Abstract 76: Alteration in bone metabolism and bone mineral density with chronic anti-epileptic drug therapy in North Indian population

Objective: Anti-epileptic drugs are the mainstay of treatment of epilepsy. Prolong use of anti-epileptic medicines can lead to reduction in bone mineral density (BMD), resulting in 2-6-fold increase in fracture risk. This study was carried out to assess the impact of AEDs on the markers of bone turnover and BMD in North Indian patients. Methods: In this hospital based observational study sixty adult patients with epilepsy, on antiepileptic drugs were included. Serum calcium, phosphorus, alkaline phosphatase (ALP), albumin, 25 (OH) vitamin D and intact Parathyroid hormone (iPTH) and BMD (at lumbar spine with DEXA) were measured in all study subjects. Results: The serum level of calcium, phosphorus and 25(OH) Vitamin D was significantly decreased and iPTH and ALP levels were increased in patients taking anti-epileptic drugs for > 5 years. There was a significant negative correlation between serum calcium, phosphorus and vitamin D levels and significant positive correlation with ALP and iPTH levels with duration anti-epileptic therapy. There was negative correlation between the T-score and anti-duration of anti-epileptic therapy. Conclusions: Use of anti-epileptic (both old and new) medication in adults is associated with decline in BMD, calcium, vitamin D and phosphorus levels and elevation in iPTH and ALP levels.