Abstracts

Rationale: Limited research focuses on bone health in young women with epilepsy. We examined bone turnover markers in young women on antiepileptic drug (AED) monotherapy. We also measured serum homocysteine due to its association with lower bone mass. Methods: Six young women with epilepsy taking carbamazepine, levetiracetam, or lamotrigine for at least six months were matched with controls by age and weight. Exclusion criteria included illnesses or medications that interfere with bone metabolism. Participants completed food and exercise logs and provided blood and urine specimens. Blood was analyzed for bone specific alkaline phosphatase, osteocalcin, calcium, 25 OH vitamin D, and homocysteine. Urine was analyzed for cross-linked telopeptides. We calculated daily nutrient intake of calcium, folate, and vitamins B 12 and D. Results: Subjects with epilepsy had higher bone specific alkaline phosphatase compared with controls (14.9 vs. 10.8 ng/ml, p = 0.03). We found no significant differences in other markers of bone turnover between groups. There was no statistical difference in serum homocysteine levels, which were in the normal range. Mean 25 OH vitamin D levels were in the relatively insufficient range in both groups (24.3 vs. 25.8 ng/ml). There were no signficant differences in intake of calcium, folate, or vitamins B 12 or D between groups. However, mean folate intake in the epilepsy group was below the recommended daily allowance of 400 mcg/day. Conclusions: In this modest-sized cohort, bone specific alkaline phosphatase was higher in subjects with epilepsy on antiepileptic drug monotherapy, suggesting higher bone turnover. The 25 OH vitamin D status and suboptimal folate intake in the epilepsy group suggest that vitamin supplementation in these patients might be beneficial.