成年人癫痫与骨代谢的关系研究
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摘要
目的探讨成年人癫痫与骨代谢的关系。方法选取2015年3月—2017年3月东莞市第三人民医院神经内科收治的癫痫患者30例,为病例组;另选取同期在本院接受体检的健康成年人30例,为对照组。检测并比较两组的血清碱性磷酸酶(ALP)、骨钙素(OC)、钙离子、磷离子、镁离子、25-羟基维生素D[25-(OH)D]、甲状旁腺激素(PTH)水平。结果病例组血清ALP、OC、钙离子、镁离子水平低于对照组,差异有统计学意义(P<0.05);两组血清磷离子、25-(OH)D、PTH水平比较,差异无统计学意义(P>0.05)。结论成年癫痫患者存在骨代谢异常情况,临床中应针对癫痫患者的骨代谢异常情况采取防治措施。
Objective To investigate the correlation between epilepsy and bone metabolism in adults. Methods The enrolled participants were 30 adults with epilepsy( case group) receiving inpatient treatment in Department of Neurology,Dongguan Third People's Hospital,and other 30 healthy adults( control group) undergoing physical examination in this hospital from March 2015 to March 2017. The levels of serum alkaline phosphatase( ALP),osteocalcin( OC),calcium,phosphorus,magnesium,25-hydroxyvitamin D [25-( OH) D]and parathyroid hormone( PTH) were measured and compared between the two groups. Results The case group had much lower levels of serum ALP,OC,calcium and magnesium than the control group( P < 0. 05). Two groups presented no significant differences in the levels of serum phosphorus,25-( OH) D and PTH( P > 0. 05). Conclusion Abnormal bone metabolism could be found in adults with epilepsy. Therefore,targeted measures should be taken in order to prevent and treat abnormal bone metabolism in these population.
Objective To investigate the correlation between epilepsy and bone metabolism in adults. Methods The enrolled participants were 30 adults with epilepsy( case group) receiving inpatient treatment in Department of Neurology,Dongguan Third People's Hospital,and other 30 healthy adults( control group) undergoing physical examination in this hospital from March 2015 to March 2017. The levels of serum alkaline phosphatase( ALP),osteocalcin( OC),calcium,phosphorus,magnesium,25-hydroxyvitamin D [25-( OH) D]and parathyroid hormone( PTH) were measured and compared between the two groups. Results The case group had much lower levels of serum ALP,OC,calcium and magnesium than the control group( P < 0. 05). Two groups presented no significant differences in the levels of serum phosphorus,25-( OH) D and PTH( P > 0. 05). Conclusion Abnormal bone metabolism could be found in adults with epilepsy. Therefore,targeted measures should be taken in order to prevent and treat abnormal bone metabolism in these population.
引文
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[2]王世琳,徐克雷.癫痫研究新进展[J].实用心脑肺血管病杂志,2015,23(1):1-3.DOI:10.3969/j.issn.1008-5971.2015.01.05.WANG S L,XU K L.Recent advances in epilepsy research[J].Practical Journal of Cardiac Cerebral Pneumal and Vascular Disease,2015,23(1):1-3.DOI:10.3969/j.issn.1008-5971.2015.01.05.
[3]CARABALLO R H,SOLOGUESTUA A,GRAANA N,et al.Idiopathic occipital and absence epilepsies appearing in the same children[J].Pediatr Neurol,2004,30(1):24-28.DOI:10.1016/S0887-8994(03)00409-0.
[4]MANGANO S,FONTANA A,SPITALERI C,et al.Benign myoclonic epilepsy in infancy followed by childhood absence epilepsy[J].Seizure,2011,20(9):727-730.DOI:10.1016/j.seizure.2011.06.008.
[5]GKAMPETA A,PAVLOU E.Emerging genetic influences in benign epilepsies with centro-temporal spikes-BECTS[J].Epilepsy Res,2012,101(3):197-201.DOI:10.1016/j.eplepsyres.2012.06.011.
[6]YEAGER M,ORR N,HAYES R B,et al.Genome-wide association study of prostate cancer identifies a second risk locus at8q24[J].Nat Genet,2007,25(Suppl 5):S645-649.
[7]THORGEIRSSON T E,GELLER F,SULEM P,et al.A variant associated with nicotine dependence,lung cancer and peripheral arterial disease[J].Nature,2008,452(7187):638-642.DOI:10.1038/nature06846.
[8]SPECCHIO N,TRIVISANO M,VIGEVANO F,et al.Idiopathic West Syndrome followed by childhood absence epilepsy[J].Seizure,2010,19(9):597-601.DOI:10.1016/j.seizure.2010.07.016.
