Effect of Antiepileptic Therapy on Serum 25(OH)D3 and 24,25(OH)2D3 Levels in Epileptic Children
Background: Vitamin D deficiency is not only associated with the adverse effects of chronic treatment with antiepileptic drugs (AEDs) but also with epilepsy. Although emerging evidence suggests that AEDs can accelerate the vitamin D catabolism, resulting in suboptimal vitamin D status, there are a limited number of studies examining the vitamin D status in epileptic patients, especially in first episode or AEDs naive children. Methods: Determined with high performance liquid chromatography tandem mass spectrometry, circulating 25(OH)D<sub>3</sub> and 24,25(OH)<sub>2</sub>D<sub>3</sub> levels, and 24,25(OH)<sub>2</sub>D<sub>3</sub>:25(OH)D<sub>3</sub> ratio were compared between AEDs treated epileptic (n 363) and control (n 159) children. To further figure out whether the patients were in a vitamin D deficient prone state even before treatment, epileptic children before their initiation of treatment (n 51) were enrolled into a follow up study. Results: A significant decrease of 25(OH)D<sub>3</sub> and 24,25(OH)<sub>2</sub>D<sub>3</sub> levels, but a significant increase of 24,25(OH)<sub>2</sub>D<sub>3</sub>:25(OH)D<sub>3</sub> ratio was observed in epileptic children, compared with controls. Baseline 25(OH)D<sub>3</sub> 24,25(OH)<sub>2</sub>D<sub>3</sub> and 24,25(OH)<sub>2</sub>D<sub>3</sub>:25(OH)D<sub>3</sub> ratio in the follow up group were similar to those in controls, but significantly changed with 2 months of AED therapy. Conclusions: Disturbed vitamin D levels were possibly the consequence of AED therapy, rather than the contributing factor of epilepsy. Collectively, circulating vitamin D levels should be monitored and corrected in AEDs treated epileptic children.
Annals of Nutrition and Metabolism