Value of routine screening for bone demineralization in an urban population of patients with epilepsy

Fred Lado, Rebecca Spiegel, Jonathan H. Masur, Alexis D. Boro, Sheryl R. Haut

Research output: Contribution to journalArticle

28 Citations (Scopus)

Abstract

Background: Reduced bone mineral density (BMD) is increasingly recognized in patients receiving antiepileptic drug therapy. The precise prevalence is not known due to variability across populations studied. We set out to characterize the prevalence of abnormal BMD in an urban population of patients with epilepsy with the intent to determine the value of routine BMD screening. Methods: We performed a cross-sectional study of 130 consecutive patients seen thorough our Comprehensive Epilepsy Center. BMD was measured using dual X-ray absorptiometry and was reported as T-score and Z-score. Additional information collected for each patient included age, race, gender, current and prior AEDs, ambulatory state, menopausal state, concomitant medications potentially associated with reduced bone mineralization, and comorbid illness potentially associated with reduced bone mineralization. Associations between reduced bone mineralization and variables were tested for significance using Fisher's exact test, Student's t-test, and Wilcoxon rank sum test. Results: The average age of the entire study population was 43.5 (±12.5) years. Fifty-five percent of patients had T-score less than or equal to -1, the WHO criterion for osteopenia in postmenopausal women. The prevalence of Z-scores less than -2.0 was 15%, which is more than sixfold greater than expected. The markers for decreased BMD included older age or menopause in women, longer duration of therapy, and a history of use of phenytoin or phenobarbital. Assisted ambulation was also associated with low BMD. Conclusion: Our results indicate that reduced bone mineralization is prevalent and a significant health concern in an urban population of patients with epilepsy. Because of the high prevalence of reduced bone mineralization reported in numerous studies including this study, routinely screening for reduced bone mineralization is warranted in patients receiving anticonvulsant therapy.

Original languageEnglish (US)
Pages (from-to)155-160
Number of pages6
JournalEpilepsy Research
Volume78
Issue number2-3
DOIs
StatePublished - Feb 2008

Fingerprint

Urban Population
Physiologic Calcification
Epilepsy
Bone Density
Bone and Bones
Nonparametric Statistics
Anticonvulsants
Metabolic Bone Diseases
Photon Absorptiometry
Phenytoin
Phenobarbital
Menopause
Population
Walking
Cross-Sectional Studies
Students
Drug Therapy
Health
Therapeutics

Keywords

  • AED
  • Antiepileptic drug
  • Bone demineralization
  • Epilepsy
  • Osteopenia
  • Osteoporosis

ASJC Scopus subject areas

  • Clinical Neurology
  • Pediatrics, Perinatology, and Child Health
  • Neurology

Cite this

Value of routine screening for bone demineralization in an urban population of patients with epilepsy. / Lado, Fred; Spiegel, Rebecca; Masur, Jonathan H.; Boro, Alexis D.; Haut, Sheryl R.

In: Epilepsy Research, Vol. 78, No. 2-3, 02.2008, p. 155-160.

Research output: Contribution to journalArticle

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abstract = "Background: Reduced bone mineral density (BMD) is increasingly recognized in patients receiving antiepileptic drug therapy. The precise prevalence is not known due to variability across populations studied. We set out to characterize the prevalence of abnormal BMD in an urban population of patients with epilepsy with the intent to determine the value of routine BMD screening. Methods: We performed a cross-sectional study of 130 consecutive patients seen thorough our Comprehensive Epilepsy Center. BMD was measured using dual X-ray absorptiometry and was reported as T-score and Z-score. Additional information collected for each patient included age, race, gender, current and prior AEDs, ambulatory state, menopausal state, concomitant medications potentially associated with reduced bone mineralization, and comorbid illness potentially associated with reduced bone mineralization. Associations between reduced bone mineralization and variables were tested for significance using Fisher's exact test, Student's t-test, and Wilcoxon rank sum test. Results: The average age of the entire study population was 43.5 (±12.5) years. Fifty-five percent of patients had T-score less than or equal to -1, the WHO criterion for osteopenia in postmenopausal women. The prevalence of Z-scores less than -2.0 was 15{\%}, which is more than sixfold greater than expected. The markers for decreased BMD included older age or menopause in women, longer duration of therapy, and a history of use of phenytoin or phenobarbital. Assisted ambulation was also associated with low BMD. Conclusion: Our results indicate that reduced bone mineralization is prevalent and a significant health concern in an urban population of patients with epilepsy. Because of the high prevalence of reduced bone mineralization reported in numerous studies including this study, routinely screening for reduced bone mineralization is warranted in patients receiving anticonvulsant therapy.",
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