Potential effects of valproate and oxcarbazepine on growth velocity and bone metabolism in epileptic childrena medical center experience

Chien Ming Lin, Hueng Chuen Fan, Tsu Yi Chao, Der Ming Chu, Chi Chieh Lai, Chih Chien Wang, Shyi Jou Chen

Research output: Contribution to journalArticle

11 Citations (Scopus)

Abstract

Background: Children with longstanding use of antiepileptic drugs (AEDs) are susceptible to developing low bone mineral density and an increased fracture risk. However, the literature regarding the effects of AEDs on growth in epileptic children is limited. The aim of this study was to investigate the potential effects of valproate (VPA) and/or oxcarbazepine (OXC) therapy on growth velocity and bone metabolism. Methods: Seventy-three ambulatory children (40 boys and 33 girls) with epilepsy, aged between 1 and 18 years (mean age 9.8 ± 4.1 years), were evaluated for growth velocity before and for 1 year after VPA and/or OXC treatment. The bone resorption marker serum tartrate-resistant acid phosphatase 5b (TRAcP5b) and the bone formation marker serum bone-specific alkaline phosphatase (BAP) were measured post-AEDs therapy for 1 year. Results: The difference in growth velocity (δHt) and body weight change (δWt) between pre- and post-AEDs treatment were -1.0 ± 2.8 cm/year (P < 0.05) and 0.1 ± 3.9 kg/year (P = 0.84), respectively. The study population had serum TRAcP5b-SDS of -1.6 ± 1.2 and BAP-SDS of 1.7 ± 3.7 compared with sex- and age-matched healthy children. Significant correlation between serum TRAcP 5b and BAP activities was noted (r = 0.60, p < 0.001). There was a positive correlation between growth velocity and serum TRAcP 5b activity after AED treatment (r = 0.42, p < 0.01). No correlation was found between δHt, δWt, serum TRAcP 5b, BAP activity and types of AEDs. Conclusion: Growth velocity was significantly decreased in epileptic children after 1 year of VPA and/or OXC treatment. The effect of VPA and/or OXC therapy on dysregulation of bone metabolism might play a crucial role in physical growth.

Original languageEnglish
Article number61
JournalBMC Pediatrics
Volume16
Issue number1
DOIs
Publication statusPublished - 2016

Fingerprint

Bone Development
Valproic Acid
Anticonvulsants
Alkaline Phosphatase
Bone and Bones
Growth
Serum
Therapeutics
Biomarkers
Body Weight Changes
Bone Resorption
Osteogenesis
Bone Density
oxcarbazepine
Epilepsy
Tartrate-Resistant Acid Phosphatase
Drug Therapy
Population

Keywords

  • Antiepileptic drugs
  • Bone metabolism
  • Bonespecific alkaline phosphatase
  • Growth velocity
  • Tartrate-resistant acid phosphatase 5b

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health

Cite this

Potential effects of valproate and oxcarbazepine on growth velocity and bone metabolism in epileptic childrena medical center experience. / Lin, Chien Ming; Fan, Hueng Chuen; Chao, Tsu Yi; Chu, Der Ming; Lai, Chi Chieh; Wang, Chih Chien; Chen, Shyi Jou.

In: BMC Pediatrics, Vol. 16, No. 1, 61, 2016.

Research output: Contribution to journalArticle

Lin, Chien Ming ; Fan, Hueng Chuen ; Chao, Tsu Yi ; Chu, Der Ming ; Lai, Chi Chieh ; Wang, Chih Chien ; Chen, Shyi Jou. / Potential effects of valproate and oxcarbazepine on growth velocity and bone metabolism in epileptic childrena medical center experience. In: BMC Pediatrics. 2016 ; Vol. 16, No. 1.
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abstract = "Background: Children with longstanding use of antiepileptic drugs (AEDs) are susceptible to developing low bone mineral density and an increased fracture risk. However, the literature regarding the effects of AEDs on growth in epileptic children is limited. The aim of this study was to investigate the potential effects of valproate (VPA) and/or oxcarbazepine (OXC) therapy on growth velocity and bone metabolism. Methods: Seventy-three ambulatory children (40 boys and 33 girls) with epilepsy, aged between 1 and 18 years (mean age 9.8 ± 4.1 years), were evaluated for growth velocity before and for 1 year after VPA and/or OXC treatment. The bone resorption marker serum tartrate-resistant acid phosphatase 5b (TRAcP5b) and the bone formation marker serum bone-specific alkaline phosphatase (BAP) were measured post-AEDs therapy for 1 year. Results: The difference in growth velocity (δHt) and body weight change (δWt) between pre- and post-AEDs treatment were -1.0 ± 2.8 cm/year (P < 0.05) and 0.1 ± 3.9 kg/year (P = 0.84), respectively. The study population had serum TRAcP5b-SDS of -1.6 ± 1.2 and BAP-SDS of 1.7 ± 3.7 compared with sex- and age-matched healthy children. Significant correlation between serum TRAcP 5b and BAP activities was noted (r = 0.60, p < 0.001). There was a positive correlation between growth velocity and serum TRAcP 5b activity after AED treatment (r = 0.42, p < 0.01). No correlation was found between δHt, δWt, serum TRAcP 5b, BAP activity and types of AEDs. Conclusion: Growth velocity was significantly decreased in epileptic children after 1 year of VPA and/or OXC treatment. The effect of VPA and/or OXC therapy on dysregulation of bone metabolism might play a crucial role in physical growth.",
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AU - Lin, Chien Ming

