Abstracts

Rationale: Epilepsy affects the length and quality of people's lives. The long-term course of epilepsy is accompanied by the development of hormonal and metabolic changes that lead to the appearance of comorbid pathology, in particular, to the pathology of the bone system in young men. It is known that long-term antiepileptic therapy significantly affects the electrolyte metabolism and reduces the bone mineral density (BMD). AEDs can accelerate bone loss through hypovitaminosis D, hypocalcemia, and hyperparathyroidism, or reduce bone build-up by reducing levels of calcitonin, growth factors, and vitamin K. In addition, AEDs can directly accelerate the osteoclasts and reduce the activity of the osteoblasts. This leads to the development of secondary osteoporosis (Figure 1). The purpose of the study was to study the markers of bone tissue metabolism, to identify metabolic and hormonal disorders in men with epilepsy aged 18-44 years.

Methods: This study involved 40 young men. The exclusion criteria were the presence of significant somatic pathology (including diseases of the gastrointestinal tract and kidneys, in which the absorption and elimination of calcium and phosphorus is impaired, which could affect the results of the study), current neurological pathology, as well as old age. Clinical-anamnestic, neurological, and biochemical methods were used (determination of calcium, phosphorus, and parathyroid hormone in blood serum). Normal parameters were considered to be included in the following intervals: for calcium, 2.02-2.6 mmol/l, for phosphorus, 1.3-2.26 mmol/l, for parathyroid hormone, 21-45 pg / ml.

Results: In the research 32 men (80%) were diagnosed with symptomatic epilepsy, and 8 (20%) with generalized epilepsy. No cases of hereditary epilepsy have been identified. When studying the content of calcium in the blood serum, it was found that its average value was 2.230 ± 0.039 mmol/L, that is, it was within the normal range. However, in 4 men (10%) there was a decrease in it, in 1 patient (2.5%) — an increase. The average serum phosphorus content was 1.370 ± 0.071 mmol/L, which is the lower limit of the norm. In the individual study of phosphorus parameters, more pronounced changes were observed in comparison with those for calcium: a decrease in its content was detected in 18 people (45%), an increase — in 5 patients (12.5%). The average parathyroid hormone content in the blood serum of patients was 36.060 ± 4.766 pg/ml, which corresponded to the standard interval. However, it was for parathyroid hormone that the most pronounced changes were detected within the group: in 15 men (37.5%), this indicator was increased, and in 7 people (17.5%) sharply, in 12 (30%) patients it was reduced, and in 5 people (12.5%) it was sharply reduced.

Conclusions: The study revealed violations of calcium-phosphorus metabolism and its regulating parathyroid hormone in young men with epilepsy. The analysis of the content's indicators of calcium in the blood serum shows that in almost all the subjects they were within the normal range, while in relation to other indicators, a pronounced imbalance was revealed. This is consistent with the literature data indicating that with the development of secondary disorders of bone metabolism, namely, against the background of epilepsy and AEDs, the level of calcium in the blood serum is within the normal range in the blood. Thus, the study of the content of calcium in the blood serum as a routine method is insufficient to assess the exchange of bone tissue and should be classified as auxiliary. Epilepsy of the brain and the use of AEDs lead to dysfunction of the endocrine system and disorders of mineral metabolism, which require additional research and treatment.

Funding: Please list any funding that was received in support of this abstract.: The funding has not been received to support this abstract.