ABSTRACT:
Long term antiepileptic therapy has been associated with altered bone metabolism, and is a risk factor for development of osteoporosis. The present study was done to know the changes in biochemical markers of bone metabolism associated with antiepileptic therapy. This was a case control study conducted at a tertiary care hospital in South India in June 2010 where 80 patients and 20 controls, aged 20 to 40 years were enrolled for the study. Measurement of seven markers were done to determine the risk of fractures namely, serum calcium, serum phosphorous and 25(OH) D levels, bone formation markers - BSAP (Bone specific alkaline phosphatase) and osteocalcin, bone resorption markers - C telopeptide and urinary hydroxyproline. Statistical analysis was done using Student t test/Chi-square test. Student t test (Unpaired, two tailed) has been used to find the significance of study parameters between two groups. In the present study alteration of all the biochemical markers was statistically significant in cases when compared with controls. When gender comparison was done among the biochemical markers, only bone specific alkaline phosphatase and serum phosphorus showed a statistically significant difference, whereas other parameters did not show any statistically significant difference. Statistically significant difference between serum calcium and phosphorus levels, C-telopeptide levels in the polytherapy group. Antiepileptic drugs appear to have negative influence bone health, there was a significant association between AED use and alteration in biochemical parameters, which may increase the fracture risk. Physicians should consider a monitoring schedule for patients taking antiepileptics, especially if they have other risk factors that contribute to bone disease.