Objective:

To evaluate the bone mineral density (BMD) in men with epilepsy and correlate it with clinical data such as age, type of seizure, and anti-seizure drugs (ASD) use.

Background:

Little is known about the multifactorial underpinning mechanisms associated with the risk of developing a metabolic bone disease in men with epilepsy.

Design/Methods:

We evaluated 505 men previously diagnosed with epilepsy and exposed (minimum of 5 years) to previous or current enzyme-inducing antiseizure drugs (phenobarbital, phenytoin, carbamazepine) and valproic acid), followed at UNICAMP-Brazil in 2021. We identified 178 patients with BMD analysis (median age range, 50.5 (21-86 years). Individuals were split into two groups (young group [90 individuals, 21-49 years],; older group [89 subjects, 50-86 years],). The BMD test provided t-score indexes from the femoral neck, whole femur, and lumbar spine. Osteopenia and osteoporosis were defined with a t-score of -1.0 and lower than -2.5, respectively. We analyzed clinical data with analyzed SPSS22. We performed chi-square tests for categorical variables.

Results:

BMD was reduced in 107/179 men (59.7%). Unfortunately, high-levels of bone disease were identified in both young and older patients (p=0.09): young-group [37/90 normal (41.1%), 40/90 osteopenia (44.4%), 13/90 osteoporosis (14.4%)]; older-group [35/89 normal (39.3%), 30/89 osteopenia (33.7%), 24/89 osteoporosis (26.9%)]. As expected, the osteoporosis group (20.6% of patients) was older than the osteopenia group (p=0.011). About 90% of patients with abnormal BMD had focal epilepsy. Unfortunately, 33/53 (62%) operated patients presented abnormal BMD.

Conclusions:

we observed an elevated frequency of bone disease (regardless of the young age and surgical treatment) in men with epilepsy exposed to ASD. Our results suggest that ASD exposure is associated with early BMD reduction. Therefore, BMD evaluation and selection of appropriate ASD for PWE may be necessary to reduce the risk of fractures and related comorbidities.