Background Osteoporosis and epilepsy are two common affections, mostly diagnosed in the elderly. The prevalence of epilepsy is 1% in people over 60 years and increases with age. An increased risk of fracture has been reported in patients with epilepsy when compared to the general population. The aim of our study was to assess the bone status in epileptic patients and to identify risk factors for osteoporosis.
Methods Eighty-two patients with epilepsy (26 M; 56F) and 98 controls matched for age and sex were included. For each patient, the following data were collected: risk factors for osteoporosis, serum dosage of 25-OH D, estimation of calcium intake by the Fardelonne questionnaire, radiological assessment including vertebral fracture assessment (VFA) and bone densitometry DXA (Hologic QDR).
Results The mean age of patients was 47.0±17.2 years (15 – 74), mean disease duration 13.6±7.54 years, mean duration since therapy was started 10.2±5.51 years (2 – 39), mean BMI 25,1±3,2 kg/m2 (15,4 - 36,9), mean calcium intake 736±148 mg/d (427 - 1131) in cases and 868±125 in controls (p=0.037). The mean level of 25-OH D was 17,6±6,7 ng/L (6 - 31) in cases and 19.4±5.8 ng/L in controls (p=0.002). Vitamin D deficiency (<20 ng/L) was noted in 72.0% cases and 48.0% controls. The number of vertebral fractures was 11 in cases and 4 in controls (p=0.003). Smoking concerned 22% cases and 78% controls and alcohol intake 18.3% cases and 82.7% controls. The mean vertebral T-score was -1.91±2.06 in cases Vs 0.59±1,48 in controls (p<0.001); the mean femoral T-score was -1.16±1.23 in cases Vs -0.45±1.02 in controls (p<0.001). Based on the IOF definition, 38.8% cases and 43.9% controls were osteopenic. Cases had lower vertebral and femoral BMD values compared with controls. Identified risk factors for a lower BMD were female, advanced age, low calcium intake and lower levels of 25-OH D. Finally, there was a significant correlation between BMD and a higher BMI, a younger age, a higher calcium intake, a higher level of 25-OH D and the number of fractures.
Conclusions Osteoporosis is more frequent in epileptic patients taking antiepileptic medications than in the general population. Risk factors are female, age, low calcium intake and low levels of 25-OH D. Detection of osteoporosis in this subpopulation seems interesting as well as the supplementation of patients undertaking antiepileptic medications with vitamin D.
Disclosure of Interest None Declared