난치성 간질 환아의 성장상태, 칼슘 조절호르몬 농도 및 골밀도 소견

Abstract

Purpose : Abnormalities in calcium(Ca), vitamin D and bone mineral density(BMD) associated with antiepileptic drug(AED) are reported, but the results are inconsistent. In case of intractable epilepsy, poor growth and altered bone mineral metabolism may be prominent, possibly related to previous long-term use of multiple AED and poor activity. The aim of this study was to assess growth status, concentrations of calcium regulating hormones and BMD In children with intractable epilepsy. Methods : Sixty-six intractable epilepsy patients aged 0.8 to 14.7 years(mean±SD : 4.6±3.6 years) were included in the study. Height and weight were measured and then height SDS and weight SDS were calculated. Serum Ca, i-Ca, P, Mg, Zinc, osteocalcin, intact-PTH, 25-OHD, 1,25(OH)₂D were measured. BMD of the lumbar spine was measured by dual energy X-ray absorption. Results : Most of the patients showed normal height SDS and weight SDS. Percentage of severe short stature(height SDS <-2) was 1.5% and tall stature(height SDS >2) was 4.5%. Percentage of severe thin(weight SDS <-2) was 1.5% and obesity(weight SDS >2) was 6%. Duration of AED was not related to height SDS or weight SDS. Etiology of epilepsy and physical activity were not related to height SDS and weight SDS. Most of them had normal Ca, iCa, P, Mg, Zinc, intact-PTH, osteocalcin, 25-OHD and 1,25(OH)₂D concentrations. BMD was not related to the levels of Ca, i-Ca, P, Mg, intact-PTH, osteocalcin, 25-OHD, 1,25(OH)₂D. BMD was not related to the duration of AED. BMD positively correlated with age(r=0.75, P<0.01) and body weight(r=0.72, P<0.01). Conclusion : Most of the children with intractable epilepsy, who regularly visits epilepsy clinic, showed normal growth and normal bone mineral metabolism, but careful monitoring about growth and bone mineral metabolism is needed.