[9]BEERHORST K,TAN I Y,DE KROM M,et al.Antiepileptic drugs and high prevalence of low bone mineral density in a group of inpatients with chronic epilepsy[J].Acta Neurologica Scandinavica,2013,128(4):273-280.DOI:10.1111/ane.12118.
[10]ERBAYAT ALTAY E,SERDAROGLU A,TUMER L,et al.Evaluation of bone mineral metabolism in children receiving carbamazepine and valproic acid[J].JPEM,2000,13(7):933-939.DOI:10.1515/JPEM.2000.13.7.933.
[11]MENON B,HARINARAYAN C V.The effect of anti epileptic drug therapy on serum 25-hydroxyvitamin D and parameters of calcium and bone metabolism——a longitudinal study[J].Seizure,2010,19(3):153-158.DOI:10.1016/j.seizure.2010.01.006.
[12]PITUKCHEEWANONT P,AUSTIN J,CHEN P,et al.Bone health in children and adolescents:risk factors for low bone density[J].Pediatric Endocrinology Reviews,2013,10(3):318-335.
[13]CHAHINE L M,MIKATI M A.Benign pediatric localization-related epilepsies[J].Epileptic Disord,2006,8(4):243-258.
[14]ARTS W F,GEERTS A T.When to start drug treatment for childhood epilepsy:the clinical-epidemiological evidence[J].Eur J Paediatr Neurol,2009,13(2):93-101.DOI:10.1016/j.ejpn.2008.02.010.
[15]BELCASTRO V,GIORDANO L,PRUNA D,et al.Do pure absence seizures occur in myoclonic epilepsy of infancy?A case series[J].Seizure,2015,(24):8-11.DOI:10.1016/j.seiz ure.2014.11.002.
[16]BONINI F,EGEO G,FATTOUCH J,et al.Natural evolution from idiopathic photosensitive occipital lobe epilepsy to idiopathic generalized epilepsy in an untreated young patient[J].Brain Dev,2014,36(4):346-350.DOI:10.1016/j.braindev.2013.06.002.
[17]FORTUNATO D.Proposal for revised classification of epilepsies and epileptic syndromes[J].Epilepsia,1989,30(4):389-399.
[18]KARAGUZEL G,AKCURIN S,OZDEM S,et al.Bone mineral density and alterations of bone metabolism in children and adolescents with type 1 diabetes mellitus[J].J Pediatr Endocrinol Metab,2006,19(6):805-814.DOI:10.1515/JPEM.2006.19.6.805.
[19]BURNHAM J M.Inflammatory diseases and bone health in children[J].Current Opinion in Rheumatology,2012,24(5):548-553.DOI:10.1097/BOR.0b013e328356b0c2.
[20]MASSA R,DE S A,CARCANGIU R,et al.EEG criteria predictive of complicated evolution in idiopathic rolandic epilepsy[J].Neurology,2001,57(6):1071-1079.DOI:10.1212/WNL.57.6.1071.
[21]STORES G.Sleep disturbance in childhood epilepsy:clinical implications,assessment and treatment[J].Arch Dis Child,2013,98(7):548-551.DOI:10.1136/archdischild-2013-303825.
[22]TANG S S,CLARKE T,OWENS J,et al.Sleep behavior disturbances in rolandic epilepsy[J].J Child Neurol,2011,26(2):239-243.DOI:10.1177/0883073810381925.
[23]SAMAITIENE R,NORKUNIENE J,TUMIENE B,et al.Sleep and behavioral problems in rolandic epilepsy[J].Pediatr Neurol,2013,48(2):115-122.DOI:10.1016/j.pediatrneurol.2012.10.012.
[24]LUYSTER S,STROLLO P J,ZEE P C,et al.Sleep:ahealthimperative[J].Sleep,2012,35(6):727-734.
[25]SWANSON C M,SHEA S A,STONE K L,et al.Obstructive sleep apnea and metabolic bone disease:insights into the relationship between bone and sleep[J].J Bone Miner Res,2015,30(2):199-211.DOI:10.1002/jbmr.2446.
[26]LEDGER G A,BURRITT M F,KAO P C,et al.Role of parathyroid hormone in mediating nocturnal and age-related increases in bone resorption[J].J Clin Endocrinol Metab,1995,80(11):3304-3310.DOI:10.1210/jc.80.11.3304.
[27]HESHMATI H M,RIGGS B L,BURRITT M F,et al.Effects of thecir cadian variation in serum cortisol on markers of bone turnover and calcium homeostasis in normal postmenopausal women[J].J Clin Endocrinol Metab,1998,83(3):751-756.DOI:10.1210/jcem.83.3.4627.
[28]SARTORIO A,CONTI A,FERRERO S,et al.Evaluation of markers of bone and collagen turnover in patients with active and preclinical Cushing's syndrome and in patients with adrenal incidentaloma[J].Eur J Endocrinol,1998,138(2):146-152.