AU - Fan, Hueng Chuen

AU - Chao, Tsu Yi

AU - Chu, Der Ming

AU - Lai, Chi Chieh

AU - Wang, Chih Chien

AU - Chen, Shyi Jou

PY - 2016

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N2 - Background: Children with longstanding use of antiepileptic drugs (AEDs) are susceptible to developing low bone mineral density and an increased fracture risk. However, the literature regarding the effects of AEDs on growth in epileptic children is limited. The aim of this study was to investigate the potential effects of valproate (VPA) and/or oxcarbazepine (OXC) therapy on growth velocity and bone metabolism. Methods: Seventy-three ambulatory children (40 boys and 33 girls) with epilepsy, aged between 1 and 18 years (mean age 9.8 ± 4.1 years), were evaluated for growth velocity before and for 1 year after VPA and/or OXC treatment. The bone resorption marker serum tartrate-resistant acid phosphatase 5b (TRAcP5b) and the bone formation marker serum bone-specific alkaline phosphatase (BAP) were measured post-AEDs therapy for 1 year. Results: The difference in growth velocity (δHt) and body weight change (δWt) between pre- and post-AEDs treatment were -1.0 ± 2.8 cm/year (P < 0.05) and 0.1 ± 3.9 kg/year (P = 0.84), respectively. The study population had serum TRAcP5b-SDS of -1.6 ± 1.2 and BAP-SDS of 1.7 ± 3.7 compared with sex- and age-matched healthy children. Significant correlation between serum TRAcP 5b and BAP activities was noted (r = 0.60, p < 0.001). There was a positive correlation between growth velocity and serum TRAcP 5b activity after AED treatment (r = 0.42, p < 0.01). No correlation was found between δHt, δWt, serum TRAcP 5b, BAP activity and types of AEDs. Conclusion: Growth velocity was significantly decreased in epileptic children after 1 year of VPA and/or OXC treatment. The effect of VPA and/or OXC therapy on dysregulation of bone metabolism might play a crucial role in physical growth.

AB - Background: Children with longstanding use of antiepileptic drugs (AEDs) are susceptible to developing low bone mineral density and an increased fracture risk. However, the literature regarding the effects of AEDs on growth in epileptic children is limited. The aim of this study was to investigate the potential effects of valproate (VPA) and/or oxcarbazepine (OXC) therapy on growth velocity and bone metabolism. Methods: Seventy-three ambulatory children (40 boys and 33 girls) with epilepsy, aged between 1 and 18 years (mean age 9.8 ± 4.1 years), were evaluated for growth velocity before and for 1 year after VPA and/or OXC treatment. The bone resorption marker serum tartrate-resistant acid phosphatase 5b (TRAcP5b) and the bone formation marker serum bone-specific alkaline phosphatase (BAP) were measured post-AEDs therapy for 1 year. Results: The difference in growth velocity (δHt) and body weight change (δWt) between pre- and post-AEDs treatment were -1.0 ± 2.8 cm/year (P < 0.05) and 0.1 ± 3.9 kg/year (P = 0.84), respectively. The study population had serum TRAcP5b-SDS of -1.6 ± 1.2 and BAP-SDS of 1.7 ± 3.7 compared with sex- and age-matched healthy children. Significant correlation between serum TRAcP 5b and BAP activities was noted (r = 0.60, p < 0.001). There was a positive correlation between growth velocity and serum TRAcP 5b activity after AED treatment (r = 0.42, p < 0.01). No correlation was found between δHt, δWt, serum TRAcP 5b, BAP activity and types of AEDs. Conclusion: Growth velocity was significantly decreased in epileptic children after 1 year of VPA and/or OXC treatment. The effect of VPA and/or OXC therapy on dysregulation of bone metabolism might play a crucial role in physical growth.

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