M. 1,25-dihydroxy D3 down regulates the rat intestinal vitamin D3-25 hydroxylase CYP27A. Am J Physiol. 2001;281:E315–E325
  31. Pascussi JM, Robert A, Nguyen M, Walrant-Debray O, Garabedian M, Martin P, et al. Possible involvement of pregnane X receptor-enhanced CYP24 expression in drug-induced osteomalacia. J Clin Invest. 2005;115:177–186
  32. Holick MF. Stay tuned to PXR: an orphan actor that may not be D-structive only to bone. J Clin Invest. 2005;115:32–34
  33. Koch HU, Kraft D, von Herrath D, Schaefer K. Influence of diphenylhydantoin and phenobarbital on intestinal calcium transport in the rat. Epilepsia. 1972;13:829–841
  34. Yanase T, Suzuki S, Goto K, Nomura M, Okabe T, Takayanagi R, et al. Aromatase in bone: roles of Vitamin D3 and androgens. J Steroid Biochem Mol Biol. 2003;86:393–397
  35. Nawata H, Tanaka S, Takayanagi R, Sakai Y, Yanase T, Ikuyama S, et al. Aromatase in bone cell: association with osteoporosis in postmenopausal women. J Steroid Biochem Mol Biol. 1995;53:165–174
  36. Tanaka S, Haji M, Takayanagi R, Tanaka S, Sugioka Y, Nawata H. 1,25-Dihydroxyvitamin D3 enhances the enzymatic activity and expression of the messenger ribonucleic acid for aromatase cytochrome P450 synergistically with dexamethasone depending on the vitamin D receptor level in cultured human osteoblasts. Endocrinology. 1996;137(5):1860–1869
  37. Perucca E. Clinical implications of hepatic microsomal enzyme induction by antiepileptic drugs. Pharmacol Ther. 1987;33:139–144
  38. Weinstein RS, Bryce GF, Sappington LJ, King DW, Gallagher BB. Decreased serum ionized calcium and normal vitamin D metabolite levels with anticonvulsant drug treatment. J Clin Endocrinol Metab. 1984;58:1003–1009
  39. Onodera K, Takahashi A, Sakurada S, Okano Y. Effects of phenytoin and/or vitamin K2 (menatetrenone) on bone mineral density in the tibia of growing rats. Life Sci. 2002;70:1533–1542
  40. Vernillo AT, Rifkin BR, Hauschka PV. Phenytoin affects osteoblastic secretion from osteoblastic rat osteosarcoma 17/2.8 cells in culture. Bone. 1990;11:309–312
  41. Guo C, Ronen GM, Atkinson SA. Long-term valproate and lamotrigine treatment may be a marker for reduced growth and bone mass in children with epilepsy. Epilepsia. 2001;42:1141–1147
  42. Pack A, Morrell M. Adverse effects of antiepileptic drugs on bone structure: epidemiology, mechanisms and therapeutic implications. CNS drugs. 2001;15(8):633–642
  43. Cauley JA, Lacroix AZ, Wu L, Horwitz M, Danielson ME, Bauer DC, et al. Serum 25-hydroxyvitamin D concentrations and risk for hip fractures. Ann Intern Med. 2008;149(4):242–250
  44. Dawson-Hughes B. Serum 25-hydroxyvitamin D and functional outcomes in the elderly. Am J Clin Nutr. 2008;88(2):537S–540S
  45. Sheth RD, Harden CL. Screening for bone health in epilepsy. Epilepsia. 2007;48(Suppl. 9):39–41
  46. Souverein PC, Webb DJ, Weil JG, Van Staa TP, Egberts AC. Use of antiepileptic drugs and risk of fractures: case-control study among patients with epilepsy. Neurology. 2006;9(66):1318–1324
  47. Pearson JA, Burkhart E, Pifalo WB, Palaggo-Toy T, Krohn K. A lifestyle modification intervention for the treatment of osteoporosis. Am J Health Promot. 2005;20(1):28–33
  48. Harinarayan CV, Joshi SR. Vitamin D status in India—its implications and remedial measures—a review. JAPI. 2009;40–48

PII: S1059-1311(10)00007-5

doi: 10.1016/j.seizure.2010.01.006

Seizure: European Journal of Epilepsy
Volume 19, Issue 3 , Pages 153-158 , April 2010

Article Tools

* Image Usage & Resolution