Determinants of low bone mineral density in children with epilepsy

Choong Yi Fong, Ann Nie Kong, Mazidah Noordin, Bee Koon Poh, Lai Choo Ong, Ching Ching Ng

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Introduction: Children with epilepsy on long-term antiepileptic drugs (AEDs) are at risk of low bone mineral density (BMD). The aims of our study were to evaluate the prevalence and determinants of low BMD among Malaysian children with epilepsy. Method: Cross-sectional study of ambulant children with epilepsy on long-term AEDs for >1 year seen in a tertiary hospital in Malaysia from 2014 to 2015. Detailed assessment of anthropometric measurements; environmental lifestyle risk factors; serum vitamin D, calcium and parathyroid hormone levels; genotyping of single nucleotide polymorphisms of genes in vitamin D and calcium metabolism; and lumbar spine BMD were obtained. Low BMD was defined as BMD Z-score ≤ -2.0 SD. Results: Eighty-seven children with mean age of 11.9 years (56 males) participated in the study. The prevalence of low lumbar BMD was 21.8% (19 patients). Multivariate logistic regression analysis identified polytherapy >2 AEDs (OR: 7.86; 95% CI 1.03-59.96), small frame size with wrist breadth of <15th centile (OR 14.73; 95% CI 2.21-98.40), and body mass index Z-score < -2.0 (OR 8.73, 95% CI 1.17-65.19) as significant risk factors for low BMD. Conclusion: One-fifth of Malaysian children with epilepsy on long-term AEDs had low BMD. Targeted BMD should be performed for those who are on >2 AEDs, underweight or with small frame size as they are at higher risk of having low BMD.

Original languageEnglish
JournalEuropean Journal of Paediatric Neurology
DOIs
Publication statusAccepted/In press - 2017

Fingerprint

Bone Density
Epilepsy
Anticonvulsants
Vitamin D
Calcium
Thinness
Malaysia
Wrist
Parathyroid Hormone
Tertiary Care Centers
Single Nucleotide Polymorphism
Life Style
Spine
Body Mass Index
Cross-Sectional Studies
Logistic Models
Regression Analysis
Serum

Keywords

  • Antiepileptic drug
  • Bone mineral density
  • Epilepsy
  • Genetic
  • Lifestyle

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Clinical Neurology

Cite this

Determinants of low bone mineral density in children with epilepsy. / Fong, Choong Yi; Kong, Ann Nie; Noordin, Mazidah; Poh, Bee Koon; Ong, Lai Choo; Ng, Ching Ching.

In: European Journal of Paediatric Neurology, 2017.

Research output: Contribution to journalArticle

Fong, Choong Yi ; Kong, Ann Nie ; Noordin, Mazidah ; Poh, Bee Koon ; Ong, Lai Choo ; Ng, Ching Ching. / Determinants of low bone mineral density in children with epilepsy. In: European Journal of Paediatric Neurology. 2017.
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abstract = "Introduction: Children with epilepsy on long-term antiepileptic drugs (AEDs) are at risk of low bone mineral density (BMD). The aims of our study were to evaluate the prevalence and determinants of low BMD among Malaysian children with epilepsy. Method: Cross-sectional study of ambulant children with epilepsy on long-term AEDs for >1 year seen in a tertiary hospital in Malaysia from 2014 to 2015. Detailed assessment of anthropometric measurements; environmental lifestyle risk factors; serum vitamin D, calcium and parathyroid hormone levels; genotyping of single nucleotide polymorphisms of genes in vitamin D and calcium metabolism; and lumbar spine BMD were obtained. Low BMD was defined as BMD Z-score ≤ -2.0 SD. Results: Eighty-seven children with mean age of 11.9 years (56 males) participated in the study. The prevalence of low lumbar BMD was 21.8{\%} (19 patients). Multivariate logistic regression analysis identified polytherapy >2 AEDs (OR: 7.86; 95{\%} CI 1.03-59.96), small frame size with wrist breadth of <15th centile (OR 14.73; 95{\%} CI 2.21-98.40), and body mass index Z-score < -2.0 (OR 8.73, 95{\%} CI 1.17-65.19) as significant risk factors for low BMD. Conclusion: One-fifth of Malaysian children with epilepsy on long-term AEDs had low BMD. Targeted BMD should be performed for those who are on >2 AEDs, underweight or with small frame size as they are at higher risk of having low BMD.",
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