Abstracts

Rationale: Antiseizure medications (ASMs) can have an adverse effect on bone tissue, increasing the risk of fractures in patients with epilepsy. Although female patients are more prone to osteoporosis, the problem of bone metabolism disorders in young men with epilepsy remains relevant. In young men, bone tissue is actively forming, and the negative effects of ASMs may be more pronounced, especially with long-term use.
The purpose of this study was to investigate mineral metabolism and bone mineral density in young male patients suffering from epilepsy.

Methods: The study involved 45 men aged 18 to 44 (Me = 31 (25–43)). Participants were divided into 3 groups depending on the drug used. Group 1 included 15 men who took first-generation ASMs (phenobarbital). Group 2 included 14 people who took second-generation ASMs (carbamazepine). Group 3 included 16 young men who took third-generation ASMs (levetiracetam). The median duration of ASMs use was 7 (3–14) years, with a minimum duration of 1 year and a maximum duration of 25 years. The control group consisted of 15 healthy volunteers who did not take ASMs or other drugs that could affect bone mineral density and who were comparable in terms of gender and age (Me = 30 (22–41)). 
All participants in the study gave their voluntary consent to participate. All participants underwent a clinical examination with an assessment of their somatic, neurological, and mental status, a detailed collection of their pharmacological history, and an analysis of laboratory indicators of trace elements and hormones related to mineral metabolism, including 25-hydroxycalciferol (vitamin D), calcium, phosphorus, and parathyroid hormone.

Results: A comparative analysis of laboratory parameters of trace elements and hormones associated with bone metabolism revealed statistically significant differences in the mean values of calcium, phosphorus, parathyroid hormone, and vitamin D. Vitamin D levels in patients in groups 1 and 2 were lower than in group 3 (p (U) = 0.05). However, in all three groups, vitamin D levels were insufficient compared to the control group (p (U) = 0.01). The Ca/P level was significantly lower in group 2 compared to groups 1 and 3 (p (U) = 0.03). However, compared to the control group, the Ca/P level was significantly lower (p (U) = 0.01). In groups 1 and 2, an increase in parathyroid hormone levels was noted in relation to group 3 and the control group (p (U) = 0.01), which causes a disruption in the processes of bone remodeling and mineralization, a decrease in bone density, and changes in bone architecture, and therefore increases the risk of fractures.

Conclusions: Thus, the data obtained indicate that the problem of osteoporosis and osteopenia is relevant not only for women but also for young men suffering from epilepsy. Therefore, it is necessary to identify mineral metabolism disorders and bone tissue conditions in a timely manner, which requires subsequent  adjustments to treatment and lifestyle. The issue of the impact of ASMs on bone mineral density in young men with epilepsy requires further in-depth study.

Funding: This study was not funded by any pharmaceutical company.